Symptoms

It is common knowledge that headaches are an extremely common part of the human experience. According to the World Health Organisation, about 50 percent of the global population experiences at least 1 headache per year [1]. 

There are many different types of headaches. In fact, the International Classification of Headache Disorders (ICHD) defines more than 150 different types of headaches. Pain from headaches may range from mild to severe, and can be caused by a variety of reasons. 

Headaches can be sorted into 2 broad categories: 

Primary headaches.  A primary headache is a result of overactivity or problems with the pain-sensitive structures in your head. It is not caused by an underlying disease or medical condition. As such, primary headaches can usually go away on their own with rest and pain-relief medications if necessary. Some common types of primary headaches include: 

  • Tension headaches. A tension headache feels like a constant, dull ache on both sides of your head. You may also experience a sensation of tightness or pressure on your scalp, forehead, back of your head and shoulders. Tension headaches are usually caused by stress, can can last for anywhere between 30 minutes to a few days. 
  • Migraines. A migraine feels like a throbbing pain, usually moderate to severe and on one side of your head. You may also experience nausea and sensitivity to light and sound. Migraines can last for anywhere between 4 to 72 hours [2].  
  • Cluster headaches. A cluster headache feels like a sharp, burning pain, usually on one side of your head behind your eyes. Cluster headaches often occur suddenly, and pain can be very severe. Cluster headaches can last for anywhere between 15 minutes to 3 hours. 

Secondary headaches. Unlike primary headaches, secondary headaches are symptoms of other underlying medical conditions. Some signs that indicate that you may be experiencing a secondary headache includes: 

  • If your headache wakes you up from sleep
  • If it is the worst headache you have experienced in your entire life
  • If your headache causes you to faint or experience a seizure
  • If you feel weak on one side of your body or have trouble walking 

The most common type of secondary headache is a thunderclap headache. Thunderclap headaches occur suddenly and out of the blue, just like a clap of thunder. Pain associated with thunderclap headaches is typically very severe, often peaking at the 30 second mark. Thunderclap headaches usually last for a few hours but less severe headaches may persist afterwards for weeks [3]. 

Some underlying medical conditions which may cause secondary headaches include: 

  • Aneurysms. An aneurysm is a bulging artery that occurs where the arterial wall is weak. The enlarged artery inflates in the weak area, and the walls can continue to weaken over time, increasing the risk of a rupture. An aneurysm is often compared to the inflation of a balloon.
  • Vasculitis. Vasculitis is a condition where there is inflammation of the blood vessels. It can affect any type of blood vessel and usually occurs because the body’s immune system mistakenly attacks the blood vessels. 
  • Neuro-infections. Neuroinfections occur when pathogens such as bacteria, viruses, parasites, fungi or prion invade the nervous system through the bloodstream or peripheral nerves. 
  • Brain tumours. Brain tumours are masses of abnormal cells that grow within the skull.
  • Intracranial hypotension. Intracranial hypotension is a condition whereby there is abnormally low pressure or volume within the brain cavity. 
  • Intracranial hypertension. Intracranial hypertension refers to a build-up of pressure around the brain. 

If you are currently experiencing signs of a secondary headache, visit a doctor and seek medical attention immediately. 

References
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  1. Headache disorders. (2016, April 8). Www.Who.Int; World Health Organization. https://www.who.int/news-room/fact-sheets/detail/headache-disorders#:~:text=Globally%2C%20it%20has%20been%20estimated 
  2. Chawla, J. (2019, November 9). Migraine Headache: Practice Essentials, Background, Pathophysiology. Medscape.com; Medscape. https://emedicine.medscape.com/article/1142556-overview 
  3. https://doi.org/10.1177/2049463712459691 
  4. Dodick, D. W. (2002). Thunderclap headache. Journal of Neurology, Neurosurgery & Psychiatry, 72(1), 6–11. https://doi.org/10.1136/jnnp.72.1.6 
  5. Ahmed, F. (2012). Headache disorders: differentiating and managing the common subtypes. British Journal of Pain, 6(3), 124–132.
  6. Rizzoli, P., & Mullally, W. J. (2018). Headache. The American Journal of Medicine, 131(1), 17–24. https://doi.org/10.1016/j.amjmed.2017.09.005

If you feel dizzy, you might describe it as feeling woozy, lightheaded, faint or unsteady. Sometimes, you might feel vertigo, which is when your surroundings feel like they’re moving or spinning.

There are different kinds of dizziness you might feel, such as:

  • Feeling woozy and faint
  • Feeling giddy; like your surroundings are moving/spinning (vertigo)
  • Feeling like you are floating
  • Having issues balancing and coordinating

Often, dizziness will go away on its own, with plenty of rest and fluids. However, if the dizziness persists, it could be an indication of an underlying condition, such as a Transient Ischaemic Attack (TIA), stroke, neuroinfection or brain tumour. This could also be the case if you are experiencing accompanying symptoms, double or blurred vision or headaches.

A stroke or mini-stroke (TIA) is likely to be the cause of your dizziness if you are older, or have known stroke risk factors like smoking, high blood pressure, diabetes or a family history of stroke or heart attacks. If you think these conditions might be the cause of your dizziness, call your doctor right away to be assessed.

