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Liu Shi Xiang
Neurology
About me
Associate Chief Physician, undergraduate education, has studied Neurology at West China Hospital of Sichuan University, member of the 8th Committee on Dementia and Cognitive Impairment of the Neurology Branch of Jiangxi Medical Association
Proficient in diseases
The diagnosis and treatment of neurological and geriatric diseases, especially in the field of cognitive dysfunction in the nervous system, have accumulated rich clinical experience.
Voices
What causes epilepsy in children?
The causes of epilepsy in children primarily include congenital factors and acquired factors. Congenital factors are mainly due to premature birth, difficult labor, umbilical cord around the neck, neonatal intracranial hemorrhage, drug factors, etc. Acquired factors mainly include brain trauma, central nervous system infections, cerebrovascular disease, intracranial tumors, and other causes. Therefore, when a child exhibits symptoms of epilepsy, it is necessary to promptly visit the department of neurology to conduct relevant examinations to determine the cause. The examination methods mainly include CT, MRI, EEG, cerebrospinal fluid analysis, etc. After identifying the cause, symptomatic treatment methods should be adopted to control the symptoms of epilepsy episodes. In clinical practice, controlling epilepsy is mainly achieved through drug treatment, with commonly used medications including carbamazepine, sodium valproate, gabapentin, etc. For some patients with refractory epilepsy, surgical treatments may also be used to control symptoms.
What are the prodromal symptoms of epilepsy?
The prodromal symptoms of epilepsy are diverse, generally involving movement, sensation, and mood. Some patients may experience transient numbness or weakness on one side of their body prior to a seizure, while others may have hallucinations and atypical mental or behavioral changes. However, these symptoms are not necessarily indicative of an impending seizure. When such symptoms occur, it is crucial to consider the possibility of an epilepsy attack, and patients should promptly visit the neurology department of a hospital for a thorough examination, including an electroencephalogram (EEG). If the EEG shows significant abnormalities such as spikes, sharp waves, slow waves, spike-and-wave complexes, or sharp-and-slow wave complexes, it suggests the potential for an epileptic seizure. In such cases, preventive medication should be administered promptly, such as carbamazepine or sodium valproate.
Early symptoms of Parkinson's disease
The early symptoms of Parkinson's disease primarily include weakness of limbs on one side, resting tremors, and bradykinesia, among others. As the disease progresses, patients will display typical Parkinson's symptoms, including a shuffling gait, reduced facial expressions, decreased sense of smell, orthostatic hypotension, anxiety and depression, cognitive decline, constipation, frequent urination, etc. Therefore, when these symptoms appear, the possibility of Parkinson's disease should be considered. Patients need to promptly visit the neurology department of a hospital for complete testing such as routine blood tests, urinalysis, MRI of the skull, and if necessary, cerebrospinal fluid analysis through lumbar puncture to confirm the diagnosis. Once diagnosed, treatment with anti-Parkinson's medication should be started as soon as possible. Commonly used medications include Levodopa, dopamine receptor agonists, monoamine oxidase inhibitors, Vitamin B6, and more.
What can severe epilepsy lead to?
Severe epilepsy can cause many complications, such as cerebral edema, brain herniation, upper gastrointestinal bleeding, etc. Therefore, severe epilepsy can seriously threaten the patient's life. If the patient's epilepsy is not controlled in time, it can easily lead to a state of status epilepticus. Status epilepticus is a very dangerous central nervous system disease. Patients may experience sudden respiratory and circulatory arrest and uncontrollable massive gastrointestinal bleeding. For severe epilepsy patients, it is necessary to promptly administer medications such as diazepam and sodium valproate to terminate the seizures. If status epilepticus occurs, the patient needs to be urgently sent to the ICU for observation and treatment, and effective interventions for various complications must be provided. For example, in the case of cerebral edema caused by epilepsy, medications such as mannitol and glycerol fructose are needed to dehydrate and reduce intracranial pressure. If epilepsy causes acute upper gastrointestinal bleeding, treatments to suppress acid, stop bleeding, and maintain blood pressure are required.
What should I do about insomnia and frequent dreams? What are the methods to treat insomnia and frequent dreams?
The methods for treating insomnia and frequent dreaming mainly include the following: Firstly, patients should try adjusting their lifestyle and diet to treat insomnia and frequent dreaming. For instance, patients can drink a small amount of milk, honey water, or herbal tea before bed. They can also listen to some slow rhythm light music before sleeping, which helps to relax nerves and muscles, promoting sleep. Patients can also soak their feet in hot water and massage their temples before bed. These physical treatments can also help improve sleep. Most patients generally see an improvement in their insomnia and dreaming after adjusting their diet and lifestyle. If these adjustments still leave the patient suffering from insomnia and frequent dreaming, they can use a small amount of sedative and sleep-inducing medications to improve sleep. Common drugs include zopiclone, eszopiclone, and zolpidem. Furthermore, psychotherapy can also help to some extent in improving the situation of insomnia and frequent dreaming.
