Definitions E-N

Epidural Hematoma
Blood clot located between the bone (cranium) and the dura (fibrous covering of the brain). An epidural hematoma is usually seen after head injury with an associated skull fracture. These hematomas can become large and can compress the underlying brain causing significant neurological problems. Treatment often consists of surgery or if the lesion is small, observation.

Epilepsy
Process where the patient has seizures in association with an underlying disorder. Treatment options consist of one or more medications but with some kinds of epilepsy may include surgery. Epilepsy can occur at all ages.

Essential Tremor
Disabling movement disorder consisting of shaking of one or both hands when the patient uses the hand to do something. They do not have tremor at rest. The cause is unknown. It sometimes runs in families. Treatment can consist of medication or surgery.

Facial Pain
Several types of facial pain are found in patients. One of the most common is trigeminal neuralgia (a sharp, shooting, lancinating pain on one side of the face). Other facial pains can be constant and mixed with one or more different headache syndromes. These can include cluster headache, sphenopalatine neuralgia or pain after facial injury.

Failed Back Syndrome
Patients who have had several back surgeries but continue with troublesome pain or other neurological problems. In some patients, a cause for the continuing pain is not clear. A detailed investigation should be performed to evaluate treatable causes in specific patients.

Fusion
Condition where one or more portions of the spine (vertebra) become attached to one another. A fusion can occur after a spinal fracture. Surgical fusion can be created (using specific hardware) to relieve pain or neurologic deficit caused by abnormal movement of the spine.

Geniculate Neuralgia
Severe deep ear pain. The pain is usually sharp and described as an "ice pick in the ear". However, it can be also described as a duller burning pain and can be accompanied by facial pain.

Glioblastoma
Specific malignant brain tumor. A glioblastoma is a tumor that is part of the astrocytoma cell line. It is considered a grade IV astrocytoma. A glioblastoma is a common brain tumor in adults diagnosed either with stereotactic biopsy or with an open craniotomy and partial tumor resection. Treatment often consists of radiation therapy and in some patients, chemotherapy. These tumors can cause different symptoms based upon their size and brain location.

Glossopharyngeal Neuralgia
Sharp, jabbing, electric, or shock like pain located deep in the throat on one side. It is generally located near the tonsil although the pain may extend deep into the ear. It is usually triggered by swallowing or chewing.

Headache
Discomfort felt in one or more portions of the head. There are many causes of headaches including tension headache, migraine headache, cluster headache, occipital neuralgia or trigeminal neuralgia (specific nerve related pain syndromes). Most headaches are treated with medical therapy.

Hemifacial Spasm
Involuntary twitching of one side of the face. It usually starts around the eye and slowly progresses to involve the lower face. In some patients, it starts around the musculature of the mouth and progresses up the face towards the eye. The muscles in the forehead and neck are usually the last to be affected.

Hydrocephalus
Dilation of the fluid filled chambers of the brain (cerebral ventricles). The cause is usually an obstruction of the normal spinal fluid passage from one fluid chamber to another. Hydrocephalus can occur at birth or develop later on in life from obstructions related to hemorrhage in the brain, meningitis, brain tumors or other causes. Treatment can consist of diverting the spinal fluid into the abdomen or chest (placement of a shunt), or opening up the diversion within the brain (third ventriculostomy). There are other specific procedures that can be used in individual patients. Medication therapy is sometimes used in specific patients. (See also Normal Pressure Hydrocephalus.)

Hyperhidrosis
Commonly noted as sweaty palms and feet. Patients generally note increased sweating in the palms of their hands, feet and possibly also in the trunk.

Lumbar Disk Herniation
Protrusion of one of the disks in the lower back. This protrusion can cause pain or neurological symptoms. When the disk protrudes on one of the nerve roots that go down to the leg, either pain, weakness or numbness can develop. If the disk compresses the nerves to the bladder, then bowel or bladder symptoms can develop. Many patients with disk herniation can be treated with rest and return to exercise with physical therapy and anti-inflammatory medications. If severe pain or progressive neurologic symptoms occur, then surgery may be considered.

Lumbar Spinal Stenosis
Narrowing of the spinal canal in the lower back usually due to overgrowth of bone or ligaments of the spinal bones. Such narrowing can cause pressure on the nerves to the leg, which may lead to pain, trouble walking, sensory or bladder symptoms. If symptoms are severe, then decompression of the spine may be necessary.

Melanoma
Malignant tumor of the skin. It often appears as a slightly raised irregular brownish tumor. It is more common in people who have had significant sun exposure. Melanoma frequently spreads to the brain (metastatic melanoma). Treatment often includes radiation (stereotactic radiosurgery or whole brain radiation therapy), or surgical resection combined with radiation.

Meningioma
Tumor that grows from the meninges (dural covering of the brain). These can occur in many different brain locations and can cause symptoms depending on the size of the tumor and the location. Most meningiomas are benign tumors although some can be more aggressive and malignant. Surgical resection can be curable for some patients while others may be best treated with irradiation approaches. In some patients both open surgery and radiation may be required.

Myelocele
Opening in the tissues that surround the spinal cord. It is often congenital (developmental). It is symptomatic. Surgical closure may be necessary. In some patients with open neural tube defects (spina bifida), the opening can proceed all the way through the skin.

Normal Pressure Hydrocephalus
Condition primarily affecting the elderly characterized by poor bladder control, difficulty walking and mild dementia. Condition often mimics Alzheimer's and Parkinson's.