Neurology and Sleep Archives - Dr. V. Sharma’s Neurology

ADHD: Far From a Hopeless Case

V Sharma MD — Tue, 24 Mar 2026 19:23:44 +0000

and Ahmet Cengiz

Attention-Deficit/Hyperactivity Disorder, more commonly known as ADHD, has become a significant issue in modern society. What many once believed to be simply a personality issue that challenged daily life is now becoming clearer, through increasing research in the field, as a complex medical condition. While many people use this term to self-diagnose or to describe various symptoms, what is ADHD really, and how does it present in patients?

What is ADHD and who is affected by it?
ADHD is a common neurological disorder that presents with multiple symptoms related to inattention, hyperactivity, and impulsivity. According to a study that examined patients between the years 2000 and 2010, ADHD diagnoses increased by 66%. According to CDC, an estimated 15.5 million Americans were diagnosed with this disorder in 2023.

These numbers have likely increased due to greater awareness of ADHD and may also be higher because of the difficulties associated with diagnosing the condition. While most people are diagnosed during childhood, many adults of different ages and ethnic backgrounds also suffer from this disorder and can improve their daily life activities with proper treatment.

What happens in the brain during ADHD?
It is believed that altered, and most likely increased, connectivity in brain networks, along with an imbalance in dopamine levels, affects attention, motivation, and impulse control in patients. ADHD also affects the development of the prefrontal cortex in younger patients, which is the brain’s executive center responsible for emotions and planning, among other functions. This can cause hyperactivity, attention deficits, poor task completion, restlessness, and difficulties with motivation. In other words, individuals with ADHD experience physical and hormonal differences rather than purely psychological ones.

Is ADHD a genetic disease?
According to the studies, about 74% of ADHD cases can be attributed to genetics. There are also other studies that show an even higher prevalence.

Can you self-diagnose?
Subjective comments play a major role in diagnosing ADHD. While patients can easily identify common ADHD symptoms in themselves, an official diagnosis requires a qualified professional who can use computerized tests and detailed evaluations to diagnose patients.

Is it curable?
While ADHD is not a curable condition, there are treatments that can help significantly in managing it. A professional can help patients learn to control ADHD symptoms and may prescribe FDA-approved stimulant and non-stimulant medications. Common ADHD medications include Adderall, Vyvanse, and Ritalin. Medications are best managed with the help of a professional, often using different combinations of treatments depending on a patient’s medical history and daily activities. It often requires monthly appointments to monitor progress.

While ADHD causes many difficulties in patients’ lives through its symptoms, it is not a hopeless case, and ongoing scientific developments promise better living conditions for patients

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Must Diagnose to Treat: Common Types of Headaches Causing Distress to Millions

V Sharma MD — Fri, 11 Jul 2025 18:01:14 +0000

and Ahmet Cengiz

Headaches are one of the most common health complaints around the world. A study by the World Health Organization (WHO) showed that headache disorders are among the top three most common neurological disorders. While there are many people who use the word headache to describe their condition, headache is a general term for different disorders. The most common types of headaches are: Migraines, Cluster Headaches, Sinus Headaches, and Tension Headaches.

Migraines
Migraines are one of the most common types of headaches. It is estimated that around 15% of Americans suffer from this disease. They are defined as episodic headaches that cause throbbing, pulsing, or pounding head pain. It is generally on one side of the head or worse on one side.

Migraines generally last between 4 hours to 72 hours with severity of any level.

In many people, they are triggered or worsened by factors like bright lights, physical activity, stress, menstruation cycle, loud noises, strong odors, and certain foods/drinks.

For example, according to the American Migraine Foundation, alcohol can cause an attack between 30 minutes to three hours of consumption. Furthermore, certain types of alcohol are also more likely to trigger migraines. Other such foods that have been known to trigger migraines are coffee, chocolate, processed food, etc.

There are multiple types of migraines, and migraines often are accompanied by other symptoms such as mood changes, difficulty concentrating, sleep difficulties, fatigue, vomiting/nausea, frequent urination, muscle weakness, visual change, tinnitus (ringing of ears), etc.

Frequency, type, and patterns of migraines will vary in patients. There are no specific tests to diagnose migraines. However, experienced providers can diagnose migraines through patient’s symptoms, genetic history, physical/neurological exams, and imaging that will eliminate other factors.

The best treatment for migraines includes avoiding triggers and having a healthy lifestyle. There are multiple migraine medications that are Over-the-Counter (OTC) and prescribed, and can be used to deal with the pain caused by the migraines.

