Ask Dr. Jitendra — Neurology Q&A

Migraine typically presents as moderate-severe throbbing headache with nausea and/or sensitivity to light or sound, worsened by routine activity. Duration 4–72 hours. Dr. Jitendra Prasad Yadav (NMC 8029) uses ICHD-3 criteria plus your headache diary (frequency, aura, medication days) and red-flag screen to distinguish migraine from tension-type, cluster or secondary headache — not scans alone. Diary for 4–8 weeks before escalation is standard at Kathmandu Neurology Clinic.

Brief spinning on rolling over or looking up suggests BPPV (ear, seconds, positional). Recurrent vertigo lasting 5 minutes to 72 hours with photophobia or migraine history suggests vestibular migraine (brain). Persistent imbalance with slurred speech or double vision suggests central cause and is urgent. At the clinic, Dr. Jitendra performs positional testing and migraine history review before ordering vestibular tests or MRI.

Occasional name or key forgetting is common, especially with stress or poor sleep. See a neurologist when forgetfulness is noticed by family, affects work or finances, or progresses over months. Dr. Jitendra uses MoCA/MMSE, informant history and reversible-cause review (sleep, mood, B12/thyroid, medications, hearing) at the clinic. Early assessment enables planning — no drug is curative but early detection improves outcomes.

Stress does not cause migraine alone but lowers threshold and increases frequency, especially with irregular sleep and frequent analgesic use. Dr. Jitendra's approach: diary for frequency/medication days, sleep regularity, hydration, caffeine review, and comorbidity screening (anxiety, insomnia, neck pain). The clinic emphasizes measurement and continuity with the same neurologist rather than repeated scans.

No. A single unprovoked seizure is not epilepsy — epilepsy requires recurrence risk or syndrome criteria (ILAE 2014). Evaluation includes witness/video history, EEG ideally within 48 hours, and MRI when focal. Dr. Jitendra counsels on sleep, alcohol, adherence and driving per local rules, and medication only when risk justifies it.

FAST: Face droop, Arm weakness, Speech change, Time to emergency. TIA (transient deficit that resolves) is also an emergency — 10–20% have stroke within 90 days. At the clinic, secondary prevention (antiplatelet/anticoagulant, blood pressure, statin, diabetes control) and rehabilitation planning follow hospital discharge. Do not wait for an appointment if FAST signs appear.

Progressive tingling starting in both feet, especially with diabetes, B12 deficiency or chemotherapy history, suggests peripheral neuropathy. Dr. Jitendra evaluates distribution (glove-stocking), underlying cause labs, and NCS/EMG when indicated. Burnout or anxiety alone rarely causes persistent stocking numbness — targeted workup does.

Prevention is discussed after 4–8 weeks of diary shows ≥8 migrainous days/month or medication-overuse pattern. Options include lifestyle regularity, comorbidity treatment and preventive medicines selected per history and contraindications. No preventive works instantly; follow-up with the same consultant tracks days/month trend at the clinic. No fabricated success percentages are quoted.

Yes. Short or fragmented sleep impairs memory consolidation and lowers migraine threshold. Snoring with apneas fragments sleep and fragments cognition. Dr. Jitendra screens sleep duration, regularity, snoring and caffeine, and refers for sleep study when indicated — often before escalating headache or memory medicines.

Prior MRI/CT/EEG/NCS reports, medication list (including over-the-counter analgesics and caffeine), headache or symptom diary, and a family informant for memory visits. At Kathmandu Neurology Clinic (Durbar Marg, Opposite of Yak & Yeti Hotel), appointments are by booking — walk-ins subject to availability. For emergencies (thunderclap headache, FAST signs, prolonged seizure), go to emergency immediately.

Brain health reflects how well the brain functions across thinking, memory, movement, and mood. Protect it through regular exercise, vascular risk control (blood pressure, diabetes, smoking), good sleep, hearing treatment, cognitive/social engagement, and avoiding smoking. Dr. Jitendra discusses brain health at Kathmandu Neurology Clinic as part of preventive neurology — no single supplement guarantees protection.

A neurologist (like Dr. Jitendra Prasad Yadav, NMC 8029) diagnoses and manages brain and nerve conditions medically; a neurosurgeon operates on brain and spine. Most headaches, vertigo, neuropathy, epilepsy, and memory concerns start with neurology; surgery is considered only for specific structural causes.

Vertigo is spinning. Dizziness is broader — lightheaded, faint, unsteady. Vertigo often indicates vestibular dysfunction (inner ear or brain) and is typically triggered by head position change, while lightheadedness often reflects blood pressure, dehydration, or medication effects. Duration and triggers guide evaluation — brief positional spinning suggests BPPV (ear).

Keep the person safe: ease them to the ground, turn onto side, clear nearby objects, do not put anything in mouth, time the event. If seizure lasts over 5 minutes, repeats without recovery, or breathing is impaired, call emergency. Afterward, arrange neurology evaluation with witness/video history for Dr. Jitendra.

Prevention without daily medication focuses on trigger stewardship: regular sleep and meals, hydration, stress management, limiting caffeine and analgesic overuse, and treating coexisting anxiety, depression, or sleep disorders. For frequent migraine, Dr. Jitendra discusses diary-based preventive options where appropriate — but lifestyle regularity is the foundation.