Neuroinfections could also be the root cause of your dizziness. These occur when pathogens such as bacteria or viruses invade the nervous system through the bloodstream or peripheral nerves. Neuroinfections may result in significant long-term cognitive disabilities such as memory loss, physical disabilities such as blindness, speech or hearing loss, permanent nerve damage, or even death due to severe inflammation in the brain. Thus it is essential to seek urgent medical attention if you suspect that you may have a neuroinfection.

Brain tumours could also cause dizziness, if they are developing in the frontal lobe, brain stem or cerebellum.

Inner ear imbalance could also cause dizziness and symptomatic medication can give major relief here.

References
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  1. Ciattei, J. (2017, July 18). If You Are Experiencing Dizziness | Department of Neurology and Neurosurgery. Hopkinsmedicine.org. https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/vestibular/dizzy-now.html
  2. Dizziness. (2017, October 18). NHS. https://www.nhs.uk/conditions/dizziness/
  3. Nausea & dizziness | The Brain Tumour Charity. (n.d.). The Brain Tumour Charity. Retrieved December 16, 2020, from https://www.thebraintumourcharity.org/brain-tumour-signs-symptoms/adult-brain-tumour-symptoms/nausea-dizziness-brain-tumour/
  4. Symptoms of brain tumours | Cancer Research UK. (2019). Cancerresearchuk.org. https://www.cancerresearchuk.org/about-cancer/brain-tumours/symptoms

What is a seizure? 

A seizure occurs when there is a burst of uncontrolled electrical activity within the brain.

There are different types of seizures. Seizures can be sorted two broad categories: 

Focal Seizures. Focal seizures are seizures which have a specific focus or area where the seizure begins. In these types of seizures, seizure activity is limited to one part of the brain. When the seizure begins, seizure activity may stay localised in that one area or may spread to other areas and hemispheres of the brain. 

The most common forms of focal seizures are:

  • Focal seizures with retained awareness
    • It does not impair awareness or consciousness 
    • Person experiencing the seizure will be able to remember it after 
  • Focal seizure with loss of awareness
    • Awareness and consciousness is impaired 
    • Person may be unable to respond 

Generalized Seizures. Generalised seizures take place when abnormal activity (seizure activity) takes place in both hemispheres of the brain simultaneously. Generalized seizures may result in a loss of consciousness, muscle spasms, and body convulsions.

What is it like to have a seizure? 

Seizures present differently for different people. However, here are some common signs that may indicate that someone is having a seizure: 

  • Shock-like jerks in one or both arms
  • Puckering or smacking of lips
  • Jerking of jaw 
  • Rhythmic jerking of legs 

Right before a seizure, you may experience an odd, out of body experience. You may also become overwhelmed with unusual smells or taste. 

What causes seizures? 

Some underlying medical conditions which may cause seizures include: 

  • Epilepsy. Epilepsy is a central nervous system disorder that causes individuals to have  recurrent, unprovoked seizures. 
  • Neuro-infections. Neuroinfections occur when pathogens such as bacteria, viruses, parasites, fungi or prion invade the nervous system through the bloodstream or peripheral nerves. 
  • Stroke. A stroke occurs when blood flow to the brain is interrupted, either because the arteries leading to your brain are blocked or burst.
  • Brain tumours. Brain tumours are masses of abnormal cells that grow within the skull.

Seek emergency medical attention immediately if: 

  • You experience a seizure for the first time
  • Your seizure lasts for more than 5 minutes 
  • You remained unconscious even after the seizure ended 

Anti-epileptic medications are the mainstay of treatment for seizures. Duration and type of medication,usually varies and decided by the neurologist in charge.

References
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  1. Epilepsy in Children. (2019, April 19). Www.Healthhub.Sg; Health Hub. https://www.healthhub.sg/a-z/diseases-and-conditions/706/managing-epilepsy-in-children#:~:text=Epilepsy%20is%20a%20common%20condition 
  2. Huff, J. S., & Murr, N. (2020). Seizure. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430765/
  3. Stafstrom, C. E., & Carmant, L. (2015). Seizures and Epilepsy: An Overview for Neuroscientists. Cold Spring Harbor Perspectives in Medicine, 5(6), a022426–a022426. https://doi.org/10.1101/cshperspect.a022426

As we age, it is normal for us to have some memory loss. However, there are times where memory loss may actually be an indication of a more sinister, underlying medical condition. In these cases, it is important to visit a doctor and seek medical advice. 

So, how can you tell between age-related memory loss and memory loss that is caused by an underlying medical condition? The answer is that the former is often mild, occurs infrequently and will have little to no impact on your day-to-day life. On the other hand, memory loss caused by an underlying medical condition is more persistent, disabling and will affect your ability to carry out daily activities (see Table 1). Furthermore, medical conditions which give rise to memory loss often present with other symptoms as well, such as: 

  • Mood changes
  • Confusion and disorientation
  • Having poor judgement 
  • Blurred or double vision
  • Slurred speech
  • Muscle weakness
  • Fevers
  • Seizures 
  • Nausea
Age-related memory problems Memory problems resulting from underlying medical conditions 
Mild  Disabling 
Occurs infrequently or as 

small memory lapses 

(eg. taking a while to recall names) 

Persistent and more severe 

(eg. forgetting your home address) 

Little to no impact on daily life Affects ability to carry out daily activities 
No other symptoms Accompanied by other abnormal symptoms 

Table 1. The above table depicts the main factors that distinguish age-related memory problems from memory problems linked to more serious, underlying medical conditions. 

