Brain and Nervous System

What’s the difference between an essential tremor and Parkinson’s?

DEAR DOCTOR K: My father was recently diagnosed with essential tremor. Is this the same thing as Parkinson's disease? If not, what is the difference?

DEAR READER: Essential tremor is a brain condition that causes tremors: uncontrollable shaky movements of the hands, limbs, head or voice. It is usually mild and is very common, often running in families. It usually starts later in life, but when it runs in families it can start in young adulthood. In contrast, Parkinson's disease is a serious neurological condition that also causes a tremor.

What’s the treatment for a subdural hematoma?

DEAR DOCTOR K: My mother is in her 70s. She fell a few weeks ago but seemed fine. Then she started to have double vision and some trouble with balance. A CT scan revealed a subdural hematoma. Her doctor advised only bed rest and medication. Does this seem reasonable to you?

DEAR READER: A subdural hematoma (or hemorrhage) occurs when blood vessels near the surface of the brain burst. Blood collects beneath the dura mater. That's the outermost layer of the brain's protective covering. Here is an illustration of a subdural hematoma:

Is periodic limb movement disorder and restless leg syndrome the same thing?

DEAR DOCTOR K: Can you discuss periodic limb movement disorder? Is it the same as restless legs syndrome?

DEAR READER: Restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) are similar disorders, and often (but not always) occur together. RLS causes a wide range of uncomfortable leg sensations. They tend to occur most often when the legs are at rest during the day or in the evening. The sensations are almost always accompanied by an irresistible need to move the legs. Moving the legs can bring temporary relief.

How do I recognize concussion symptoms?

DEAR DOCTOR K: My son got a concussion playing football. His doctor said he shouldn't play again until his symptoms have completely disappeared. What symptoms should we be looking out for?

DEAR READER: A concussion follows a physical blow or impact to the head that disturbs the way the brain works. While it sometimes causes a person to temporarily lose consciousness, it doesn't always do that. It also can cause other symptoms that indicate the brain has been injured -- and those can become apparent days or weeks after a person who has been knocked out regains consciousness. A concussion is a serious injury, more serious than we used to think.

How does regular exercise help prevent memory loss?

DEAR DOCTOR K: I'm in my late 60s. I've read that regular exercise helps prevent memory loss. I find that hard to believe. How does it do that? And how much exercise do I need to reap this benefit?

DEAR READER: It's easy to understand why regular exercise would be good for your bones, muscles, lungs and heart. Regularly challenging those organs would make them stronger.

What is restless leg syndrome?

DEAR DOCTOR K: My doctor says I have restless leg syndrome. What is it, and how is it treated?

DEAR READER: Restless legs syndrome (RLS) is a brain and nervous system disorder that causes uncomfortable sensations in the legs. The discomfort is usually accompanied by an overwhelming urge to move the legs. Doing so can temporarily relieve the discomfort.

What do I need to know if my 9-month-old has another seizure due to a high fever?

DEAR DOCTOR K: My 9-month-old daughter had a seizure last time she had a high fever. The pediatrician said it could happen again. What do I need to know?

DEAR READER: The medical term for what your daughter experienced is febrile seizure. I was taught that febrile seizures are caused by a high fever or a sudden rise in body temperature. The effect of the higher body temperature makes the brain "irritable" and causes a seizure. But in the last few years, we've learned it may be more complicated than that.

Can you tell me about my treatment options for relapsing remitting multiple sclerosis?

DEAR DOCTOR K: I was recently diagnosed with relapsing remitting multiple sclerosis. Can you tell me about my treatment options?

DEAR READER: Multiple sclerosis (MS) is a disabling illness that affects the brain and spinal cord and worsens over time. MS damages nerve cells and a substance that is wrapped around the nerve cells, called myelin. A nerve cell functions like a copper wire -- it transmits electrical signals. Myelin is like the insulation surrounding a wire. It helps the electrical signal get transmitted down the nerve cell. When myelin is damaged, that transmission is interrupted.

Are there any other treatment options for Parkinson’s Disease?

DEAR DOCTOR K: I've been taking levodopa for years to treat my Parkinson's disease. Lately, though, it hasn't been as effective. Are there any other treatment options?

DEAR READER: It is quite common for the effectiveness of levodopa to change over time. Fortunately, there are other treatments available. Some are very high-tech, reflecting the latest scientific knowledge. Others are very low-tech, reflecting the wisdom of the past.

Can you tell me more about ALS?

DEAR DOCTOR K: Former Massachusetts governor Paul Cellucci recently died from complications of ALS. Can you tell me more about this disease?

DEAR READER: ALS stands for amyotrophic lateral sclerosis. You may know it as Lou Gehrig's disease, named after the famous baseball player who suffered from it. There are many different kinds of brain cells. Some do our thinking, some move our muscles (when the ones that think tell them to), and other brain cells do other things (such as see and hear). ALS primarily causes a slow degeneration of the nerve cells that control muscle movements. As a result, people with ALS gradually lose the ability to control their muscles.