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We provide personalized, comprehensive and compassionate care for patients with all types of neurological diseases. We offer advanced screening, prevention, diagnostic and treatment services, as well as comprehensive education and support programs. We offer you and your family the physical, emotional and spiritual support you need during your journey. Click on the "Learn More" links below for in-depth information on each type of neurological disorder or disease.
Alzheimer disease is a disease that affects the brain and nervous system. It happens when nerve cells in the brain die. The disease gets worse over time. It is a type of dementia.
Alzheimer disease often causes:
The disease does not affect a person’s movement. He or she can still get around normally.
Doctors do not know what causes Alzheimer disease. They think it might be caused by one or more of these:
The following are the most common symptoms of Alzheimer disease. But not everyone has all of these symptoms. Symptoms may include:
The symptoms of Alzheimer disease may look like other health conditions or problems. Always see your healthcare provider for a diagnosis.
No single test can diagnose Alzheimer disease. A healthcare provider will first rule out other conditions. At that point, a a diagnosis of Alzheimer disease is accurate in 9 out of 10 cases. But the only way to confirm a diagnosis of Alzheimer disease is after death. An autopsy can show changes in the brain that mark the disease.
It’s important to find out if the dementia is caused by an illness that can be treated. A healthcare provider will do thorough exams of the person’s nervous system. The provider may also do:
Your healthcare provider will figure out the best treatment for you based on:
At this time, Alzheimer disease has no cure. There is no way of slowing down the progression of this disease, and no treatment is available to reverse the changes that the disease brings on. But new research findings give reason for hope. Several medicines are being studied in clinical trials to see if they can slow the progress of the disease or improve memory for a period of time. No medicines can bring back memory that has been lost, but some medicines may help in the early stages of the disease.
Some medicines are available to help manage some of the most troubling symptoms of Alzheimer disease. These symptoms include:
Exercise and social activities are important to help manage the disease. So are good nutrition, a healthy lifestyle, and a calm and well-structured environment.
Because doctors don’t know what causes the disease, they can’t recommend any steps to prevent it.
Alzheimer disease is a progressive disease. This means that memory problems and problems with doing daily tasks gradually get worse. Each person is affected differently, but people with Alzheimer disease have mood and behavior problems that make it difficult for family members to care for them. As a person is less able to care for himself or herself, families or others must help with personal care, meals, and daily activities. People with advanced Alzheimer disease will most likely need to stay in a place that specializes in care of people with memory disorders.
Care programs for people with Alzheimer disease differ depending on the symptoms a person has and how far along the disease is. These programs can help a person and his or her family manage the disease.
Any skills lost will not be regained, but the following tips can help people and families living with Alzheimer disease:
Tips to help you get the most from a visit to your healthcare provider:
Alzheimer's disease is a degenerative disease which destroys brain cells, causing problems with memory, thinking and behavior.
A headache is pain or discomfort in the head or face area. Headaches vary greatly in terms of pain location, pain intensity, and how frequently they occur. This results in several categories of headaches. While the actual brain tissue doesn’t have pain-sensitive nerve fibers and doesn’t feel pain, other parts of the head can be responsible for a headache including:
Different types of headaches include:
This type of headache is distinguished by the fact that symptoms other than pain occur as part of the headache. Nausea and vomiting, lightheadedness, sensitivity to light (photophobia), and other visual symptoms typically occur with migraine. Migraines are also unique in that they have distinct phases. Not all people have each phase, however. The phases of a migraine headache may include:
Tension headaches are the most common type of headache. Stress and muscle tension are often factors in tension-type headaches. While symptoms may differ, the following are common symptoms of a tension-type headache:
Cluster headaches usually occur in a series that may last weeks or months, and the headache series may return every year or two.
While people often experience symptoms differently, the following are the most common symptoms of a cluster headache:
Headaches are classified as primary or secondary.
Headache symptoms depend on the type of headache. The frequency of headaches and the intensity of the symptoms may vary as well. Typical headache symptoms include:
Tension type headaches typically do not cause nausea, vomiting, or sensitivity to light (photophobia).