Some medical conditions which may give rise to memory problems include: 

Transient global amnesia (TGA). TGA refers to a sudden episode of memory loss. An episode of TGA is temporary and typically lasts only for a few hours. When experiencing an episode of TGA, you will have normal cognition, retain your personal identity and preserve your ability to carry out complex tasks such as driving. However, you will not be able to formulate or recall any memories. 

Dementia. Dementia is a generic term used to describe chronic or progressive memory loss and deterioration in thinking, language, problem-solving and ability to carry out everyday tasks. 

Stroke. A stroke occurs when blood flow to the brain is interrupted, either because the arteries leading to your brain are blocked or burst. As a result, oxygen supply to the brain is cut off, causing brain damage as cells in part of your brain die. When this happens, bodily functions controlled by damaged parts of your brain are lost. 

Brain tumours. Brain tumours are masses of abnormal cells that grow within the skull. 

Neuroinfections. Neuroinfections occur when pathogens such as bacteria, viruses, parasites, fungi or prion invade the nervous system through the bloodstream or peripheral nerves. The two most common neuroinfections are meningitis and encephalitis. 

If you are currently experiencing memory problems that are interfering with your daily life, consult a doctor and seek medical attention as soon as possible. 

References
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https://www.facebook.com/NIHAging. (2018). Do Memory Problems Always Mean Alzheimer’s Disease? National Institute on Aging. https://www.nia.nih.gov/health/do-memory-problems-always-mean-alzheimers-disease

Do you happen to be experiencing problems with your sleeping? 

Well, sleep-related difficulties and issues affect many people worldwide, but if they do not resolve on their own, they could be an indication of something more serious. They differ in severity and how they affect you. For example, sleep disorders can affect the duration of your sleep, the quality of your sleep and how you fall asleep. Sleep disorders are common conditions that prevent a person from getting a good sleep. As a result, they can cause daytime sleepiness and dysfunction.

Some sleep issues you might experience are:

  • Trouble falling asleep
  • Excessive daytime sleepiness (EDS)
  • Unusual breathing patterns when sleeping
  • Excessive snoring
  • Uncomfortable sensations in the limbs that prevent you from sleeping

Insomnia is a type of sleep disorder. If you have trouble falling asleep or staying asleep, this is an indication that you may be suffering from insomnia. With insomnia, you will most likely experience poor quality sleep, and in turn, feel extremely tired and lethargic the next day. You may notice that you are more irritable and unfocused throughout the day as well. 

Narcolepsy is a long-term condition whereby your brain’s ability to control your own sleep-wake cycles is reduced. This causes excessive daytime sleepiness (EDS) and sudden muscle weakness (cataplexy), and you might find yourself falling asleep at inappropriate times throughout the day, which is called a “sleep attack”. If you have narcolepsy, you also might have hallucinations and sleep paralysis when you do manage to fall asleep.

Sleep apnea is a common sleep disorder that occurs when you breathe abnormally or unusually while you are sleeping. It is characterized by extended pauses in breath and breathing lapses when you sleep. Sleep apnea can cause a lower quality sleep and affects your body’s supply of oxygen to be affected. If you have unusual breathing patterns or excessive snoring, you could have sleep apnea.

Restless leg syndrome (RLS) is a nervous system disease that causes uncomfortable sensations in your legs that make you want to move them, especially at night time. These sensations can range from prickling and itching to pulling or crawling. The urges to move can make it difficult to fall asleep and remain asleep at night. Due to the lack of sleep at night, people with RLS can be fatigued, sleepy, and irritable or grumpy during the day. 

Find out more about these key sleep disorders today, and if you suspect you might have any of them, speak to your doctor about conducting the proper diagnostic tests to be sure. Most sleep disorders can be treated effectively by doctors once properly diagnosed.

References
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  1. Parish, J. M. (2009). Sleep-Related Problems in Common Medical Conditions. Chest, 135(2), 563–572. https://doi.org/10.1378/chest.08-0934
  2. Sleep and Sleep Disorders. (2019). Centers for Disease Control and Prevention. https://www.cdc.gov/sleep/about_sleep/key_disorders.html
  3. Sleep Disorders | Cleveland Clinic. (2013). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/11429-common-sleep-disorders
  4. What are some common sleep problems? (2019, April 29). The Eunice Kennedy Shriver National Institute of Child Health and Human Development. https://www.nichd.nih.gov/health/topics/sleep/conditioninfo/sleep-problems

Also known as diplopia, double vision causes a person to see two or double of an object. There are two different types of double vision. 

The first type of double vision is monocular diplopia which is double vision in one eye. Even if the other eye is covered, double vision still continues. The double vision will continue despite looking in different directions. 

