Insomnia : Insomnia, or sleeplessness, is a sleep disorder in which there is an inability to fall asleep or to stay asleep as long as desired Non pharmacological strategies provide long lasting improvements to insomnia and are recommended as a first line and long term strategy of management. The strategies include attention to sleep hygiene, stimulus control, behavioral interventions, sleep-restriction therapy, paradoxical intention, patient education and relaxation therapy Medicatons Antihistamines The antihistamine diphenhydramine is widely used in nonprescription sleep aids. The antihistamine doxylamine is used in nonprescription sleep aids Benzodiazepine The most commonly used class of hypnotics prescribed for insomnia are the benzodiazepines. Hypnotic benzodiazepines include drugs such as temazepam, flunitrazepam, triazolam, flurazepam, midazolam, nitrazepam, and quazepam. Non-benzodiazepines Nonbenzodiazepine sedative-hypnotic drugs, such as zolpidem, zaleplon, zopiclone, and eszopiclone, are a class hypnotic medications indicated for mild to moderate insomnia. Antidepressants Some antidepressants such as amitriptyline, doxepin, mirtazapine, and trazodone can have a sedative effect, and are prescribed to treat insomnia Other Opioid medications such as hydrocodone, oxycodone, and morphine are used for insomnia that is associated with pain due to their analgesic properties and hypnotic effects


Epilepsy : Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain sometimes signal abnormally. Neurons normally generate electrochemical impulses that act on other neurons, glands, and muscles to produce human thoughts, feelings, and actions. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior, or sometimes convulsions, muscle spasms, and loss of consciousness. During a seizure, neurons may fire as many as 500 times a second, much faster than normal. In some people, this happens only occasionally; for others, it may happen up to hundreds of times a day. EPILEPSY SYMPTOMS • Generalized seizures: All areas of the brain (the cortex) are involved in a generalized seizure. Sometimes these are referred to as grand mal seizures. o The person experiencing such a seizure may cry out or make some sound, stiffen for several seconds to a minute and then have rhythmic movements of the arms and legs. Often the rhythmic movements slow before stopping. o Eyes are generally open. o The person may appear to not be breathing and actually turn blue. This may be followed by a period of deep, noisy breathes. o The return to consciousness is gradual and the person may be confused for quite some time –minutes to hours. o Loss of urine is common. o The person will frequently be confused after a generalized seizure. • Partial or focal seizures: Only part of the brain is involved, so only part of the body is affected. Depending on the part of the brain having abnormal electrical activity, symptoms may vary. o If the part of the brain controlling movement of the hand is involved, then only the hand may show rhythmic or jerky movements. o If other areas of the brain are involved, symptoms might include strange sensations like a full feeling in the stomach or small repetitive movements such as picking at one's clothes or smacking of the lips. o Sometimes the person with a partial seizure appears dazed or confused. This may represent a complex partial seizure. The term complex is used by doctors to describe a person who is between being fully alert and unconscious. • Absence or petit mal seizures: These are most common in childhood. o Impairment of consciousness is present with the person often staring blankly. o Repetitive blinking or other small movements may be present. o Typically, these seizures are brief, lasting only seconds. Some people may have many of these in a day DRUGS: Medicines that may be used first to treat epileptic seizures include: • Carbamazepine (such as Carbatrol). • Ethosuximide (Zarontin), for absence seizures only. • Oxcarbazepine (Trileptal). • Phenobarbital (Luminal). Phenobarbital is a first-line medicine for newborns. • Phenytoin (Dilantin, Phenytek) or fosphenytoin (Cerebyx). • Primidone (Mysoline). The body converts primidone into phenobarbital. • Topiramate (Topamax). • Valproate (Depakene, Depakote). If epileptic seizures continue even though you are being treated, may prescribe one or more of the following medicines: • Benzodiazepines (such as Klonopin) • Ezogabine (Potiga) • Felbamate (Felbatol) • Gabapentin (Neurontin) • Lacosamide (Vimpat). This medicine can be used along with other antiseizure medicine to treat partial seizures. • Lamotrigine (Lamictal) • Levetiracetam (Keppra) • Phenobarbital (Luminal). Phenobarbital is a first-line medicine for newborns. • Pregabalin (Lyrica). This medicine is intended to be used along with other antiseizure medicine. • Primidone (Mysoline). The body converts primidone into phenobarbital. • Rufinamide (Banzel). This medicine can be used along with other antiseizure medicine to treat seizures caused by Lennox-Gastaut syndrome. • Tiagabine (Gabitril) • Topiramate (Topamax) • Vigabatrin (Sabril) • Zonisamide (Zonegran)


Vertigo : Vertigo is a sensation of spinning. If you have these dizzy spells, you might feel like you are spinning or that the world around you is spinning. Causes of Vertigo Vertigo is often caused by an inner ear problem. Some of the most common causes include: BPPV. These initials stand for benign paroxysmal positional vertigo. BPPV occurs when tiny calcium particles (canaliths) clump up in canals of the inner ear. The inner ear sends signals to the brain about head and body movements relative to gravity. It helps you keep your balance. BPPV can occur for no known reason and may be associated with age. Meniere's disease. This is an inner ear disorder thought to be caused by a buildup of fluid and changing pressure in the ear. It causes episodes of vertigo along with ringing in the ears (tinnitus) and hearing loss. Vestibular neuritis or labyrinthitis. This is an inner ear problem usually related to infection (usually viral). The infection causes inflammation in the inner ear around nerves that are important for helping the body sense balance Less often vertigo may be associated with: • Head or neck injury • Brain problems such as stroke or tumor • Certain medications that cause ear damage • Migraine headaches Symptoms Vertigo is often triggered by a change in the position of your head. People with vertigo typically describe it as feeling like they are: • Spinning • Tilting • Swaying • Unbalanced • Pulled to one direction Other symptoms that may accompany vertigo include: • Feeling nauseated • Abnormal or jerking eye movements (nystagmus) • Headache • Sweating • Ringing in the ears or hearing loss • • Medicine • In some cases, medication may be given to relieve symptoms such asnausea or motion sickness associated with vertigo. • If vertigo is caused by an infection or inflammation, antibiotics or steroids may reduce swelling and cure infection. • For Meniere's disease, diuretics (water pills) may be prescribed to reduce pressure from fluid buildup. • Surgery. In a few cases, surgery may be needed for vertigo.