The symptoms of a headache may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.
The full extent of the problem may not be understood immediately, but may be revealed with a comprehensive medical evaluation and diagnostic testing. The diagnosis of a headache is made with a careful history, physical examination and diagnostic tests.
Questions commonly asked during the exam may include, but are not limited to, the following:
If the history is consistent with migraine or tension-type headaches and the neurological exam is normal, no further diagnostic testing may be necessary. However, if it is not a primary type headache, then other tests may be needed to determine the cause.
Tests used to determine the cause of a headache may include:
Specific treatment for headaches will be determined by your health care provider based on:
The ultimate goal of treatment is to stop headaches from occurring. Adequate headache management depends on the accurate identification of the type of headache and may include:
Migraine headaches may require specific medication management including:
Some headaches may require immediate medical attention including hospitalization for observation, diagnostic testing, or even surgery. Treatment is individualized depending on the underlying condition causing the headache. Full recovery depends on the type of headache and other medical problems that may be present.
When headache triggers are known, avoiding the triggers can prevent a headache. Reducing stress can minimize or prevent headaches caused by stress. Migraine headaches may be prevented by taking a daily preventive medication.
Most headaches can be managed with over-the-counter pain relievers. However, you should call your health care provider right away if a severe headache is accompanied by:
Symptoms that may suggest a more serious headache include any of the following:
Tips to help you get the most from a visit to your health care provider:
A headache is pain or discomfort in the head, scalp, or neck. Serious causes of headaches are very rare.
Parkinson's disease (or, simply, Parkinson's) is the most common form of parkinsonism, a group of motor system disorders. It is a slowly progressing, degenerative disease that is usually associated with the following symptoms, all of which result from the loss of dopamine-producing brain cells:
Tremor or trembling of the arms, jaw, legs, and face
Stiffness or rigidity of the limbs and trunk
Bradykinesia (slowness of movement)
Postural instability, or impaired balance and coordination
Dopamine is a substance produced in the body that has many effects, including smooth and coordinated muscle movement.
It is a myth that Parkinson's disease was cured after the introduction of levodopa (L-dopa) in the 1960s. In fact, about 60,000 Americans are newly diagnosed with Parkinson's disease each year, and more than 1 million Americans affected at any one time. in addition, more people suffer from Parkinson's disease than multiple sclerosis, muscular dystrophy, and amyotrophic lateral sclerosis combined.
The specific cause of PD is unknown; however, medical experts believe the symptoms are related to a chemical imbalance in the brain caused by brain-cell death. Parkinson's disease is chronic (persists over a long period of time), and progressive (symptoms grow worse over time).
Although the disease may appear in younger patients (even teenagers), it usually affects people in late middle age. It is not contagious.
The biggest risk factor for developing PD is advancing age. The average age for the onset of PD is 60 years. In addition, 50 percent more men are affected than women, according to the National Institute of Neurological Disorders and Stroke. However, the reason for this is unclear.
Family history is another important risk factor. Individuals with a parent or sibling who are affected have approximately two times the chance of developing PD. This increased risk is most likely because of a combination of environmental and genetic factors.
Environmental causes are being researched and the strong consistent findings are that rural living, exposure to well water, and exposure to agricultural pesticides and herbicides are related to PD. It is important to remember, however, that these factors do not guarantee the development of PD, nor does their absence prevent it. Having one or more close relatives with PD increases one's risk of developing the disease; however, unless there is a known genetic mutation for PD present, the increased risk is only 2 to 5 percent.
Currently researchers believe that in most individuals the cause of PD is a combination of genetics and environmental exposure.
Parkinson's disease is also called primary parkinsonism or idiopathic Parkinson's disease. (Idiopathic is the term for a disorder for which no cause has yet been identified.)
