Loading…
Loading…
Evidence-based deep dives authored by our consultant team — neurology by Dr. Jitendra Prasad Yadav (MBBS, MD (Internal Medicine), FICN (Neurology), FCNV, FIHM, NMC 8029), psychiatry & CBT by Dr. Ruja Shrestha (NMC 19766). Each topic follows international guidance and links to clinic services.
24 authoritative topics
All topics are authored and medically reviewed by the consultant who wrote them.
Chronic migraine is defined by headache on ≥15 days/month for >3 months with migrainous features on ≥8 days. At Kathmandu Neurology Clinic & Cognitive Center, Dr. Jitendra Prasad Yadav (NMC 8029) applies ICHD-3 criteria, headache-diary analysis, medication-overuse review and red-flag screening to separate chronic migraine from tension-type, cluster and secondary headaches.
Read topic →
vestibularNot all dizziness is ear disease. Vestibular migraine presents with recurrent vertigo lasting minutes to days, often with photophobia or migraine history, while BPPV is brief rotational vertigo triggered by rolling over or looking up. Dr. Jitendra evaluates positional testing, migraine history and central red flags to guide next steps.
Read topic →
cognitive-neurologyMCI is objective cognitive impairment (typically 1–1.5 SD below norms) with preserved functional independence and no dementia. Annual conversion to dementia is 10–15% in clinic samples vs 1–2% in cognitively normal elders. Dr. Jitendra uses MoCA/MMSE, informant history and subtype classification (amnestic vs non-amnestic) to plan follow-up at the clinic.
Read topic →
behavioral-neurologyPrefrontal circuits mediate planning (dorsolateral), reward/social control (orbitofrontal) and initiation (medial/cingulate). Lesions produce executive failure, disinhibition or apathy respectively. Dr. Jitendra evaluates informant history, FAB/MoCA and MRI volumetry to localize and prognosticate.
Read topic →
epilepsyA first unprovoked seizure warrants careful history (witness account, video if available), neurological exam and risk stratification. Dr. Jitendra discusses EEG, MRI, recurrence risk, driving/lifestyle advice and when medication is indicated — decisions shared with patient and family, not protocol-driven.
Read topic →
cerebrovascularTIA is a transient focal deficit with no infarct on imaging — yet 10–20% have stroke within 90 days, half within 48 hours. Dr. Jitendra emphasizes rapid evaluation, ABCD2 risk, antithrombotic/antihypertensive/statin secondary prevention and rehabilitation planning at the clinic.
Read topic →
headache-medicineMedication-overuse headache (MOH) affects roughly 1–2% of the general population and up to half of chronic headache clinic attendees. It develops when acute headache medications — simple analgesics on ≥15 days/month or triptans, opioids, and combination analgesics on ≥10 days/month — are used for more than three months. Dr. Jitendra Prasad Yadav (NMC 8029) screens every frequent-headache patient at Kathmandu Neurology Clinic & Cognitive Center for MOH because it is the single most common reason preventive treatment appears to fail.
Read topic →
headache-medicineMost recurring headaches are primary disorders such as migraine or tension-type headache, but certain features raise concern for a secondary cause — bleeding, infection, raised pressure, vascular injury or tumour. Red-flag screening is systematic at Kathmandu Neurology Clinic & Cognitive Center: Dr. Jitendra Prasad Yadav (NMC 8029) applies the SNOOP framework and ICHD-3 secondary-headache logic to decide who needs urgent imaging or emergency care and who can be managed confidently without it.
Read topic →
headache-medicineTension-type headache (TTH) affects up to 80% of people at some point and is the second most disabling condition worldwide by years lived with disability. It presents as bilateral pressing or tightening pain of mild-to-moderate intensity, without the nausea and sensory sensitivity that define migraine. Because it overlaps with neck pain, stress, sleep problems and analgesic overuse, misclassification is common — Dr. Jitendra Prasad Yadav (NMC 8029) uses ICHD-3 criteria and diary review at Kathmandu Neurology Clinic & Cognitive Center to separate TTH from migraine and medication-overuse headache, since their treatments differ fundamentally.
Read topic →
cognitive-neurologyVascular cognitive impairment (VCI) spans the spectrum from mild executive slowing to vascular dementia and is the second most common cause of dementia after Alzheimer disease — yet it is also the most preventable, because its drivers are the same vascular risk factors that cause stroke. Dr. Jitendra Prasad Yadav (NMC 8029), whose practice bridges stroke medicine and cognitive neurology at Kathmandu Neurology Clinic & Cognitive Center, evaluates patients with memory or slowness concerns specifically for vascular contributions: hypertension, diabetes, atrial fibrillation, prior silent infarcts and white-matter disease.
