Dr Sudhir Kumar - Neurologist

24/10/2025

Migraine in Children: How It Differs from Adults
How Common Is It?
*Migraine affects about 8–10% of school-age children and up to 20% of adolescents.
*It can occur even in preschool years, though diagnosis may be difficult since young children can’t describe their symptoms well.
*Before puberty, boys and girls are equally affected, but after puberty, migraine becomes more common in girls due to hormonal factors.

How does migraine in children differ from that of adults?
1. Headache episodes are shorter in children, lasting 1-2 hours (in adults they last 4-72 hours)
2. Headaches are usually bilateral in children (involving front of head or temples); adults can have ones-sided headaches more commonly
3. Features of nausea, vomiting and abdominal pain are more common in children.

Common Migraine Triggers in Children
1. Many are similar to adults, but emotional and lifestyle triggers play a stronger role in children:

*Irregular sleep patterns-sleeping too little or too much
*Skipped meals or dehydration
*Stress, exams, or emotional tension
*Certain foods — chocolate, cheese, processed meats, and caffeine
*Bright lights, loud noise, or prolonged screen time
*Travel, motion sickness, or changes in routine
*Hormonal changes in adolescents

If your child has feartures of migraine, consult a doctor, as it can be easily managed.

Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube.

23/10/2025

Here are the three top causes of memory loss that are fully reversible when treated promptly:

1. Depression (“Pseudodementia”)
*In some people, especially older adults, depression can mimic dementia, causing poor concentration, forgetfulness, and lack of motivation.
*Once the depression is treated through counselling, antidepressants, or both, memory and thinking usually return to normal.
*Clue: The person is more bothered by their memory lapses than their family is, and symptoms fluctuate with mood.

2. Vitamin B12 Deficiency
*Vitamin B12 is essential for healthy nerve and brain function.
*Deficiency can cause forgetfulness, confusion, and tingling or numbness in hands and feet.
*Treatment with B12 supplements or injections restores memory and nerve function in most cases, if given early.
*Clue: Common in vegetarians, vegans, and those on long-term metformin or acid-suppressing drugs.

3. Hypothyroidism (Underactive Thyroid)
*Low thyroid hormone levels slow down metabolism, including brain activity, leading to mental fog, poor memory, and fatigue.
*Once diagnosed with a simple blood test and treated with thyroxine replacement, memory and alertness fully recover.
*Clue: Look for associated symptoms like weight gain, dry skin, and feeling unusually cold or sluggish.

✅ In short:
The top reversible causes of memory loss are depression, vitamin B12 deficiency, and hypothyroidism- all treatable with full recovery if recognised early.

Here are the three top causes of memory loss that are fully reversible when treated promptly:1. Depression (“Pseudodementia”)*In some people, especially olde...

22/10/2025

🧠 Mothers, take note:
Low B12 during pregnancy isn’t just a nutrient issue; it may mean smaller brain size and slower cognitive growth in your child.
Early action matters. Make B12 a priority.
1. Maternal B12 deficiency is a risk factor for impaired brain development and lower cognitive outcomes in offspring.
2. There is suggestion of structural brain effects (e.g., smaller volumes, altered neuronal architecture) but human proof is still emerging.
3. Because brain development begins very early (first trimester and even pre-conception), ensuring adequate maternal B12 from very early on is biologically sensible.

21/10/2025

Both drug and non-drug (lifestyle and behavioral) measures play major roles in migraine prevention.
Here are the details about their relative contribution:
Drug therapy (preventive medicines)
1. Typically reduces migraine frequency by 40–60%, and often shortens the duration and severity of attacks.
2. Common options include propranolol, amitriptyline, topiramate, flunarizine, and CGRP antagonists.
3. However, these drugs work best when combined with healthy habits and many patients discontinue due to side effects.

Non-drug (lifestyle and behavioral) measures
*Clinical studies show that consistent lifestyle changes can reduce migraine frequency by 30–50%, sometimes even matching the effect of preventive drugs.
*The most evidence-backed interventions include:
1. Regular sleep (7–9 hours): Poor or irregular sleep is one of the strongest triggers.
2. Regular meals: Skipping or delaying meals can directly precipitate attacks.
3. Stress management (relaxation, meditation, yoga, CBT, biofeedback) has been shown to reduce attack frequency by up to 45%.
4. Exercise: Moderate aerobic activity 3–5 times a week can lower migraine frequency like propranolol in some studies.
5. Trigger avoidance: Avoiding personal food or environmental triggers significantly reduces attack frequency in sensitive individuals.

