Some of the most common problems patients came in with were
migraines and sleep apnea. Another patient I also met had profound cerebral palsy, a
disorder in which the patient experiences decreased muscle tone and cognitive
impairment.
Many of the patients with severe migraines were given nerve blocks, injections that decrease or stop the passage of nerve impulses for pain signals going to the brain. These injections are used when medications are not helping with the headaches.
Today, I watched an Electromyography (EMG), a procedure used
to diagnose a problem with the motor neurons of muscles. An EMG (a picture of the machine is shown below) takes the electrical signals transmitted by motor
neurons using needle electrodes or surface electrodes, and translates them into
graphs. These electrical signals cause muscle contraction.
Through observing patients with sleep apnea, I realized how
complicated neurology itself is. There are many different problems that can be
attributed to a change in one's sleep cycle. For instance, a patient who had
come in earlier because she felt really dizzy, came in for a follow-up visit
saying she was experiencing memory loss. She was also diagnosed with sleep
apnea.
Another patient came in due to a seizure he had recently.
Dr. Qureshi asked him to get a CPI test done. During his follow-up visit, he
was diagnosed with sleep apnea. Therefore, sleep disorders, like sleep apnea,
not only lead to cognitive impairment, but can also cause a variety of other
problems like seizures and memory loss.
Another thing I noticed was that the staff and the patients were very welcoming and encouraging. Dr. Qureshi and his
medical student made me very comfortable. We spent a half hour talking about how similar my language, Hindi, is to Dr. Qureshi’s language, Urdu! He also introduced me to each of
the patients I visited and allowed me to ask questions during the sessions.
This week was phenomenal and I am confident that the rest of my time at PNPI is going to be even better!
Stay tuned for more!
Stay tuned for more!
~Shubhangi
What you are doing sounds really interesting! Did Dr. Qureshi explain how he might treat a patient with cerebral palsy? I know there is no cure, but symptoms can be treated.
ReplyDeleteOf course! The treatment plan of a patient with cerebral palsy includes taking care of symptoms such as mobility and pain. It also involves providing a better quality of life. One of the other things that can be used is a Botox Injection. When I was with Dr. Qureshi, he gave the patient these injections in the muscles of her arm. Basically, these injections are used to temporarily weaken the muscles and relieve some of the pain. Of course, there are also side effects to this method of treatment.
ReplyDeleteYour internship sounds amazing! Will you get to learn how to read EMG's later on? It's really cool that they are able to translate impulses into visual graphs!
ReplyDeleteDr. Qureshi actually mentioned a little bit about reading an EMG this week. In a patient with neuropathy, or nerve damage, the EMG will show abnormally large action potentials on the graph. The EMG of a patient who has myopathy, or a muscle disease, shows very brief and short action potentials. Good question!
ReplyDeleteThat's great that you get to ask patients your own questions! Make sure to keep detailed notes in that journal of yours. Have you standardized the questions that you are asking?
ReplyDelete- Ms. Holtzman
Hello Ms. Holtzman. As of the past couple of week, I have been able to take a Mini Mental State Examination (MMSE) of some patients. It is a questionnaire that checks the extent of memory loss and possible dementia. The questions check for orientation, calculation, attention, recall, and language. I have also been able to ask questions about the nerves being tested during EMGs.
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