In the other forms of parkinsonism, either the cause is known or suspected, or the disorder occurs as a secondary effect of another primary neurological disorder that may have both primary and secondary symptoms of Parkinson's disease. These disorders, described as Parkinson's syndrome, atypical Parkinson's, or, simply, parkinsonism, may include the following:
Tumors in the brain
Repeated head trauma
Drug-induced parkinsonism. This occurs due to the prolonged use of tranquilizing drugs, such as the phenothiazines, butyrophenones, reserpine, and the commonly used drug, metoclopramide for stomach upset.
Toxin-induced parkinsonism. This occurs due to manganese and carbon monoxide poisoning.
Postencephalitic parkinsonism. A viral disease that causes "sleeping sickness."
Striatonigral degeneration. The substantia nigra of the brain is only mildly affected, while other areas of the brain show more severe damage.
Parkinsonism that accompanies other neurological conditions. Examples of this are Shy-Drager syndrome, (multiple system atrophy, once thought to be a distinct disease, is now commonly thought to be simply an extensive progression of idiopathic PD), progressive supranuclear palsy, Wilson disease, Huntington's disease, Hallervorden-Spatz syndrome, Alzheimer's disease, Creutzfeldt-Jakob disease, olivopontocerebellar atrophy, post-traumatic encephalopathy, and dementia with Lewy bodies.
The following are the most common symptoms of Parkinson's disease. However, each individual may experience symptoms differently. Symptoms may include:
Muscle rigidity. Stiffness when the arm, leg, or neck is moved back and forth.
Resting tremor. Tremor (involuntary movement from contracting muscles) that is most prominent at rest.
Bradykinesia. Slowness in initiating movement.
Postural instability. Poor posture and balance that may cause falls; gait or balance problems.
Symptoms of Parkinson's disease vary from patient to patient. The symptoms may appear slowly and in no particular order. Early symptoms may be subtle and may progress over many years before reaching a point where they interfere with normal daily activities.
The four cardinal symptoms of PD are listed above. Other symptoms are divided into motor (movement-related) and nonmotor symptoms.
Bradykinesia (slow movement)
Rigidity and freezing in place
Decreased arm swing when walking
Difficulty rising from a chair
Micrographia (small, cramped handwriting)
Lack of facial expression
Slowed activities of daily living (for example, eating, dressing, and bathing)
Difficulty turning in bed
Remaining in a certain position for a long period of time
Diminished sense of smell
Low voice volume (hypophonia)
Difficulty speaking (dysarthria)
Painful foot cramps
Emotional changes (fearful and insecure)
Male erectile dysfunction
As the disease progresses, walking may become affected, causing the patient to stop in mid-stride or "freeze" in place, and maybe even fall over. Patients also may begin walking with a series of quick, small steps as if hurrying forward to keep balance, a practice known as festination.
The symptoms of Parkinson's disease may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.
Making an accurate diagnosis in the early stages of Parkinson's disease can be difficult, as the beginning signs and symptoms may be considered to be indications of other conditions or the effects of normal aging. For this reason, observation of the patient may be required for some time until the symptoms are consistently present.
Currently, there are no blood or laboratory tests that are useful in the diagnosis of PD. Diagnosis of PD is based primarily on a medical history and thorough neurological examination. Brain scans and/or lab tests may be performed to help rule out other diseases or conditions, but brain scan generally will turn out to be normal with PD.
Methods to assist with the diagnosis of PD include:
Neurological examination (including evaluation of symptoms and their severity)
Trial test of drugs. When symptoms are significant, a trial test of drugs (primarily levodopa [L-dopa]) may be used to further diagnose the presence of PD. If a patient fails to benefit from levodopa, a diagnosis of Parkinson's disease may be questionable.
Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.
Specific treatment for a Parkinson's disease will be determined by your doctor based on:
Your age, overall health, and medical history
Extent of the condition
Type of condition
Your tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
With today's medicine, we have yet to find a cure for Parkinson's disease. However, based on the severity of the symptoms and medical profile, the doctor will establish an appropriate treatment protocol. Treatment for Parkinson's disease may include the following:
Complementary and supportive therapies, such as diet, exercise, physical therapy, occupational therapy, and speech therapy
Once the diagnosis of PD has been made, the next decision is whether a patient should receive medication, which depends on the following:
The degree of functional impairment
The degree of cognitive impairment
Ability to tolerate antiparkinsonian medication
The advice of the attending doctor
No two patients react the same way to a given drug, therefore, it takes time and patience to find an appropriate medication and dosage to alleviate symptoms.