Overall takeaway:
*On average, non-drug measures alone can achieve about 60–80% of the benefit that preventive medications provide.
*When both are used together, their effects are additive and complementary, leading to the best control, with fewer relapses and less medication use.

✅ Bottom line for patients:
Lifestyle consistency, especially good sleep, stress control, and regular exercise, can sometimes be as powerful as medication for long-term migraine prevention, and should always be the foundation of treatment.

Both drug and non-drug (lifestyle and behavioral) measures play major roles in migraine prevention.Here are the details about their relative contribution:Dru...

19/10/2025

The two most common causes of pain and burning in the feet are:
1. Diabetes (Diabetic Neuropathy)
*Most common cause overall.
*High blood sugar over time damages the small nerves of the feet, leading to burning, tingling, numbness, or electric-like pain, often worse at night.
*These symptoms can occur in people with prediabetes also; and can sometimes be the first (presenting) symptom of diabetes or prediabetes.
*It usually starts in the toes and progresses upward in a “stocking” pattern.
*Diagnosis can be made by testing for HbA1C, fasting blood sugar and oral glucose tolerance test (in selected cases).

2. Vitamin B12 Deficiency (Nutritional Neuropathy)
*Second most frequent cause, especially in vegetarians, vegans, or people taking metformin or acid-lowering medicines.
*Leads to nerve damage causing burning, pins-and-needles, and sometimes balance problems or numbness in both feet.
*Diagnosis can be made by testing for vitamin B12 level.

Treatment
1. Treatment of underlying cause- diabetes or vitamin B12 deficiency, as the case may be.
2. Treatment of symptoms with medications such as gabapentin, pregabalin or duloxetine.

The two most common causes of pain and burning in the feet are:1. Diabetes (Diabetic Neuropathy)*Most common cause overall.*High blood sugar over time damage...

19/10/2025

Runners love Sundays, not to get two hours of extra sleep, but to wake up early and complete that long run- Sunday Long Run (SLR).

Today's run was fun, as I had the company of several runners along the way. Weather was good in the first half, though it got hotter in the second half.

I ran on the shaded cycling/running track, which has facilities for chilled drinking water as well as clean toilets.

From my first half marathon in Jan 2021 (50th year of my life) to 149th HM today, I have really enjoyed my running journey.

Runners love Sundays, not to get two hours of extra sleep, but to wake up early and complete that long run- Sunday Long Run (SLR).Today's run was fun, as I h...

18/10/2025

Minimum effective doses of exercise proven to give meaningful health benefits, even for busy people

1. Walking
*Minimum effective dose: 20–25 minutes per day (≈ 150 minutes per week of brisk walking).
*Health benefits: Reduces risk of heart disease, diabetes, stroke, depression, and early death by 20–30%.
*Short on time? Even 10 minutes after each meal or 3 brisk 10-minute walks per day provide measurable benefits.

2. Running
*Minimum effective dose: 5–10 minutes per day (≈ 50 minutes per week) of slow-to-moderate running.
*Health benefits: Lowers cardiovascular and all-cause mortality risk significantly — even at low doses.
*Key point: More is not always better; consistent, moderate running yields the best longevity benefit.

3. Daily Step Count
*Minimum effective dose: Around 6,000–8,000 steps per day for adults.
*Health benefits: Noticeable reduction in heart disease, cancer, and overall mortality risk.
*Bonus: Every extra 1,000 steps adds incremental benefits up to about 10,000–12,000 steps/day.

4. Strength Training
*Minimum effective dose: 2 sessions per week, about 20–30 minutes each, covering major muscle groups.
*Health benefits: Improves muscle and bone strength, metabolism, blood sugar control, and longevity.
*Even once per week gives measurable benefit compared to doing none.

✅ In short:
If you can manage 20–25 minutes of brisk walking daily or 10 minutes of running, plus 2 short strength sessions weekly, you are already getting most of the proven health benefits of regular exercise.