The other type of double vision is binocular diplopia which is double vision that occurs when eyes do not normally align with each other. The double vision will go away if one of the eyes are covered. There is double vision because the eyes are misaligned. 

Blurry vision results when your vision lacks sharpness and you cannot see a clear image. Sudden blurry vision may be caused by a single event. While blurry vision is very common, slow and progressive blurry vision can be a sign of more serious long-term medical conditions such as stroke, TIA, brain tumour, migraines, neuropathy, and MS. 

Like blurry vision, double vision can be caused by many different factors. However, double vision can also be a sign of more serious long-term conditions. 

Because stroke affects the brain, it can cause problems in eye movement and coordinations. As a result, both eyes might not work well together as a pair. People with stroke might experience a sudden painless change in vision leading to double vision (diplopia) or blurry vision. 

Blurry vision or double vision can also be a symptom of Transient Ischemic Attacks (TIA). TIA symptoms last anywhere from minutes to hours. Because they are relatively brief, some people might try to ignore these symptoms. Instead, it is useful to recognize if you have a stroke and to call 911 right away

In both cases of TIA and stroke, symptoms of double/blurry vision will be very likely accompanied by other symptoms such as weakening of limbs, balancing issues, slurred speech, drooping of half the face. 

Having changes in vision like what we’ve written about above could also be an indicator of a brain tumour and may be accompanied by other signs and symptoms like partial loss of vision. Prolonged vision changes (i.e. double vision) may be from a tumor in the temporal lobe, occipital lobe, or brain stem. 

Migraines are also another possible cause. A migraine is a moderate to severe headache that is felt as an intense throbbing pain on one side of the head. Some migraines are accompanied by auras. During the aura stage of a migraine one might experience changes in vision like blurry vision. Along with this, you may also experience sensitivity to light, sound, and touch, nausea, vomiting, and an intense throbbing pain on one side of the head. 

Neuropathy is a disorder which damages your nerves, affecting your ability to move and function normally. It often is accompanied by numbness, weakness, and pain in your hands and feet. 

Double vision may also occur due to multiple sclerosis (MS). Diplopia due to MS occurs when the nerves that control your eye movements are inflamed or damaged. Such damage of the nerve may also cause aching pain with eye movements and blurred vision. 

References
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Brain Tumor – Symptoms and Signs. (2012, June 25). Cancer.net. https://www.cancer.net/cancer-types/brain-tumor/symptoms-and-signs#:~:text=Difficulty%20swallowing%2C%20facial%20weakness%20or

Publishing, H. H. (2019, July). Double Vision (Diplopia). Harvard Health. https://www.health.harvard.edu/a_to_z/double-vision-diplopia-a-to-z#:~:text=Published%3A%20July%2C%202019

Abnormal or involuntary facial movements can come in different forms, and you might feel them regularly or only occasionally. These facial movements can indicate that you might have a certain neurological disorder, and they should not be ignored.

These are a few different kinds of abnormal facial movements:

  • Facial muscle twitching
  • Facial drooping
  • Facial muscle spasming
  • Facial muscle weakness
  • Facial muscle cramps
  • Loss of facial expression

Neurological Conditions Causing Abnormal Facial Movements

Epilepsy is a central nervous system disorder or also known as a neurological disorder. Essentially, it is a seizure disorder that can affect anyone at any age. It is characterized by abnormal activity in the brain, and as a result of this, affects any process that your brain coordinates. If you have epilepsy, your facial twitching could be part of a seizure, which has various other symptoms as well.

A stroke occurs when blood flow to the brain is interrupted. Oxygen supply to the brain is cut off, causing brain damage as cells in part of your brain die. When this happens, bodily functions controlled by damaged parts of your brain are lost. If you are having a stroke, you might realise one side of your face is drooping and you might have a lopsided smile. If this occurs along with other symptoms of a stroke, seek help immediately. A transient ischemic attack (TIA) is a minor stroke that lasts only for a few minutes. 

Dystonia is a neurological movement disorder, where your muscles involuntarily co-contract against each other or spasm abnormally. This might affect your facial muscles, making them spasm randomly and you will find it difficult to control your expressions. If dystonia affects your eyelids, you might blink rapidly and uncontrollably, making it more difficult for you to see clearly.

Motor neurone diseases (MND) are a group of neurodegenerative diseases that deteriorate the motor neurons, causing the nerves in your spine and brain to gradually lose function over time. These diseases can cause facial muscle weakness, cramps and twitching.

Multiple Sclerosis (MS) is a disease that impacts the brain and spinal cord, part of the central nervous system. If you have MS, you might have facial spasms and numbness and tingling in your facial muscles.

Parkinson’s disease (PD) is a long-term neurological degenerative disease that affects the central nervous system, that affects 1% of all people over 60 years old [1]. The most common MS symptoms affect the motor system, like tremors in the hands and fingers, however it can also cause the loss of facial expression.

Find out more about these neurological disorders today, and if you suspect you might have any of them because of any abnormal facial movements, speak to your doctor about it today.