Based on the severity of the condition and the medical profile, the doctor may recommend surgery as one treatment option for Parkinson's disease.
There are several types of surgery that may be performed that can help patients with Parkinson's disease. Most of the treatments are aimed at helping the tremor or rigidity that comes with the disease. In some patients, surgery may decrease the amount of medication that is needed to control the symptoms of Parkinson's disease.
There are three types of surgeries that may be performed for Parkinson's disease, including the following:
Lesion surgery (burning of tissue). In this procedure, deep parts of the brain are targeted and small lesions are made in critical parts of the brain that help control movement. The surgery may be done while the patient is awake to help determine the exact placement of the lesion. The lesion is placed to help control, or stop, the area of the brain that is causing the tremor.
Deep brain stimulation (DBS). With this type of surgery, a small electrode is placed in the critical parts of the brain that help to control movement. The electrode is attached to a small battery in the chest wall and is connected by wires that are placed under the skin. The stimulator is then turned on and interrupts the normal flow of information in the brain and can help to decrease symptoms of Parkinson's disease.
Neural grafting or tissue transplants. Experimental research is being done to find a replacement for the part of the brain that functions improperly in Parkinson's disease.
It is important to remember that surgery may help with symptoms of Parkinson's disease, but does not cure the disease or stop the progression of the disease.
Parkinson's is a motor system disorder, resulting from the loss of dopamine-producing brain cells.
There are many conditions that affect the spine, shoulder, and pelvis, which require clinical care by a physician or other healthcare professional. Listed in the directory below are some, for which we have provided a brief overview.
Treatment for Arthritis
Hip Replacement Surgery
Low Back Pain
Neck Pain and Problems
Overview of Shoulder Problems
Rotator Cuff Injury
Spine disorders and injuries affect the main support system of the body.
A stroke, or brain attack, happens when blood flow to your brain is stopped. It is an emergency situation.
The brain needs a constant supply of oxygen and nutrients in order to work well. If blood supply is stopped even for a short time, this can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen.
When brain cells die, brain function is lost. You may not be able to do things that are controlled by that part of the brain. For example, a stroke may affect your ability to:
A stroke can happen to anyone at any time.
A stroke is caused when blood flow to your brain is stopped or disrupted.
There are 2 kinds of stroke: ischemic and hemorrhagic.
Anyone can have a stroke at any age. But your chance of having a stroke increases if you have certain risk factors. Some risk factors for stroke can be changed or managed, while others can’t.
Risk factors for stroke that can be changed, treated, or medically managed:
Risk factors for stroke that can’t be changed:
Other risk factors include:
A stroke is an emergency situation. It’s important to know the signs of a stroke and get help quickly. Call 911 or your local emergency number right away. Treatment is most effective when started right away.
Stroke symptoms may happen suddenly. Each person’s symptoms may vary. Symptoms may include:
Other less common symptoms of stroke may include:
A TIA can cause many of the same symptoms as a stroke. But TIA symptoms are passing. They can last for a few minutes or up to 24 hours. Call for medical help right away if you think someone is having a TIA. It may be a warning sign that a stroke is about to occur. But not all TIAs are followed by a stroke.
FAST is an easy way to remember the signs of a stroke. When you see these signs, you will know that you need to call 911 fast. FAST stands for:
F - Face drooping. One side of the face is drooping or numb. When the person smiles, the smile is uneven.
Arm weakness. One arm is weak or numb. When the person lifts both arms at the same time, one arm may drift downward.
S - Speech difficulty. You may see slurred speech or difficulty speaking. The person can't repeat a simple sentence correctly when asked.