Can mild epilepsy be treated?
Mild epilepsy is treatable. If the patient is experiencing their first seizure or if the seizures are infrequent, it’s generally appropriate to observe clinically and not rush to use anti-epileptic drugs. Such patients typically experience only very mild neurological symptoms during a seizure, such as limb weakness, numbness, or facial droop. However, if the patient's seizures occur frequently, it is necessary to control the symptoms with anti-epileptic medications, which often include drugs such as levetiracetam, gabapentin, sodium valproate, and lamotrigine. Patients with mild epilepsy should also work on strengthening their exercise routines, maintaining a calm mind, and getting sufficient sleep to help prevent seizures to a certain extent. If the patient's condition worsens or becomes intractable epilepsy, surgical treatment methods may be considered to control the symptoms.
How to relieve neuralgia
Neuropathic pain can be relieved through treatments such as medication, physical therapy, and surgery. Medications used primarily include antiepileptic drugs and non-steroidal anti-inflammatory analgesics, such as carbamazepine, oxcarbazepine, gabapentin, pregabalin, sodium diclofenac, ibuprofen, and celecoxib. Physical therapy mainly involves localized heat application, massage, manipulation, and acupuncture. Surgical treatment is mainly suitable for patients who do not respond well to medication and physical therapy. Currently, the surgical approach mainly involves minimally invasive surgery to relieve nerve compression, thereby alleviating the symptoms of neuropathic pain. Beyond symptomatic treatment, it is important to identify and treat the underlying cause of the neuropathic pain, such as tumors, trauma, diabetes, etc. These causes can lead to neuropathic symptoms, so it is crucial to actively control these underlying diseases to potentially relieve neuropathic pain at its root. (Medications should be used under the guidance of a doctor.)
Does amyotrophic lateral sclerosis skip generations in inheritance?
Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease, may possibly be inherited through generations. The exact cause of ALS is still not very clear, but there is a certain genetic predisposition. Patients with ALS gradually experience symptoms such as limb weakness and muscle atrophy. As the disease progresses, it will eventually lead to difficulties in speech, swallowing disorders, and breathing difficulties, resulting in the patient losing the ability to take care of themselves independently and requiring full-time care from others. Currently, ALS is an incurable disease. The treatment available to patients includes medications to nourish the nerves and systematic rehabilitation training. However, this treatment can only improve the symptoms to a certain extent and enhance the quality of life but cannot stop the progression of the disease. Eventually, the patient will be confined to bed.
What are the symptoms of meningitis?
The symptoms of meningitis mainly include headache, nausea, vomiting, fever, epileptic seizures, and mental abnormalities. Severe cases may also present with disturbances in consciousness and signs of meningeal irritation, among others. Therefore, when a patient exhibits the above symptoms, the possibility of meningitis should be considered. The patient needs to promptly visit the neurology department to undergo a cranial CT scan, cranial MRI, electroencephalogram, and lumbar puncture for cerebrospinal fluid analysis to confirm the diagnosis. Treatment should be based on the test results, selecting appropriate anti-infective medications. For example, patients with viral meningitis should be treated with antiviral medications such as acyclovir and ganciclovir; patients with bacterial meningitis should be treated with potent antibacterial drugs, including carbapenems and quinolones; patients with tuberculous meningitis should receive antitubercular drugs, such as isoniazid, rifampin, and ethambutol. In addition, patients may also need symptomatic treatments such as dehydration to reduce intracranial pressure, fever reduction, and control of psychiatric symptoms. (Medication should be used under the guidance of a doctor.)
How to treat insomnia caused by excessive brain excitement?
If the issue is short-term brain excitement and insomnia, treatment should involve interventions in lifestyle and adjustments in sleeping habits. Firstly, the patient needs to establish a regular routine, going to bed and getting up at fixed times. Secondly, before bedtime, it is advisable to avoid consuming stimulant drinks like strong tea, coffee, alcohol, and also to refrain from engaging in excessive physical activities within two hours before sleep. If the condition of brain excitement and insomnia persists for an extended period, it might be necessary to use sedative-hypnotic medications to alleviate symptoms. Commonly used sedative-hypnotic drugs in clinical settings include zopiclone, eszopiclone, estazolam, melatonin, among others. Through these treatments, symptoms of insomnia in most patients can be improved. If the symptoms continue unabated, it may be necessary to consider whether the patient might also be suffering from anxiety or depressive disorders affecting their sleep. In such cases, an evaluation with the Hamilton Anxiety and Depression Scale can be conducted to determine. If such conditions are present, treatment with anti-anxiety and anti-depression medications, such as citalopram, may be administered.