Cluster Headaches
Cluster headaches affect 1 in 1000 people and can show symptoms similar to migraines. However, they also differ in some points. They are named after the fact that they come in “groups”. They are generally like piercing pain on one side of the head accompanied by a sharp pain in the eye.

They generally last 30–90 minutes and happen multiple times during the day. However, unlike most headaches, what defines them is their onset. They are sudden and occur in a matter of minutes. This makes them difficult to prepare for and requires patients to be more careful with triggers.

These headaches are the result of a sudden release of histamine or serotonin in the body, which may be caused by triggers such as emotions, allergies, tobacco, alcohol, and certain foods. However, they can also be due to dysfunction in the brain or genetic make-up.

Cluster headaches can be diagnosed by neurologists through physical examination and ruling out of other conditions through imaging.

These types of headaches can be very severe and require attention to avoid intense pain. OTC drugs are not effective most of the time. Medications prescribed by neurologists can help with pain and frequency of these headaches.

Sinus Headaches
Sinus headaches are uncommon types of headaches that are often misdiagnosed. According to one research, 88% of participants who reported they had sinus headaches actually had migraines. These headaches are caused by sinusitis or sinus infection. They generally present as dull pain behind the eyes, around the nose, and the forehead.

The duration of sinus headaches is mostly dependent on treatment of sinusitis, which can take days. Triggers may include allergies and illnesses causing sinusitis.

Imaging such as CTs will show whether there is an inflammation or blockage in one’s sinuses.

These types of headaches are generally treated with decongestants or antihistamines. Treating the sinusitis will resolve the headaches. Prolonged headache without sinus symptoms may be a sign of tension headaches or migraines.

Tension Headaches
Tension headaches are the most common types of headaches that present as dull, pressure-like aching pain around the head. They generally affect both sides of the head at the same level and are bothersome rather than unbearable, which makes them differ from migraines.

They generally last at least two hours, but can last shorter or longer.

Like other types of headaches, these headaches also have triggers. Many researchers believe these headaches are caused by muscle strains. For example, neck strains due to one’s position can trigger these headaches. Other triggers can include anxiety, depression, and sleep difficulties.

These headaches can be diagnosed by neurologists with examination and can require imaging that might reveal an underlying condition causing the headaches.

Both OTC medications and prescribed medications can help deal with this condition. Other treatments may include treating the triggers of these headaches like depression/anxiety, sleep difficulties, neck conditions, etc.

Headaches have been a part of our lives for a long time. However, with the advancements in medicine, they can be dealt with through help. As mentioned above, all of these headaches can be managed with changes in our lifestyles. For those suffering more, medications can be beneficial. However, to deal with the symptoms, one must first know the issue. Neurologists can help with diagnosing your condition and guide you in managing the headaches.

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Balance and Fall Prevention

V Sharma MD — Mon, 24 Mar 2025 18:02:46 +0000

As we grow older, maintaining balance becomes increasingly important—but also more challenging. A decline in balance is a normal part of aging, yet it’s one of the most significant risk factors for falls, injuries, and loss of independence. The good news? There are strategies you can use right now to improve your balance and reduce your risk.

Why Balance Matters

Balance isn’t just about muscles—it involves your brain, nervous system, vision, inner ears (vestibular system), and sensory input from your feet and joints. When one or more of these systems weakens, your stability can suffer.

Fortunately, the brain has remarkable plasticity, meaning it’s never too late to improve coordination and stability through targeted exercises.

A Simple Exercise to Try: “The Clock”

One of the easiest and most effective balance exercises is what doctors often refer to as the “Clock” technique. It works your proprioception (sense of body position), leg strength, and coordination.

How to do it:

Stand on a flat, stable surface near a wall or sturdy chair for support.
Stand on one leg and imagine you’re in the center of a clock face.
Slowly extend your free leg toward 3 o’clock, then bring it back to the center.
Repeat for 6 o’clock, 9 o’clock, and so on—switching legs as needed.

This exercise not only challenges your balance but also activates your brain by engaging multiple systems at once.

Other Activities

Incorporate these practices into your weekly routine:

Tai Chi – Improves coordination and focus.
Yoga – Builds core strength and flexibility.
Pilates – Enhances postural control.
Resistance Training – Strengthens key muscle groups for stability.

These activities have been shown to reduce fall risk and promote better neuromuscular control.

Safety Starts at Home

Many falls occur not because of physical weakness, but due to environmental hazards or poor preparation. We would recommend the following home safety checks:

Install grab bars in the bathroom.
Use non-slip mats on tile and wood floors.
Ensure handrails are sturdy and reachable.
Keep pathways, especially to the bathroom, clear and well-lit.
Store frequently used items within easy reach.