T - Time to call 911. If someone shows any of these symptoms, call 911 right away. Call even if the symptom goes away. Make note of the time the symptoms first appeared.
Your healthcare provider will take a complete health history and do a physical exam. You will need tests for stroke such as brain imaging and measuring the blood flow in the brain. Tests may include:
The following heart tests may also be used to help diagnose heart problems that may have led to a stroke:
Your healthcare provider will create a care plan for you based on:
There is no cure for stroke once it has occurred. But advanced medical and surgical treatments are available. These can help reduce your risk for another stroke.
Treatment is most effective when started right away. Emergency treatment after a stroke may include:
Recovery from stroke and the specific ability affected depends on the size and location of the stroke.
A small stroke may cause problems such as weakness in your arm or leg.
Larger strokes may cause parts of your body to not be able to move (be paralyzed). Larger strokes can also cause loss of speech or even death.
Know your risk for stroke. Many stroke risk factors can be changed, treated, or medically modified. Some things you can do to control your risk factors are listed below.
A healthy lifestyle can help reduce your risk for stroke. That includes the following:
Take your medicines as instructed by your healthcare provider. The following medicines can help prevent stroke:
Several types of surgery may be done to help treat a stroke, or help to prevent one. These include:
How a stroke affects you depends on where the stroke occurs in your brain. It also depends on how much your brain is damaged.
Many people who have a stroke are left with paralysis of one of their arms.
Other problems can include having trouble with:
Some people may need long-term physical rehabilitation. They may not be able to live in their home without help.
Support services are available to help with physical and emotional needs after a stroke.
Strokes can happen again. Call your healthcare provider if you have symptoms that seem like a stroke, even if they don’t last long.
If you have repeated damage to your brain tissue, you may be at risk for life-long (permanent) disabilities.
Cerebrovascular disorders affect the blood flow in the arteries and veins which supply the brain - such as aneurysms and strokes.
Seizures cause involuntary changes in body movement or function, sensation, awareness or behavior.
A tumor forms when an abnormal cell grow to form a mass of abnormal cells. Spinal cord tumors are tumors that form on the spinal cord or in the area around it.
A spinal cord tumor may be cancerous (malignant) or noncancerous (benign). Even if benign, a tumor often causes pain and discomfort because it pushes on the spinal cord or nerves.
A spinal cord tumor may be called “primary,” which means the cancer started in the spinal cord, or “secondary,” which means the cancer started somewhere else in body and spread to the spinal cord. Most of the time, spinal cord tumors are secondary tumors. A spinal cord tumor is often a cancer of the lung, breast, prostate, or another cancer that has extended throughout the body to reach the spine.
Spinal cord tumors are sometimes caused by a genetic disorder, like neurofibromatosis.
Spinal cord tumors are relatively uncommon. It's much more common to develop a brain tumor than a tumor on the spinal cord. A spinal cord tumor may form inside the spinal cord itself or around the bones that make up the spine. Spinal cord tumors cause problems with the nerves, blood vessels, and bones.
Some spinal cord tumors can be successfully treated. The earlier you tell your doctor about your symptoms, get a diagnosis, and start treatment, the better your outcome is likely to be. But spinal cord tumors often cause permanent damage to the nerves and result in disability.