References
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  1. Parkinson Disease: Practice Essentials, Background, Anatomy. (2019, February 2). Medscape.com. https://emedicine.medscape.com/article/1831191-overview
  2. Involuntary Movements: Types, Causes, and Examples, Stanford 25. (n.d.). Stanford Medicine 25. https://stanfordmedicine25.stanford.edu/the25/im.html

Problems or difficulties with speech can come in different forms, and you might experience them regularly or only occasionally. These speech difficulties can indicate that you might have a certain neurological disorder, and they should not be ignored.

Aphasia, dysarthria and apraxia of speech are neurological conditions affecting speech that can occur at the same time in a person.

Aphasia is a condition where an individual has difficulty communicating or understanding both verbal and written language. If you experience aphasia, you may also encounter troubles with reading and writing. Aphasia often results from damage to portions of the brain that are responsible for language. 

Dysarthria is a condition where the muscles used in speech are damaged, paralysed or weakened. People with dysarthria may be difficult to understand when they speak. They might only be able to communicate in short words or phrases, or even be completely unintelligible. 

People with dysarthria can experience the following symptoms:

  • Slurred, slow speech
  • Nasal sounding or breathy speech
  • Inability to control speech volume
  • Strained, hoarse voice
  • Monotone speech
  • Difficulty moving tongue and facial muscles

Apraxia of speech (AOS) is a condition in which you might have difficulty coordinating complex oral movements needed to enunciate words. If you have AOS, you will have trouble speaking correctly and consistently, although you might know exactly what you want to say.

Parkinson’s disease (PD) is a long-term neurological degenerative disease that affects the central nervous system, that affects 1% of all people over 60 years old [1]. The most common MS symptoms affect the motor system, like tremors in the hands and fingers, however as the disease develops, you might also start to experience more symptoms, like soft or monotone speech, inability to control speech volume and slurred speech.

References
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Parkinson Disease: Practice Essentials, Background, Anatomy. (2019, February 2). Medscape.com. https://emedicine.medscape.com/article/1831191-overview

Dysphagia is a medical term used to describe difficulty with swallowing. In certain cases, people with dysphagia may also experience pain when swallowing or find it impossible to swallow any food or liquid at all. 

Dysphagia occurs when there is a problem with the nerves or muscles involved in the swallowing process, and is often a result of other underlying medical conditions. 

Dysphagia may not seem that serious at first. However, dysphagia may cause you to choke on your food and put you off from eating or drinking, potentially leading to dehydration and malnutrition. 

Some medical conditions which may lead to dysphagia includes: 

Stroke. A stroke occurs when blood flow to the brain is interrupted, either because the arteries leading to your brain are blocked or burst. As a result, oxygen supply to the brain is cut off, causing brain damage as cells in part of your brain die. When this happens, bodily functions controlled by damaged parts of your brain are lost. 

Brain tumour. Brain tumours are masses of abnormal cells that grow within the skull. 

Motor neuron disease (MND). MND refers to a group of neurodegenerative diseases that deteriorate your body’s motor neurons, causing the nerves in your spine and brain to gradually lose function over time. Motor neurones are nerve cells that transmit electrical signals, also known as nerve impulses, from your spinal cord to your muscles, enabling you to move. 

Myopathy. Myopathy is a general term that refers to diseases that affect muscles in the body, Neuromuscular disorders weakness of neuromuscular junction.

If you think that you may be experiencing dysphagia, consult a doctor and seek medical attention as soon as possible. 

References
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  1. Dysphagia. (2015, August 18). NIDCD. https://www.nidcd.nih.gov/health/dysphagia#5
  2. NHS Choices. (2019). Overview – Dysphagia (swallowing problems). NHS’. https://www.nhs.uk/conditions/swallowing-problems-dysphagia/

Neck pain is something that is extremely common, and many of us would have experienced it in our lives before. 

Neck pain could arise due to a variety of reasons. Most of the time, the causes of neck pain are not serious. For example, the most common cause of neck pain is muscle strain. This is usually a result of poor posture or overuse of the neck muscle while exercising. However, there are instances when your neck pain could be a result of more serious, underlying medical conditions. In these cases, it is important to consult a doctor and seek medical attention.

So, how can you tell the difference between neck pain that is likely not a cause of concern from one that is? Well, neck pain that is caused by other underlying medical conditions are usually accompanied by other symptoms, such as: 

  • Muscle weakness 
  • Pins-and-needles in your arms, fingers, legs or feet
  • Radiating pain that shoots down your arms, buttocks or legs
  • Loss of balance 
  • Blurred or double vision
  • Slurred speech 

Some medical conditions which may cause neck pain include: 

Arterial dissection. Arterial dissection occurs when the inner lining of an artery is torn. As this tear becomes bigger and bigger, blood leaks between the layers of your artery walls, forming a pouch, also known as a “false lumen”. Blood can accumulate here and form blood clots. When these blood clots block blood flow, or even break off and travel further up the artery and block blood flow to the brain, they can cause a stroke. 

Herniated disc. Your spine is made up of 24 small bones, known as vertebrae, stacked on top of each other. In between each vertebrae, there is a rubbery pad known as a disc that acts as a cushion and prevents the vertebrae from rubbing against each other. Each disc has a harder exterior, known as the annulus, which surrounds an inner core, known as the nucleus. The nucleus contains loose fibers that are suspended in a gel-like substance. A herniated disc occurs when a fragment of the nucleus pushes out through the annulus as it is weak or torn. 

