Epilepsy is a condition where people have seizures or ‘fits’. Seizures may present in many forms but are due to bursts of electrical activity within the brain. The problem can be with the electricity of the brain on its own or due to some underlying structural lesion of the brain. Anyone can have a seizure if the stimulus is great enough to exceed a threshold in the brain. Factors such as fever, changes in blood chemistry, anxiety, sleep deprivation or alcohol may influence the onset of a seizure. Although some disorders and traumas play a role in developing epilepsy most people who have epilepsy have no known reason. A seizure may present as a convulsion, unusual body movement, a change in awareness or simply a blank stare. The person may be unconscious or completely unaware of what is happening. What type of symptoms people have depends on what part of the brain is involved. The diagnosis of epilepsy is made on the basis of the history so it is useful when you come to clinic if someone who has witnessed an event can come with you. Depending on your symptoms and examination findings you may undergo an EEG test and/or an MRI of your brain to aid in the diagnosis and planning of treatment. Not everyone needs these tests and the doctor will talk with you about what is needed. Epilepsy is usually treated with medication to prevent seizures. There will also be implications for driving if you are diagnosed with this condition, as it needs to be well controlled before you can drive. Your doctor will discuss this with you. For more information visit www.epilepsy.org.nz

Parkinson's disease is a disorder of the brain characterised by shaking (tremor), slowing of movement and difficulty with walking and coordination. The disease is due to progressive deterioration of the cells in the part of the brain that controls muscle movement. The disorder may affect one or both sides of the body, with varying degrees of loss of function. Symptoms include: shaking (not always present), stiffness, loss of balance, shuffling walk, slow movements, difficulty initiating any voluntary movement, muscle aches and pains, reduced ability to show facial expressions, voice or speech changes, difficulty writing (may be small and hard to read), difficulty with any activity that requires small movements. Diagnosis is usually made on the history and with an examination, with no need for further testing unless there is some uncertainty. There are some diseases that can mimic Parkinson’s disease. There is no known cure for Parkinson's disease. Treatment is aimed at controlling the symptoms. Many of the medications can cause severe side effects, so monitoring and follow-up by doctors is important. For more information about Parkinson’s disease and related conditions as well as support groups in New Zealand visit www.parkinsons.org.nz

Most headaches are not due to significant underlying problems but you may be referred if your GP is worried about the nature of your headaches or you are having difficulty controlling them with standard treatment. Migraine headaches are repeated or recurrent headaches, often accompanied by other symptoms. They can be triggered by certain factors/events/foods. In some people, a visual disturbance called an aura happens before the headache starts. Other symptoms that may precede or accompany the headache include loss of appetite, nausea, vomiting, increased sweating, irritability, fatigue, intolerance of light or noise. The headache may last several hours to days. Prior to coming to clinic for review of headaches it is useful to keep a diary. Write down: when your headaches occurred, how severe they were, additional symptoms, what you've eaten, sleep patterns, menstrual cycles, any other possible factors. There is no cure for migraine headaches but treatment is aimed at: preventing migraines from occurring, stopping the migraine once early symptoms develop, and treating the symptoms of migraine (e.g. pain, nausea).

Multiple sclerosis is a progressive disease involving the brain and spinal cord. It occurs over time in multiple sites in these two areas of the nervous system. The cause is not known but it is thought that a person’s immune system for some reason attacks the sheath that surrounds and protects nerves, causing inflammation, scarring and damage to the underlying nerves. Symptoms suffered depend on where and to what degree the nerves are affected. They include: reduced or abnormal sensation, weakness, vision changes, clumsiness, sudden loss of bladder control and vertigo. Symptoms might appear in any combination and be mild or severe. They are usually experienced for unpredictable periods of time. These symptoms alone don't necessarily indicate MS and can easily be due to other unrelated conditions. The diagnosis is made based on the history, examination and a number of tests including an MRI and sometimes a lumbar puncture. Blood tests are also looking for other conditions that can mimic the same symptoms. There is no cure for MS but several treatments are available aimed at preventing attacks, improving symptoms and slowing progression. For more information visit www.msnz.org.nz

This refers to a group of progressive disorders where there is destruction of motor neurones (the nerves that control voluntary muscle activity such as speaking, walking, breathing, and swallowing.) Symptoms include: gradual weakening, shrinking of muscles and uncontrollable twitching of the muscles. Sensation, memory and personality are not affected. The diagnosis is made with the history examination findings, nerve conduction studies and electomyography tests. There are often other tests looking for other diseases to exclude before the diagnosis is confirmed. There is no cure or treatment for MND. Physical therapy, occupational therapy, and rehabilitation improve posture, prevent joint immobility, and slow muscle weakness and wasting. There are some medicines used to treat particular symptoms. The course of disease varies depending on the type of MND and the age of onset but it is progressive. For more information see www.mndanz.org.nz