Spinal cord tumors affect many different areas and come in many different types, including:
Leukemia or lymphoma, cancers of the blood
Myeloma, cancer of the bone marrow
Medulloblastomas, which start in the brain and metastasize to the spine, and are most common in children
Gliomas (ependymomas, astrocytomas, or gangliogliomas), which are cancers that form in cells called glial cells
Chordomas, which form in the spine and can push against it
Schwannomas, which start inside the peripheral nerves
Meningiomas, which start in the tissues around the spinal cord (meninges)
Metastatic (secondary) tumors, which are cancers that have spread from the lung, breast, prostate, or other organs
Spinal cord tumors can cause many different symptoms:
Inability to control the bowels and/or bladder
Weak muscles that you can't seem to control, so that you fall or have trouble walking
An unusual feeling or sensation in the legs
Feeling cold in the hands, fingers, or legs
Spinal cord tumors often cause back pain, including:
Feeling worse when you strain in any way, sneeze, or cough
Increased pain when you lie down
Pain that’s specific to the spine
Extreme pain that isn't improved by taking medicine
Pain that feels worse as time passes
Pain that spreads into the arms, feet, legs, or hips
A doctor will usually do a neurologic exam to diagnose a spinal cord tumor. The exam will look for these signs:
Soreness in the area of the spine
Inability to feel pain, heat, or cold
An abnormal reflex response
These tests can help your doctor see a spinal cord tumor and find out more information about it:
Imaging tests of the spine, such as a CT scan, MRI, or myelogram, which uses an X-ray in combination with an injection of contrast dye into the spine to better see the tumor
Biopsy (removal of a small pieces of the tumor to determine what type it is)
Exam of the cerebrospinal fluid and the cells in the fluid
Treatment for a spinal cord tumor is different for everyone and depends on the type of tumor, its location, and your overall health. These are treatment options:
Surgery to remove all or part of the tumor
Radiation therapy, which is sometimes used in addition to surgery
Corticosteroid medications to lessen swelling
Some types of spinal tumors require radiation of the whole spine. This procedure, called craniospinal radiation, can lead to anemia and other side effects. When there is radiation to the lumbar spine, fertility needs to be considered.
Since it's not understood why most primary spinal cord tumors develop, experts don't know how to prevent them.
Working with your doctor can help you to ease your symptoms so that you feel more comfortable before and during treatment.
After your treatment, you may need physical therapy to strengthen muscles and help them work properly again.
During the course of your treatment, always tell your doctor or seek emergency help if your symptoms suddenly become more severe or change in some way.
Joining a support group for people with cancer or spinal cord problems can be helpful when you're battling a spinal cord tumor.
To find out more information about spinal cord tumors, you may want to contact:
American Brain Tumor Association
National Brain Tumor Society
National Cancer Institute
If you are currently undergoing treatment for any type of cancer and develop back pain, you should let your doctor know right away. It's also a good idea to contact your doctor about any back pain that worsens or doesn't go away with time.
Spinal cord tumors are tumors that form on the spinal cord or in the area around it.
Talking with healthcare providers about your tumor can be overwhelming. It can be hard to take in all of the information. It helps to be prepared. Make a list of questions and bring them to your appointments. Write the answers down in a notebook. Make sure you ask how the treatment will change your daily life, including your diet, and how you will look and feel after treatment. Ask how successful the treatment is expected to be, and what the risks and possible side effects are.
You may also want to ask a friend or family member to go with you. He or she can take notes and write down the answers, and also ask questions you may not think of. You can also ask your healthcare provider if you can record the conversation.
Below are some questions to ask during your appointments.
What type of brain tumor do I have?
How quickly is this type of tumor expected to grow?
Where exactly is the tumor? How big is it?
How often do you treat this type of tumor?
Do I need to be treated right away?
What are my treatment choices?
Can the tumor be removed with surgery?
What treatments do you think are best for me and why?
What treatments do you think are not for me and why?
What are the goals of the treatment you are recommending?
What is the success rate of this treatment for my type of tumor?
Are there any clinical trials I should apply for?
What is the length of the treatment period?
How long will each treatment take?
Where do I have to go for the treatment?
Who will give me the treatment?
Does someone need to go with me during treatments?
Can I take my other medicines during treatment?
What side effects should I expect?
How long will side effects last?
Are there side effects that I need to call you about?
How do I reach you after hours and on weekends?
What can I do to ease the side effects?
Should I change my diet? Are there foods I should not eat?
Will I be able to go to work and be around my family?
Are there support groups nearby that I can join?
How will I feel after the treatment?
What type of follow-up will I need after treatment?
How will we know if treatment worked?
What are my options if the treatment doesn't work or the tumor comes back?
Tumors of the Brain are abnormal growths of tissue found inside the skull or brain.
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