Cervical radiculopathy. Your skull is connected to your upper back by a series of 7 small bones, known as vertebrae. This is known as your cervical spine. Cervical radiculopathy occurs when the nerve root, the initial segment of a nerve leaving your central nervous system, of the cervical spine becomes compressed, damaged or inflamed. 

If you are currently experiencing neck pain that is interfering with your daily life, consult a doctor and seek medical attention as soon as possible. 

References
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Neck Pain. (n.d.). Www.Sgh.com.Sg; Singapore General Hospital Singhealth. Retrieved December 17, 2020, from https://www.sgh.com.sg/patient-care/conditions-treatments/neck-pain/

Back pain is something that is extremely common, and many of us would have experienced it in our lives.

Back pain could arise due to a variety of reasons. Most of the time, the causes of back pain are not serious. For example, the most common cause of back pain is muscle strain. This is usually a result of poor posture or overuse of the back muscle while exercising. However, there are instances when your back pain could be a result of more serious, underlying medical conditions. In these cases, it is important to consult a doctor and seek medical attention.

Back pain can be:

  • Like a muscle ache
  • Burning 
  • Sharp and shooting/stabbing
  • Radiating down your leg
  • Worsening with movement of your back/legs

So, how can you tell the difference between back pain that is likely not a cause of concern from one that is? Well, if back pain is caused by any underlying conditions, it tends to:

  • Persist for a few weeks
  • Be severe and not improve with rest
  • Be accompanied by other symptoms like fever, inflammation and bowel issues

Cervical myelopathy occurs when your spinal cord is compressed. You may experience a burning or shock-like pain in your neck and upper back that shoots down your arms, lower back or legs. 

Abnormal growths such as spinal tumours within or near the cervical spine may also compress on cervical spinal cord and cause pain that is not relieved when lying down.

Sciatica is pain caused by irritation or compression of the sciatic nerve. The sciatic nerve runs from your lower back, through your hips, buttocks and down your legs. You may experience a burning or shock-like pain in your lower back that shoots down your buttocks, legs and even toes. The severity and duration of pain varies from person to person. 

Spondylolisthesis happens when one of the vertebrae slips out of position. This commonly occurs in the lower back, but can happen in the mid to upper back too. You might experience lower back pain, similar to a muscle strain that gets worse when you move around or stand up. It might be relieved when you lie down.

Spinal stenosis occurs when spaces within your spine, known as the foramen, begin to narrow, thus putting pressure on the nerves that run through your spine. You will likely experience a burning or shock-like pain in your neck or lower back that shoots down your arms, buttocks and legs. 

Spinal infections are rare, but often very serious diseases that happen when pathogens such as bacteria, viruses, parasites, fungi or prion invade the spinal tissues through the bloodstream or peripheral nerves. 

A herniated disc happens when the rubbery pad that lies between each vertebra is displaced. The main tell-tale sign of a herniated disc is a sudden sharp or burning pain that shoots down your arms, buttocks or legs. In some cases, you may experience a tingling sensation instead, and in rare cases, numbness or paralysis. 

If you are currently experiencing back pain that is interfering with your daily life, consult a doctor and seek medical attention as soon as possible. 

References
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5 signs your back pain might be an emergency | Back and Spine | Orthopaedics and Rehab | UT Southwestern Medical Center. https://utswmed.org/medblog/5-signs-your-back-pain-might-be-emergency/

For many, nerve pain feels like a sudden shooting, burning or tingling sensation. Some patients have also described the pain as ‘electric’. If you have nerve pain, you will likely be very sensitive to touch too, whereby even the slightest breeze against your skin may cause you severe pain. 

The location and severity of your nerve pain depends on the severity of the underlying medical condition causing it. 

Some medical conditions that cause nerve pain include: 

Peripheral neuropathy. Peripheral neuropathy refers to conditions resulting from damage to the peripheral nerves. The peripheral nerves are the network of nerves outside the brain and spinal cord, and they work to send information from the brain and spinal cord to other parts of the body.

Post infection neuralgia. Postherpetic neuralgia (PHN) is a condition which affects your nerves and skin. It is the most common complication of shingles, a viral infection that affects your nerves and the skin surrounding it, resulting in a painful rash. When pain from shingles continues even after the rash subsides, it is known as postherpetic neuralgia.

If you are currently experiencing any nerve pain, visit a doctor and seek medical attention immediately. 

References
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Colloca, L., Ludman, T., Bouhassira, D., Baron, R., Dickenson, A. H., Yarnitsky, D., Freeman, R., Truini, A., Attal, N., Finnerup, N. B., Eccleston, C., Kalso, E., Bennett, D. L., Dworkin, R. H., & Raja, S. N. (2017). Neuropathic pain. Nature Reviews Disease Primers, 3(1). https://doi.org/10.1038/nrdp.2017.2

Muscle cramps can vary in terms of intensity but generally evoke a tight knotted sensation in the muscle. A cramping muscle could appear hard to touch and may be visibly twitching beneath the skin. Muscle cramps tend to last anywhere from a few seconds to a few minutes. 

