Dr Carol Tham, Consultant, Department of Neurology, National Neuroscience Institute, shares the importance of identifying early symptoms of brain diseases like stroke, Parkinson's disease, dementia and epilepsy.
Case 1: Mr Tan (not his real name), 80, was home alone when he felt a sudden weakness in his left arm and leg. He dragged himself to bed and tried to sleep, hoping the weaknesswould subside. When his children returned from work, they saw his state and called an ambulance. He reached hospital seven hours after the first symptoms hit – too late for doctors to give him a drug to dissolve the blood clot in an artery in his brain. To be effective, the drug needs to be injected within 4½ hours from the onset of the stroke.
Case 2: Contrasting the first case, this case involves a 65-year-old patient who collapsed in the office, but got to the hospital in time because his colleagues called an ambulance immediately. He had a blood clot blocking his basilar artery, which supplies the most critical part of the brain – the brainstem. Doctors gave him the clot-busting drug, and did a procedure using a catheter inserted through a small incision near the hip to access a blood vessel. This was to remove the clot from the artery in his brain. The next day, he was sitting up in bed having his lunch.
Because incidences of brain disorders like Case 1 happen too often, the
National Neuroscience Institute (NNI), a member of the
SingHealth group, is keen to advise patients to act more quickly. “If people come in beyond that time window, the blockage would’ve already caused permanent damage to the brain,” said
Dr Carol Tham, Consultant,
Department of Neurology, NNI.
Stroke: Heed warning signs
“There have been many advances in stroke treatment over the past few years. Such miraculous recoveries wouldn’t have been possible 10 or 15 years ago,” said Dr Tham.
She advises patients
not to dismiss mini strokes or transient ischaemic attacks (TIAs) – where symptoms are mild and subsequently subside – because they are a harbinger of a fullblown stroke.
“We’ve seen patients who have had TIA s for a day or two, but didn’t come to the hospital until they had a big stroke, which is sometimes too late. If they’d come earlier, we could’ve started them on blood thinners to reduce the risk, and monitored them.”
She said patients with stroke symptoms should not go to bed hoping the symptoms will subside. They should call an ambulance, even while waiting for family members to return home. Also, neither they nor their family members should drive to the hospital.
To recognise symptoms, use the global acronym “FAST”.
F is for facial weakness or droop
A for arm weakness
S for speech difficulty or slurring
T for time to call 995 for an ambulance
Parkinson’s disease: Early diagnosis helps
There is currently no cure for Parkinson’s disease, but an early diagnosis can improve the patient’s quality of life.
Hand tremors is the first sign of the illness in some patients. In others, it could be difficulty walking, where the person takes small steps and trips or falls easily, even when the ground is flat. He ends up not going out because he is always trailing after others.
Caused by a lack of dopamine in the brain, some patients mistake its symptoms for old age, but a neurologist can confirm the diagnosis and ensure early treatment.
Medication can improve gait, help prevent them from falling, and enable them to carry on with their daily activities, said Dr Tham.
Read on to learn
how to detect the early symptoms of dementia and epilepsy - two other common brain diseases.