A concussion is the mildest form of traumatic brain injury (TBI) and results in temporary loss of brain function. It is caused by events such as a fall, a blow to the head, a car accident, or forceful impact of the body that jar or shake the brain back and forth inside the skull.
- There are an estimated 3.8 million concussions each year in the U.S., but only 1 in 6 concussions is diagnosed.
- In many cases, there are no visible signs of head trauma.
- Symptoms of concussion include:
- Headache
- Confusion
- Dizziness
- Nausea or vomiting
- Slurred speech
- Fatigue
- Double vision or blurred vision
- Balance problems
- Some people may experience a loss of smell or taste
- Temporary loss of consciousness
- Sleeping more or less than usual
- Recovery from a mild concussion may take only a few hours, but recovery from a severe concussion may take up to a few weeks.
- Your doctor or healthcare provider may do a general neurological exam to evaluate your vision, balance, coordination, and hearing. Your doctor may order imaging tests such as CT scan or an MRI to see if there is any bleeding or bruising.
- The best way to recover from a concussion is to physically and mentally rest. Physical activity should be minimized, especially if activity makes your symptoms worse. You may need to have shortened school or work days, or even stay home for a few days right after your injury.
- Your doctor or healthcare provider will monitor you for improvement and let you know when it is safe to increase physical activities or activities that involve thinking.
- You should not drive a car or operate machinery until your doctor or healthcare provider tells you it is safe to do so.
Muscle Disorders
Muscle is the tissue in the body that allows you to move and helps your body function. There are 3 types of muscle in the body, each with a different job.
- Skeletal muscle is attached to bones and provides movement
- Your heart is made of cardiac muscle
- Internal organs are made of smooth muscle
Muscle disorders may be a direct result of the muscle not working properly (myopathy), or it may be the result of the nerve that communicates or “talks” to the muscle not working (neuropathy).
Symptoms of different muscle disorders can vary. Depending on the disorder, only some muscles may be affected, such as those in the face or legs, or all the muscles may be affected. Patients with muscle disorders may require physical aids such as leg braces, crutches, or a wheelchair.
Some of the muscle disorders we treat are listed here.
Duchenne Muscular Dystrophy
This is a fatal genetic disorder that occurs when a person does not make a particular protein, called dystrophin, which is needed for muscles to work the way they should.
- It occurs primarily in boys between the ages of 3 and 5.
- The muscles get progressively weaker, usually starting in the hips, pelvis, thighs, and shoulders. Later, muscles in the arms and legs are affected, and by the early teens the heart and respiratory muscles may be affected.
- Patients with this disorder develop problems walking and breathing.
- There is no cure for Duchenne muscular dystrophy, and treatment is done to control symptoms and maximize the patient’s quality of life.
- Please go to Cure Duchenne for more information on this fatal disease.
Hereditary Motor Sensory Neuropathy (HMSN)
HMSN is a genetic disease that affects the peripheral nerves causing weakness and numbness in the legs, feet, and arms.
- Sometimes the nerves don’t work because the protective cover (myelin) is damaged, and sometimes the nerve itself is damaged.
- Common symptoms of the disease include pain, numbness, poor balance, fatigue, and foot deformities such as high arches in the feet or “hammer” toes.
- A neurological evaluation by your doctor to evaluate muscle weakness and sensory responses is needed to diagnose this disease.
- Your doctor or healthcare provider may order a genetic blood test, an EMG, or nerve conduction study to confirm the diagnosis.
- Because it is hereditary, your doctor will ask you questions about your family’s health.
- There is no cure or definitive treatment for HMSN, but physical and occupational therapy, physical activity, and stretching may help maintain muscle strength and improve independent functioning.
- This disorder is also called Charcot-Marie-Tooth disease after the three doctors who first identified it.
Lambert-Eaton Myasthenic Syndrome (LEMS)
LEMS is an autoimmune disease in which the body’s immune system attacks the connection between nerves and muscles. This disease produces harmful proteins that cause faulty communication between nerves and muscles so the nerves cannot “talk” to the muscles.
- Many people with LEMS are often diagnosed with a certain type of cancer called small cell lung cancer.
- LEMS often begins in middle age, but it can also begin in childhood.
- Some symptoms of LEMS include bladder and bowel changes, changes in blood pressure, dizziness when standing, dry mouth, fatigue, problems talking or swallowing, or trouble breathing.