Dehydration, overuse of a muscle, muscle strain, or simply being in one position for a long time could cause a muscle cramp. They are fairly common and most muscle cramps are harmless. However, some muscle cramps could be related to an underlying and serious long-term condition. It might not always be about just the muscle — it could be about the nerves as well. 

Below are some neurological conditions that could lead to muscle cramps: 

Myopathy is a disease which affects the functions of muscles in the body. Due to dysfunction of the muscle fibres, muscles become weaker and work less efficiently than normal. Due to this myopathy causes muscle cramps along with other symptoms like muscle stiffness and muscle spasms. 

Motor neuron disease (amyotrophic lateral sclerosis, ALS) is a neurodegenerative neuromuscular disease that affects the nerves which control voluntary muscles. ALS causes motor neurons to deteriorate then slowly die. When these motor neurons are damaged they can no longer control the muscles. It often begins with muscle twitching, weakness in limbs, and slurred speech. 

Neuromuscular disorders are a large group of disorders which affect the nerves that control voluntary muscles causing muscle cramps and twitching. In fact, ALS is one of the neuromuscular disorders. 

If you are experiencing the symptoms for any of the above mentioned conditions, it is important to consult your doctor of physician right away. 

References
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Neuromuscular disorders | Neuroscience nursing | Royal College of Nursing. (2020, August 11). The Royal College of Nursing. https://www.rcn.org.uk/clinical-topics/neuroscience-nursing/neuromuscular-disorders#:~:text=are%20Neuromuscular%20Disorders%3F-

Numbness refers to a loss of sensation in a part of your body. It can also refer to a reduced or altered sensation in the body. Oftentimes, it can be combined with other feelings and sensations like pins & needles, tingling, or burning. While numbness can appear on a single nerve on one side of the body, it can also appear symmetrically on both sides of the body. 

Of course, many of us have experienced the feeling of pins & needles and temporary numbness when we sit in one position for too long. However, if feelings of numbness begin to be severe and disabling it might be caused by more serious and long-term neurological conditions or nerve damage. 

Below are some conditions that might be the cause of serious, long-term numbness:

Cervical Radiculopathy is a damage or change in the way a nerve in the cervical spine works. Due to this damage and alteration of the nerve, feelings of numbness and tingling sensations in the arms and legs might persist.  

Strokes or TIA (Transient Ischemic Attack) is when there is a blockage of the flow of blood to the brain. Numbness that is felt on one side of the face or body and in the arms and legs are early symptoms of strokes and TIA. 

Peripheral Neuropathy is a condition or disease that occurs when the nerves between the brain and spinal cord are damaged. Damage to peripheral nerves can interrupt the communication between certain parts of the body and brain. It often causes numbness, pain, and weakness in parts of the body especially the hands and feet. 

Tumours in the brain or the spine can put pressure on the nerves in the brain or the spine causing feelings of numbness and the loss of sensations in certain areas. The location of the tumor tends to determine where the sense of touch would be altered. 

Multiple Sclerosis (MS) is a disease of the brain and the spinal cord. Overtime, the disease affects nerves, causing nerve damage and deterioration. Numbness is the most common symptom of MS. People with MS may experience mild to severe numbness in various places including the arms and legs, hands and feet, face, and whole body.

References
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Numbness and tingling: Causes and treatments. (2019, August 15). Www.Medicalnewstoday.com. https://www.medicalnewstoday.com/articles/326062#causes

If you have weakness of limbs, you might describe it as feeling tired in the arms and legs, having reduced power, or sometimes not being able to use your limbs at all. If it does not resolve on its own, or if there are other significant symptoms you have as well, this could be an indication of a few more serious conditions.

A stroke or mini-stroke (TIA) is likely to be the cause of your limb weakness if you are older, or have known stroke risk factors like smoking, high blood pressure, diabetes or a family history of stroke or heart attacks. If you are having a stroke, you might feel weakness in half your body or your whole body. If you think this might be the cause of your limb weakness, get help immediately, as a stroke is a serious medical emergency.

Brain tumours could also cause weakness of limbs if developing in the frontal lobe or parietal lobe.

Myopathy is a general term that refers to diseases that affect muscles in the body, also known as neuromuscular disorders. The main sign of myopathy is muscle paralysis or weakness, though symptoms differ depending on the type of myopathy and its development stage. With myopathy, you will most likely find it more difficult to move around as well. 

Peripheral neuropathy refers to conditions resulting from damage to the peripheral nerves. The peripheral nerves are the network of nerves outside the brain and spinal cord, and they work to send information from the central nervous system to other parts of the body. These can cause limb weakness when damaged.

Motor neurone diseases (MND) are a group of neurodegenerative diseases that deteriorate the motor neurons, causing the nerves in your spine and brain to gradually lose function over time. These diseases can cause limb muscle weakness and cramps.

Multiple Sclerosis (MS) is a disease that impacts the brain and spinal cord, part of the central nervous system. If you have MS, you might have numbness, tingling, muscle fatigue and even muscle paralysis. These symptoms may be temporary or long-lasting. 