Minimum effective doses of exercise proven to give meaningful health benefits, even for busy people 1. Walking*Minimum effective dose: 20–25 minutes per day ...

17/10/2025

Which Diet Is Best for Vitamin B12?

Vitamin B12 is essential for healthy nerves, red blood cells, and brain function but where you get it from depends on your diet.

*If you are vegan (eating only plant-based foods)- you are not getting any natural vitamin B12, because plants don’t make or store B12. You will need to take B12-fortified foods or supplements regularly.

*If you are vegetarian and include milk, curd, paneer, or cheese, you can get moderate amounts of B12, but still, many vegetarians have low levels and may need supplementation.

*If you are non-vegetarian, eating eggs, fish, chicken, or meat, you are getting abundant natural B12.

⚠️ However, even people who eat animal-based foods can become deficient if their stomach or intestines don’t absorb B12 properly, as can happen with age, certain medicines (like metformin or acid blockers), or digestive diseases.

✅ Bottom line:

Vegans---must take B12 supplements.

Vegetarians---may need supplements.

Non-vegetarian--- usually get enough, unless absorption is poor.

Which Diet Is Best for Vitamin B12?Vitamin B12 is essential for healthy nerves, red blood cells, and brain function — but where you get it from depends on yo...

16/10/2025

All types of exercises are associated with a lowering of blood pressure, however, different types of exercise influence blood pressure (BP) in distinct ways.

Here are the details:
1. Isometric exercises (wall sit, plank, handgrip)
*Best for lowering both systolic and diastolic BP.
*Average reduction: ~8–10 mmHg systolic and ~5–6 mmHg diastolic.
*Most effective protocols: 4 sets of 2 minutes wall sits or handgrip holds, 3 times per week.
*Mechanism: improves vascular function, reduces sympathetic tone, enhances nitric oxide release.

2. Aerobic exercises (running, cycling, brisk walking)
*Also very effective, especially for overall cardiovascular health.
*Typical reduction: ~5–7 mmHg systolic, ~3–5 mmHg diastolic.
*Works through improved endothelial function, reduced arterial stiffness, and weight/fat reduction.

3. Yoga
*Yoga modestly reduces BP- Systolic BP by 5-7 mmHg, and Diastolic BP by 3-5 mmHg
*The benefit is greatest when yoga programs include meditation, breathing, and relaxation components, not just physical postures (asanas).
*Mechanism:
-Lowers sympathetic nervous system activity (reduces stress hormones like adrenaline and cortisol)
-Improves endothelial function and heart rate variability
-Promotes weight reduction and better sleep

4. Dynamic resistance training (weights, resistance bands)
*Has modest effect: around 2–4 mmHg reduction, though it helps build muscle and improve insulin sensitivity.

All types of exercises are associated with a lowering of blood pressure, however, different types of exercise influence blood pressure (BP) in distinct ways....

16/10/2025

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/vitamin-b12-deficiency-these-common-medications-are-the-hidden-cause-top-doc-says/articleshow/124541324.cms

A top Indian neurologist warns that common medications like Metformin and proton pump inhibitors (PPIs) can silently deplete Vitamin B12 levels. This

16/10/2025

https://economictimes.indiatimes.com/magazines/panache/46-year-olds-mysterious-facial-pain-solved-salman-khan-battled-it-too-apollo-doctor-decodes-rare-condition-causing-this/articleshow/124556100.cms?from=mdr

A 46-year-old man who suffered sharp, recurring pain on one side of his face for a year was diagnosed with secondary trigeminal neuralgia, a rare nerve disorder also experienced by actor Salman Khan. Dr. Sudhir Kumar, senior neurologist at Apollo Hospitals, revealed that an MRI scan showed a cerebel...

16/10/2025

https://economictimes.indiatimes.com/magazines/panache/apollo-doctor-warns-two-common-medicines-that-affect-vitamin-b12-absorption-in-the-body/articleshow/124531947.cms?from=mdr

Long-term use of certain common medications, including metformin for diabetes and proton pump inhibitors (PPIs) for acidity, can reduce the bodys absorption of vitamin B12, warns Dr. Sudhir Kumar, a senior neurologist at Apollo Hospitals, Hyderabad. Deficiency may lead to fatigue, tingling, numbness...