Consider Assistive Devices Without Shame

Some people resist using canes or walkers out of pride or fear of appearing frail. But these tools can prevent serious injuries. It’s far better to use a cane with confidence than risk a life-changing fall.

Know When to Seek Help

If you notice your gait has become uneven, or you feel unsure on your feet, it’s important to consult a healthcare professional. A physical therapist or neurologist can:

Evaluate your balance systems.
Identify any deficits in sensory processing or muscle strength.
Design a tailored exercise program to reduce your risk of falling.

Proactive, Not Reactive

The key to preventing falls is being proactive. Don’t wait until an accident happens to start caring about balance. With regular practice, attention to your surroundings, and a commitment to staying active, you can improve your stability and maintain your independence for years to come.

Remember: Healthy balance is a lifelong skill—and with a little intention and practice, it’s a skill you can always improve.

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Understanding Dementia: A Quick Guide to Alzheimer’s Disease

V Sharma MD — Fri, 21 Mar 2025 18:16:58 +0000

Dementia is a general term for a decline in memory, thinking, and reasoning skills that interferes with daily life. The most common cause is Alzheimer’s Disease—a progressive condition that affects millions of older adults, typically over age 65.

What Is Dementia?

Unlike normal aging, dementia involves significant changes in memory, language, judgment, and behavior. Alzheimer’s gradually damages brain cells, leading to increasing challenges with daily tasks and independence.

How Alzheimer’s Affects the Brain

In Alzheimer’s, abnormal protein buildup disrupts brain cell communication and function. Over time, this leads to shrinkage of brain tissue, memory loss, confusion, and behavioral changes.

Common Signs and Stages

Early signs include forgetting recent events, repeating questions, or subtle personality shifts. As the disease progresses, difficulties with managing finances, navigating familiar places, or performing routine tasks become more noticeable. In advanced stages, full-time care is often needed.

Diagnosis and Risk Factors

Doctors use memory tests, brain scans, and lab work to identify dementia. Risk factors include age, family history, cardiovascular conditions, and lifestyle habits. While some risks can’t be changed, others—like staying physically and mentally active—can help reduce the likelihood of developing dementia.

Treatment and Management

Due to recent advances several medications are available that can help manage symptoms or slow progression in some individuals. Non-medication approaches—like regular physical activity, cognitive engagement, and structured routines—also play a key role in care.

Support for Families and Caregivers

Caring for someone with dementia is challenging, but you’re not alone. Many organizations offer support, education, and resources for families and caregivers. Early planning and compassionate care can greatly improve quality of life for everyone involved.

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The Intricacies of Attention and its Ties to Sleep

V Sharma MD — Sun, 02 Mar 2025 23:36:32 +0000

Attention, while a common word in our daily lexicon, is a multifaceted cognitive function. Just as sleep isn’t merely the absence of wakefulness, attention isn’t just the act of focusing. It’s a dynamic system that allows us to process the infinite stimuli around us, choosing which deserve our mental spotlight. The quality of this function, as we’ll discover, is intricately linked with sleep.

The Different Facets of Attention

Selective Attention:

Description: The ability to focus on a single stimulus while ignoring distractors.
Example: Listening to a friend at a noisy party.

Sustained Attention:

Description: The ability to maintain focus on a task over an extended period.
Example: Reading a book or watching a movie without getting distracted.

Divided Attention:

Description: The capacity to distribute attention to multiple tasks simultaneously.
Example: Driving while listening to an audiobook.

Alternating Attention:

Description: The capability to shift focus between tasks that require different cognitive skills.
Example: Switching between writing an email and attending a meeting.

How Sleep Influences Attention

Now that we’ve established an understanding of the different facets of attention, let’s explore how sleep — or the lack thereof — impacts each of them:

Sleep and Selective Attention:

Impact: Sleep deprivation hampers our ability to filter out irrelevant stimuli. This is why, after a poor night’s sleep, we might find it hard to concentrate in environments with even minor distractions.

Sleep and Sustained Attention:

Impact: A classic victim of sleep deprivation, our ability to maintain prolonged focus dwindles significantly when we’re fatigued. Tasks that require vigilance, like monitoring systems or long drives, become particularly challenging.

Sleep and Divided Attention:

Impact: Multitasking is already a challenge for the human brain, and lack of sleep further compounds this issue. Our ability to juggle multiple tasks takes a nosedive.

