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COVID-19 Featured

Did you know? Covid-19 vaccination can also be associated with unexplained neurological symptoms!!

Recently Mrs. R aged about 55 years consulted us with a range of symptoms that closely followed the first dose of vaccination for Covid-19. They included

  • Pricking and pulling pain in the hands and feet
  • Pain in the neck and shoulders
  • Altered sensation in the soles, feels roughness in them.
  • Pulling pain in the back of the knees and legs
  • Palpitations on exertion.
  • Disturbed sleep

She had visited her family doctor and an orthopaedic surgeon and was diagnosed as having cervical and lumbar spondylosis and carpal tunnel syndrome. When it became apparent to us that her symptoms had followed vaccination, she having not considered this piece of information important in her earlier consultations, we proceeded to carry out our comprehensive 360* evaluation at Buddhi Clinic. Mrs. R met our team- physician, physical therapist, psychologist and electrophysiologist and was evaluated for a neuropathy as well as dysautonomia.

Lo and behold we discovered evidence of both a peripheral neuropathy (responsible for the pain in her hands and feet and altered sensation in her soles) as well as clinical autonomic dysfunction (Postural Orthostatic Tachycardia Syndrome being the diagnostic indicator) contributing to fatigue, palpitations and sleep dysfunction. There was also considerable health related anxiety about her new and unusual symptoms. A working diagnosis of “post vaccination neuropathy and clinical autonomic dysfunction” was made and Mrs. R inducted into our comprehensive care program. From a drug perspective we used pregabalin (a nerve membrane stabilising agent and weak anti-epileptic drug that helps with both neuropathy and dysautonomia), nortryptyline (a conventional antidepressant with anti-pain and anxiety relieving/ sleep promoting effects) and baclofen (for muscle spasm identified in clinical evaluation). 

She started also on our comprehensive care (non-drug therapy) program with our Mobility & CAM labs. The mobility lab team delivered manual and electrotherapy treatments for pain/ dysasthesia and a comprehensive exercise therapy program for dysautonomia. The CAM lab team delivered focal abhyangam with Sahachadhari thailam and kizhi together with acupressure, reflexology and mud therapy sessions. 

After 15 hours of each treatment paradigm Mrs. R was reviewed in our case conference, with the following outcomes. 

Mobility Lab:

  • Muscle spasm and pain in the neck and shoulders has reduced completely – the Visual Analogue Scale scores were- Pre therapy-8, Mid therapy-4, End therapy-0
  • Mild pain in the right brachioradialis continues with a Visual Analogue Scale Score of 2
  • Altered sensation in the hands and feet has reduced by 50% but tends to fluctuate, being present on and off
  • Grip, grasp and fine motor skills are improving

CAM Lab: 

  • Pricking and pulling pain in the legs improved
  • Her metabolism improved and she perceives overall wellness in her daily functions
  • Sleeps 5 hours fitfully but would like that to return to her customary 7 hours  
  • The self-application (assisted by family) of lepam (herbal paste) in both palms and soles is helping her; when her night time symptoms are bothersome she has learnt to apply ice packs to the dysasthetic areas and is able to sleep
  • Abnormal sensation in palms continues to fluctuate

Summary:

A vaccination is nothing but a minor and contained infection inducer, designed to help people develop immunity. Not just COVID-19 vaccination, but all vaccinations can induce some adverse effects, unexplained neurological and neuropsychiatric symptoms not being uncommon. The temporal relationship between the de novo symptoms that Mrs. R developed, detailed by our comprehensive evaluation and targeted testing, confirmed for us new onset peripheral neuropathy and dysautonomia. As is our practice in Buddhi Clinic we combined modern drug treatment with the wisdom of convention (physiotherapy) and ancient traditions (Ayurveda and Naturopathy) to give Mrs. R much needed relief. Mrs. R continues in a step down program combining weekly clinic visits with our “Do it Yourself” (DIY) Buddhi kits and is on the pathway towards complete recovery. She discovered Buddhi Clinic and in her we have evolved the pathway to helping people with post-vaccination neurological symptoms. 

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COVID-19 Epilepsy & Seizures Featured

Managing epilepsy during COVID-19

Epilepsy is the most common serious neurological disease affecting over 50 million people worldwide and an estimated 5 million plus people in India.

People with epilepsy have recurrent, unprovoked seizures and these have to be differentiated from provoked seizures that follow a tumour, stroke, infection, inflammation, metabolic disease (like very low or very high blood sugar) and so on. A seizure is an electrical storm in the brain; a short circuit in the brain’s normal electrochemical activity.

World Epilepsy Day or Purple Day just passed us on 26th March. In this time of COVID let’s ask ourselves what the implications are for people with epilepsy. Here are some common FAQs.

Can COVID-19 cause epilepsy?

According to the International League Against Epilepsy, there is no direct evidence that the coronavirus infection can directly cause epilepsy. However, like all infections that can cause high fever, breathing difficulties and other problems with normal functioning, being infected can result in a person who is susceptible to epilepsy, suffer breakthrough episodes.

Does epilepsy or its treatment make one more susceptible to COVID-19?

At present there is no information to suggest that either epilepsy or its treatment (anti-epileptic drugs, most commonly) will in any way make a person susceptible to COVID-19. Indeed, there is no suggestion that people with epilepsy have any special immune vulnerability either. However, the stress a pandemic of this nature can induce in people, the sleep deprivation and attendant lifestyle changes, can all make a person already vulnerable to seizures, express them more frequently.

What should I do if I have a seizure in this time of COVID-19?

If one has never had a seizure before in their lives, it is obviously imperative that they consult a neurologist, urgently and undergo relevant investigations as advised. As most routine clinics are cancelled, the emergency room of a hospital may be a better point of access at this time. However, for people with pre-existent epilepsy, a single seizure is no reason for panic. Call your usual doctor and discuss what you can do to manage your epilepsy better; follow your doctors advice.

Avoid visiting clinics and hospitals for single breakthrough seizures unless you feel it is absolutely necessary. However, if seizures cluster together, or indeed a person suffers continuous seizures with no recovery of consciousness in-between, what is called “status epilepticus”, it must be treated as an emergency.

What precautions should a person with epilepsy take at this time?

People with epilepsy are advised to stock up adequately on their anti-epileptic drugs, as even missing a single dose can cause a breakthrough seizure for some. Compliance with drug treatment is extremely important for people with epilepsy. Stress is inevitable and managing it with meditation, yoga, a healthy diet and lifestyle are all possible. Many good online tutorials exist on all the above. If one is very stressed out an online consultation with a psychiatrist or psychologist can be helpful. Sleep deprivation is another risk factor for people with epilepsy; adequate rest and sleep are therefore very important. Sleep can be disturbed due to stress or indeed due to excessive exposure to digital media — televisions, computers, tablets and smartphones.

Good sleep hygiene: making oneself clean and comfortable before going to bed, making the temperature and lighting in the room ambient and suitable to the extent possible, putting way all digital media and retiring to bed with either a book or gentle instrumental music (if one must have a distraction) are all encouraged.

Are there special precautions?

Unless one is a healthcare worker or otherwise at high risk of exposure, no special precautions are recommended. If a person with epilepsy belongs to this category, they are encouraged to speak with their usual doctor about drug prophylaxis and other precautions. For all other people with epilepsy, the principles of social distancing, avoiding unnecessary contact with people outside one’s immediate family, or indeed taking due care around anyone who is symptomatic of COVID, is adequate.