Read topic →
cognitive-neurologySleep disorders are both neurological and systemic — chronic insomnia, obstructive and central sleep apnea, restless legs syndrome, parasomnias, circadian rhythm disorders, excessive daytime sleepiness, shift work sleep disorder and REM sleep behavior disorder frequently overlap with headache, epilepsy and cognitive concerns. Dr. Jitendra Prasad Yadav (NMC 8029), Founder of Nepal Sleep Clinic & Headache Center, Dillibazar, evaluates sleep-related neurological disorders with sleep evaluations, diagnosis, CPAP therapy management and long-term care planning — among the few physicians in Nepal actively involved in neurological sleep medicine.
Read topic →
cognitive-neurologyPeripheral neuropathy, diabetic neuropathy, radiculopathy, nerve compression syndromes, myopathy, motor neuron disorders, neuromuscular junction disorders and chronic nerve pain syndromes require careful distribution mapping, metabolic review and electrodiagnostics. Dr. Jitendra Prasad Yadav provides comprehensive diagnosis and management with EMG and NCS interpretation — distinguishing demyelinating from axonal, entrapment from generalized, and myopathic from neurogenic patterns.
Read topic →
Cognitive-behavioral therapy (CBT) is the first-line psychotherapy for generalized anxiety disorder, social anxiety, panic disorder, and specific phobias. At Dr. Ruja's clinic, treatment begins with a functional analysis of anxiety triggers, cognitive restructuring of maladaptive thoughts, and graduated exposure hierarchies. Unlike medication-only approaches, CBT addresses the maintaining factors — avoidance, safety behaviors, and catastrophic misappraisal — that perpetuate anxiety over time.
Read topic →
mood-disordersMajor depressive disorder affects over 280 million people globally and is the leading cause of disability worldwide. At Dr. Ruja's clinic, depression assessment begins with structured screening (PHQ-9), thorough differential diagnosis (medical mimics, bipolar screening, grief), and risk stratification for self-harm. Treatment follows a stepped-care model: mild depression with watchful waiting and behavioral activation; moderate depression with psychotherapy ± pharmacotherapy; severe depression with combined treatment and closer monitoring.
Read topic →
traumaPost-traumatic stress disorder develops in 5–10% of trauma-exposed individuals, characterized by intrusive re-experiencing, avoidance, negative alterations in cognition and mood, and hyperarousal. Dr. Ruja's approach follows the International Society for Traumatic Stress Studies (ISTSS) phased model: safety and stabilization first, then trauma processing (PE, CPT, or EMDR), then reconnection and meaning-making. Complex PTSD and dissociative presentations require extended stabilization before trauma-focused work.
Read topic →
child-psychiatryChild and adolescent mental health disorders affect 10–20% of young people globally, yet most conditions are under-diagnosed until adolescence or adulthood. At Dr. Ruja's clinic, assessment integrates developmental history, school functioning, family dynamics, peer relationships, and collateral information from caregivers and teachers. Treatment modalities are adapted to developmental stage: play therapy and parent management training for young children; CBT and family therapy for adolescents; and careful pharmacotherapy when evidence supports it.
Read topic →
addictionSubstance use disorders affect over 36 million people globally and carry high mortality from overdose, medical complications, and suicide. Dr. Ruja's clinic provides integrated dual-diagnosis treatment, recognizing that addiction rarely occurs in isolation — depression, PTSD, ADHD, and personality disorders frequently co-occur and must be treated simultaneously. Treatment combines medication-assisted treatment (MAT), motivational interviewing, relapse prevention therapy, and harm reduction principles.
Read topic →
anxiety-disordersObsessive-compulsive disorder affects 2–3% of the population and is characterized by intrusive, distressing thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed to reduce anxiety. Dr. Ruja's clinic specializes in exposure and response prevention (ERP), the gold-standard psychotherapy for OCD. Unlike generic anxiety management, OCD requires targeted interventions that break the obsession-compulsion cycle through deliberate, sustained exposure to the feared stimulus without performing the ritual.
Read topic →
mood-disordersBipolar disorder affects 1–2% of the population and carries significant mortality from suicide, medical comorbidity, and functional impairment. Accurate diagnosis distinguishes bipolar I (mania), bipolar II (hypomania + depression), and cyclothymia from unipolar depression — a critical distinction because antidepressants can destabilize bipolar patients. Dr. Ruja's clinic emphasizes mood charting, long-term pharmacotherapy (lithium, valproate, lamotrigine, atypical antipsychotics), and psychoeducation for adherence and early warning sign detection.