Cervical radiculopathy occurs when the nerve root, the initial segment of a nerve leaving your central nervous system, of the cervical spine becomes compressed, damaged or inflamed. If you have cervical radiculopathy, you may experience muscle weakness or a tingling pins-and-needles sensation in your arms and fingers. You may also find yourself having a lack of coordination or being more clumsy than usual. 

Cervical myelopathy occurs when your spinal cord is compressed. You may experience muscle weakness or a tingling pins-and-needles sensation in your arms and fingers. For example, you may notice yourself not being able to write or grip things properly. 

Find out more about these neurological disorders today, and if you suspect you might have any of them because of any limb weakness, speak to your doctor about it today.

References
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Symptoms of brain tumours | Cancer Research UK. (2019). Cancerresearchuk.org. https://www.cancerresearchuk.org/about-cancer/brain-tumours/symptoms

Tremors are repetitive, involuntary muscle contractions that result in trembling or shaking movements in parts of the body. It is a common symptom that many people experience, and most often affects the hands and fingers, though other parts of the body can be affected as well. 

Tremors arise when there are problems with the part of your brain that controls movements. This can be attributed to a number of reasons. 

At times, tremors can appear spontaneously and seemingly without any logical explanation. These cases of tremors are most likely linked to genetics and a family history of tremors. 

However, there are instances when tremors could be a result of more serious, underlying medical conditions. Some medical conditions which may give rise to tremors include: 

Parkinson’s disease. Parkinson’s disease (PD) is a very common long-term neurological disorder, affecting 1% of all individuals over the age of 60 [1]. It affects the central nervous system, and the most common symptoms in patients affect the motor system, including tremors. 

Dystonia. Dystonia is a neurological movement disorder, where your muscles involuntarily co-contract against each other or spasm abnormally. This causes abnormal and often debilitating postures and repetitive movements. People with dystonia can find their body parts unusually contorted or twisted because of these muscle contractions. 

Multiple Sclerosis (MS). MS is a disease that impacts the brain and spinal cord, part of the central nervous system. 

Motor Neurone Diseases (MND). MND refers to a group of neurodegenerative diseases that deteriorate your body’s motor neurons, causing the nerves in your spine and brain to gradually lose function over time. Motor neurones are nerve cells that transmit electrical signals, also known as nerve impulses, from your spinal cord to your muscles, enabling you to move. 

Stroke. A stroke occurs when blood flow to the brain is interrupted, either because the arteries leading to your brain are blocked or burst. As a result, oxygen supply to the brain is cut off, causing brain damage as cells in part of your brain die. When this happens, bodily functions controlled by damaged parts of your brain are lost. Tremors may develop after a stroke. 

If you are currently experiencing tremors, consult a doctor and seek medical attention as soon as possible. 

References
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  1. Parkinson Disease: Practice Essentials, Background, Anatomy. (2019, February 2). Medscape.com. https://emedicine.medscape.com/article/1831191-overview
  2. Tremor Fact Sheet | National Institute of Neurological Disorders and Stroke. (2020). Nih.Gov. https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/tremor-fact-sheet#1

Unsteady gait refers to instability while walking and a lack of proper balance. An unsteady gait can be mild and unnoticeable or can be more severe leading to difficulty in walking. An unsteady gait might be temporary and due to an injury or infection, or it could be a sign of something more serious. This symptom may be caused by a problem in the legs or feet (such as with the bones, joints or soft tissue), for example, knee osteoarthritis. However, it also could be due to issues in the nervous system, which control the muscles necessary for walking. 

Below are some neurological conditions which may be the cause of such a symptom: 

Stroke/TIA (Transient ischemic attack) occurs when there is a blockage to the blood flowing into the brain. A TIA can be seen as a mini-stroke as symptoms last for a short amount of time, however, it is just as serious a condition. You may face problems with balance and vision during a stroke and may experience weakness in your legs causing it to be difficult to walk properly. 

Brain tumour is a mass located in the brain. As the tumour grows, it exerts pressure on surrounding tissue, affecting the function of the surrounding tissue and nerves. Because of this, signs like nausea, vomiting, and difficulty balancing/walking occur. 

Peripheral neuropathy is a condition that occurs when the peripheral nerves are deteriorating and damaged. Because of this, it affects your ability to feel and sense your feet it can make it much harder to keep your balance and have a steady gait. 

Cervical myelopathy is a condition involving the compression of the cervical spinal cord (near the neck area). The nerves in your cervical spine is affected and this causes you to feel symptoms elsewhere, besides your neck. It can cause balance issues and an unsteady gait along with other symptoms like sharp shooting neck pain, weakness, numbness, and clumsiness. 

Normal pressure hydrocephalus (NPH) occurs when the normal flow of cerebrospinal fluid (CSF) is blocked in some way, causing a build-up of CSF in the brain’s ventricles and cavities. This in turn puts pressure on the brain. It causes balance issues, progressive mental impairment, and impaired bladder control. 

Neurodegenerative conditions – can cause long term unsteadiness which could be progressive in nature.

If you are experiencing difficulty walking or an unsteady gait it would be a good idea to visit a doctor, especially if there are no direct leg injuries or infections that you and your doctor are already aware of. 

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