- To help diagnose LEMS, your doctor or healthcare provider will perform a physical exam and ask you about your symptoms.
- Your doctor may order a special blood test, an EMG, or a nerve conduction study.
- Because people with this disease often have small cell lung cancer, your doctor may check you for this or other types of cancers
- Treatment for LEMS includes removing harmful proteins in blood (called plasmapheresis) or given large amounts of helpful proteins.
- People with LEMS who also have cancer receive treatment for the cancer; if you respond well to the cancer treatment then the LEMS often improves, too.
- Some medications can help make the immune system less active so it does not attack the nerves.
McArdle Disease
McArdle disease is a genetic condition that interferes with the body’s ability to metabolize food for energy production. People with this disease are not able to break down, or metabolize, a protein called glycogen.
- Because their muscles cannot properly metabolize food to create energy, people with this disease may feel tired or fatigued when they try to do strenuous activities such as jogging, swimming, biking, or for some, even walking.
- Some people may suffer muscle damage if they try to do exercises that require strength, such as weightlifting, doing squats, or activities that require lifting heavy objects.
- Symptoms of McArdle disease include muscle cramps, pain, weakness, or stiffness, fatigue, and poor stamina.
- The disease may start in childhood, but not be identified until adulthood.
- Some of the tests your doctor or healthcare provider may do to help diagnose this disease are an EMG, MRI, genetic tests, special blood tests, muscle biopsy, or urine test.
- Although there is no specific treatment, McArdle disease is not life-threatening.
- Lifestyle management to reduce symptoms includes doing a gentle warm up before exercising, not exercising for too long or too strenuously, and eating enough protein.
Motor Neuron Disease
Also known as amyotrophic lateral sclerosis (ALS) or Lou Gehrig’s disease, motor neuron disease is a rare, progressive nerve disease that affects cells in the brain and the spinal cord.
- This disease causes nerves that control chewing, walking, breathing, and talking to slowly stop working.
- Symptoms of ALS include muscle twitches or muscle cramps in the arms, legs, shoulder, or tongue, tight and stiff muscles, muscle weakness in the arms, legs, neck or diaphragm, and slurred speech and difficulty chewing or swallowing.
- Exact causes of ALS are not known, but certain things such as prolonged strenuous physical activity, physical trauma, viruses, and behavioral and occupations and in few cases genetic factors have been found to be associated with patients who have this disease.
- There is no cure for ALS so treatments focus on controlling symptoms and preventing unnecessary complications.
- Medications can help manage muscle cramps and stiffness; physical therapy is used to help maintain range of motion, and speech therapy teaches patients communication strategies and how to use assistive devices.
- Please visit the ALS Association web site for more information.
Myasthenia Gravis (MG)
MG is a chronic autoimmune disease that causes weakness and rapid fatigue in the muscles responsible for movement and breathing.
- The body’s immune system creates antibodies that attack the connection between nerves and muscles (neuromuscular junction) which results in problems in the normal communication between nerves and muscles.
- Researchers think the thymus gland, a part of your immune system, may tell your body to create the antibodies.
- Affected muscles can include those in your neck, arms, legs, eyes, face, or throat, although arms are usually more often than legs.
- Symptoms may include weakness in the arms, hands, fingers, legs, and neck, blurred or double vision, difficulty breathing, or difficulty chewing or swallowing.
- Your doctor or healthcare provider may do a physical and neurological exam and order several tests to confirm the diagnosis, including a pulmonary function test (PFT) to see how well you are able to breathe, special blood tests, an EMG, or imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI).
- There is no known cure for MG, and treatment helps to reduce and improve muscle weakness.
- More information can be found at the Myasthenia Gravis Foundation of America.
Polymyositis
Polymyositis is a type of myopathy (muscle disease) that causes inflammation of the muscles or blood vessels that are in the muscles. The weakness may be sudden, but it usually develops gradually and progress slowly. If the lungs are involved, it can be difficult to breathe.
- The exact cause is unknown.
- Symptoms can be different for each person, but include weakness in the hands and fingers, pain or weakness in the joints, difficulty swallowing, fatigue, and chronic dry cough.
- Your doctor will ask for a complete medical history and will perform a thorough physical examination.
- Diagnostic tests that your doctor or healthcare provider may order include blood tests, and EMG, MRI, or a muscle biopsy.
- There is no cure for polymyositis, but treatments such as medications and therapy can improve muscle strength and function.