Read topic →
sleep-psychiatrySleep disturbance is both a symptom and a maintaining factor in virtually every psychiatric disorder. Insomnia increases depression risk 2–3-fold, worsens anxiety and PTSD, and is a prodromal marker of mania. Dr. Ruja's clinic treats sleep as a primary therapeutic target, not merely a secondary complaint. CBT for insomnia (CBT-I) is first-line, with pharmacotherapy reserved for severe or treatment-resistant cases. Addressing sleep often improves psychiatric outcomes more rapidly than treating the psychiatric condition alone.
Read topic →
geriatric-psychiatryMental health disorders in older adults are under-recognized and under-treated, yet depression affects 10–15% of community-dwelling elders and up to 30% of those in residential care. Delirium affects 10–30% of hospitalized medical patients and is a psychiatric emergency. Dr. Ruja's clinic provides comprehensive geriatric psychiatric assessment: differential diagnosis of depression vs dementia vs delirium, medication review for anticholinergic burden and polypharmacy, behavioral management of dementia-related agitation, and caregiver psychoeducation and support.
Read topic →
women-mental-healthWomen experience depression and anxiety at twice the rate of men, with onset often linked to hormonal transitions: premenstrual, perinatal, and perimenopausal periods. Perinatal mental health disorders affect 10–20% of mothers and have profound effects on infant bonding, development, and family functioning. Dr. Ruja's clinic provides gender-informed psychiatric care: screening for PMDD, perinatal depression and anxiety (Edinburgh Postnatal Depression Scale), postpartum psychosis risk assessment, and hormone-related mood disorders with integrated treatment plans.
Read topic →
stress-burnoutBurnout is recognized by the WHO as an occupational phenomenon characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment. It affects 20–30% of working adults and has significant psychiatric consequences: depression, anxiety, substance use, cardiovascular disease, and immune dysfunction. Dr. Ruja's clinic treats burnout as a systemic problem requiring assessment of workload, recovery capacity, boundary integrity, and meaning in work — not merely stress management techniques.
Read topic →
psychotherapyPsychotherapy encompasses a diverse range of evidence-based treatments, each with specific mechanisms of action, indications, and evidence bases. No single therapy is universally superior — the best approach depends on diagnosis, severity, patient preference, and therapeutic alliance. Dr. Ruja's clinic draws from multiple modalities: cognitive-behavioral therapy (CBT) for anxiety and depression, dialectical behavior therapy (DBT) for emotion dysregulation, interpersonal therapy (IPT) for relationship-focused presentations, EMDR for trauma, and acceptance and commitment therapy (ACT) for experiential avoidance. The clinic emphasizes measurement-based care and transparent discussion of what each therapy offers.
Read topic →
Authority topics are structured, evidence-based deep dives into specific neurology conditions. Each topic is authored and medically reviewed by Dr. Jitendra Prasad Yadav (MBBS, MD (Internal Medicine), FICN (Neurology), FCNV, FIHM), drawing on 15+ years of clinical experience of clinical practice at National Trauma Center (NAMS) and Kathmandu Neurology Clinic.
Unlike general health articles, authority topics follow international diagnostic criteria — ICHD-3 for headache disorders, AAN guidelines for neurodegenerative conditions, and WHO classifications for epilepsy and stroke. They are designed to bridge the gap between specialist knowledge and patient understanding.
Neurology conditions are complex and often misunderstood. Patients frequently encounter fragmented information online that lacks clinical context. Authority topics provide a single, reliable reference point where patients can learn about their condition, understand diagnostic criteria, explore treatment options, and know when to seek urgent care.
Each topic links directly to relevant clinic services, appointment booking, and related blog posts — creating a clear path from education to action. This approach supports informed conversations between patients and their neurologist.
Each topic is authored by a consultant neurologist with 15+ years of specialist experience, follows international diagnostic criteria (ICHD-3, AAN, WHO), and is medically reviewed before publication. Content links to clinic services and is regularly updated as guidelines evolve.
No. These topics are educational and designed to help you understand conditions, prepare for appointments, and have informed discussions with your clinician. Diagnosis requires a personal neurological examination, history, and sometimes investigations — none of which can be replaced by reading alone.
Topics are reviewed periodically and whenever major guideline updates are published. If you notice outdated information, please contact the clinic so it can be reviewed and corrected promptly.
Content on this website is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified healthcare professional. Always seek the advice of your physician or other qualified provider with any questions regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this website. In case of a medical emergency, contact emergency services immediately. No doctor–patient relationship is established by use of this site or by contacting the clinic through the site.