Sleep and Alternating Attention:

Impact: Sleep deprivation impedes our cognitive flexibility. Switching between tasks becomes slower, and we’re more prone to errors.

Why Does Sleep Have Such a Profound Effect?

Attention is governed by several brain regions, including the prefrontal cortex, which is especially sensitive to sleep deprivation. When we skimp on sleep, neurotransmitter imbalances ensue, neural pathways get disrupted, and our brain’s overall capability to process information efficiently diminishes. The result? Our attentional spotlight dims, our focus wavers, and our productivity suffers.

A Two-Way Street: How Attention Affects Sleep

While the influence of sleep on attention is evident, it’s essential to note that the relationship is bidirectional. Chronic attentional issues, especially conditions like ADHD, are often accompanied by sleep disturbances. The hyperarousal and constant mental ‘chatter’ can make it difficult to wind down, leading to insomnia or fragmented sleep.

In understanding the nuanced relationship between sleep and attention, we equip ourselves with the knowledge to improve both.

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Common Misconceptions About Sleep

V Sharma MD — Tue, 25 Feb 2025 18:53:12 +0000

As with any fundamental aspect of human life, myths and misconceptions about sleep abound. Let’s debunk some of the most common ones.

Everyone Needs 8 Hours of Sleep:

Truth: While 7-9 hours is a general guideline for adults, individual needs vary. Some people might feel rested with 6 hours, while others might require a full 9 hours. Factors like age, lifestyle, and genetics play a role.

Older Adults Need Less Sleep:

Truth: The need for sleep doesn’t necessarily decrease with age. However, older adults might sleep more lightly and for shorter time spans, leading to the perception that they need less sleep.

If You Can’t Sleep, It’s Best to Lie in Bed Until You Do:

Truth: Staying in bed while anxious about sleep can create a negative association between your bed and sleep. If you can’t sleep for more than 20 minutes, it’s often better to leave the bedroom and engage in a quiet activity until you feel sleepy.

Snoring is Normal and Harmless:

Truth: While occasional snoring can be harmless, frequent and loud snoring might be a sign of sleep apnea, a serious sleep disorder where breathing is briefly and repeatedly interrupted during sleep.

More Sleep is Always Better:

Truth: Just as there’s such a thing as too little sleep, there’s also such a thing as too much sleep. Consistently sleeping more than 9-10 hours might be indicative of an underlying health issue.

Understanding sleep’s intricacies is the first step towards improving its quality. There are implications of disrupted sleep and its impact on attention. But for now, let’s recognize sleep for what it is—a vital, active, and rejuvenating process that forms the cornerstone of our health.

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Sleep and Focus

V Sharma MD — Wed, 19 Feb 2025 14:26:34 +0000

Sleep and Focus

In the vast realm of human health, few elements are as universally recognized yet persistently overlooked as sleep. We all know we need it; we all have felt the consequences of a restless night. Yet, sleep remains an enigma, often sacrificed in the name of productivity, entertainment, or anxiety. Similarly, our ability to focus and attend to tasks is crucial, dictating our performance at work, our interactions with loved ones, and our engagement with the world. While many realize the importance of sleep and focus separately, fewer understand the intricate dance they perform together, each influencing and reinforcing the other.

Understanding the Significance of Sleep & Focus

Imagine our body as a grand symphony orchestra. Each instrument or body system plays its part, and when all components synchronize, beautiful melodies emerge. Sleep is the conductor of this orchestra. It ensures harmony, guiding the rhythm, and making sure every section is ready to play its part. A conductor ensures recuperation, rehearsals, and rest. Without sleep, our ‘musical body’ loses its rhythm, leading to a cacophony of health issues, mood disturbances, and cognitive deficits.

On the other hand, focus is our ability to play the solo, to shine when the spotlight is on us. It’s our brain’s capability to sift through numerous stimuli and decide what deserves our undivided attention. In an age of constant digital notifications, multitasking demands, and endless distractions, maintaining this focus is more challenging than ever.

The Relationship Between Sleep and Attention

Now, consider what happens when the conductor is absent or not performing at their best. The soloist struggles, the rhythm falters, and the melody loses its charm. This is the scenario in our body when sleep is compromised. The immediate victim is our attention span and cognitive sharpness.

Scientific research has continually shown the intricate link between sleep and attention. Sleep-deprived individuals often showcase symptoms akin to attention deficit disorders. Their ability to concentrate dwindles, decision-making falters, and even simple tasks seem herculean. On the flip side, individuals with chronic attention issues often suffer from disrupted sleep patterns. It’s a cycle where one feeds into the other, perpetuating a state of fatigue and distractibility.

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