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Thursday, January 27, 2011
As we struggle to improve the treatment of epilepsy, we often focus on finding a cure for the disease. Although this is always our hope and our goal, we should remind ourselves that we should implement the best up-to-date treatment as we continue our journey to find a cure. As clinical research and basic science try to reach this goal, the treatment and the management of epilepsy should reach every epileptic who is interested in ...
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Tuesday, December 21, 2010
Stroke is the third leading cause of death and major cause of permanent disability in the United States. There are several medical conditions known to increase the risk of having a stroke such as lack of exercise, high blood pressure, diabetes, heart disease, smoking, and high cholesterol. However, the public is less aware that obstructive sleep apnea (OSA), a common disease, is increasingly considered as treatable risk factor of stroke.
OSA is the presence of ...
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Wednesday, December 01, 2010
Andrea Natale, MD - Guest Contributor Migraine, a neurovascular disorder affecting more than 29.5 million Americans, is characterized
by recurrent attacks of incapacitating headache associated with extreme sensitivity to light
and sound, nausea and vomiting. Although the cause and triggers of migraine is not fully
understood yet, it has been widely accepted as being caused by dilatation of blood vessels in
the brain, abnormal firings from unusually excitable brain nerve cells and/or inflammation of
the meninges. Atrial fibrillation (AF) is ...
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Wednesday, September 29, 2010
Radiculopathies or pinched nerves are clinical conditions caused by compression or damage of the nerve roots at the spine level. Radicle is Latin for root. In the spine there are seven vertebrae in the neck, 12 in the chest and five in the lower back plus the tailbone. Radiculopathies are therefore labeled as cervical (neck), thoracic (chest), and lumbosacral (lower back). The vertebral bodies are separated by discs that provide cushion from downward compression and ...
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Monday, March 15, 2010
Trigeminal neuralgia (TN), also known as tic doloureux, is a paroxysmal lancinating pain that occurs in one or more of the distributions of the trigeminal nerve. The pain often occurs with sensory stimulation to the face or teeth, with patients being unable to eat or have anything touch their face. Spontaneous remission is common, with patient often having prolonged periods where they are symptom-free. This occurs in the general population in 4/100000 people but in ...
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Tuesday, February 16, 2010
Chorea is a classical neurological illness, the name of which derives from both Latin and Greek referring to dance or choral dance. Chorea has been described since the Middle Ages and describes a syndrome of brief, rapid, abrupt, involuntary movements coming from random muscle contractions. The pattern of movement may at times give the impression that the patient is restless or fidgety. Chorea is an uncommon but nevertheless very interesting neurological condition. In the Middle ...
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Friday, January 08, 2010
Of the 3 nerves going to the forearm and hand that make the hand move, the ulnar nerve is arguably the most important as it provides all of the fine finger control, and much of the thumb movement. This nerve supplies the sensation to the 4th and 5th fingers, both the top and palm surface of the hand, and also the sensation of the hand just below the 5 finger.
The most common symptoms associated ...
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Thursday, December 24, 2009
With approximately 12,000 new cases of spinal cord injury (SCI) each year with roughly 259,000 persons living with a traumatic SCI in the US, rehabilitation treatment plans must be individualized based on other factors such as age, co-morbidities, body habitus and level of motivation. It is also imperative to assess and manage the various affected systems. Muscle paralysis is often the most recognized sequela arising from SCI but other common complications include neuropathic pain, spasticity, ...
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Wednesday, October 21, 2009
Movement disorder is a group of neurodegenerative diseases that primarily affects the motor and movement processes. The most common disorders include Parkinson’s disease (PD), Essential tremor (ET) and Dystonia.
Medications can be effective in the early treatment of these movement disorders. However, with the progression of disease, medications alone become ineffective. In PD, long-term management is often complicated with development of motor fluctuation and dyskinesia (involuntary dance like movement). In theses patient dyskinesias can be ...
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Monday, October 05, 2009
Peripheral neuropathy is a common neurological condition. Neuropathy means "pathology of nerves" or "something wrong with the nerves" and peripheral neuropathy most often refers to symptoms of numbness or pain in the toes and feet or in the hands. Diabetes, including early or pre-diabetes, is the most common cause of peripheral neuropathy in the U.S. but many other conditions are associated with the diagnosis.
People with immunological disease such as Lupus may develop a peripheral ...
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Friday, October 02, 2009
No one over the age of 50, not even a lifelong athlete in seemingly excellent health, is free from the risk of stroke. With people living longer and the modern era of pre-made and pre-packaged foods, the rate of strokes has increased. Over the last several decades, stroke prevention measures have not changed much, but more awareness about stroke and its devastating nature are getting wider publicity.
The most important part of stroke prevention is ...
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Thursday, September 24, 2009
Clinical pathways are interdisciplinary plans of care that outline the sequencing and timing of therapeutic interventions and expected patient outcomes as derived from available evidence and current best practices. They are comprehensive, integrated clinical process tools, employed to optimize patient care and to help ensure positive patient outcomes. The implementation process generally requires that they be continuously evaluated and improved upon in real time.
Pathways are designed to provide benefits to patient care by increasing ...
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Thursday, September 17, 2009
Parkinson's disease, first described by James Parkinson in 1817, is a debilitating, neurodegenerative disease that presents late in life, manifested by slowness of movement, rigidity, and resting tremor. The diagnosis of Parkinson's disease is based on clinical findings; there are no reliable biologic markers or radiologic features to confirm the diagnosis.
An estimated 1 million persons in the United States suffer from PD, and there are a reported 60,000 new cases each year. Unlike most ...
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Friday, August 28, 2009
This week, the death of Senator Edward Kennedy again puts the spotlight on the struggle for victory over brain cancer. Fifteen months ago, Senator Kennedy was diagnosed with glioblastoma multiforme, the most common and most aggressive primary malignant brain tumor. The tumor was located near the area of the brain responsible for speech and he suffered several seizures due to the tumor. Treatment of tumors such as his is determined by a multidisciplinary team of ...
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Thursday, August 27, 2009
As time passes, there is a growing interest in and application of less-invasive techniques in all areas of surgery. Spine surgery is no exception. For many years, the use of the operating microscope has been commonplace for neurosurgeons and initially got its start in applications for brain surgery. The familiarity of the neurosurgeon with microscopic techniques allowed a relatively easy transition to its use in spine surgery. Thus, there followed the widespread use of the ...
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Friday, August 21, 2009
Obstructive sleep apnea (OSA) is a common treatable disorder that involves pauses in breathing during sleep.
OSA occurs when your muscles relax during sleep. This causes soft tissue in the back of the throat to collapse and block the airway. These breathing pauses produce drastic changes in blood pressure and oxygen levels, while also fragmenting sleep. Over time, untreated OSA puts a tremendous amount of stress on the brain and body.
OSA increases your risk ...
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Monday, August 03, 2009
One cannot imagine the anxiety and terrifying nature of hearing the news that a brain tumor has been found. Patients are left stunned and at a loss as to where to turn for help. Psychological reactions to a cancer diagnosis can lead to initial denial, anxiety, anger, depression, as well as anticipatory fear as to what deficits may arise from surgical, chemotherapy and radiotherapy treatment options.
Previous research has proven that both psychotherapy and ...
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Friday, July 10, 2009
In the debate on healthcare reform, you often hear a lot said about quality. Although quality healthcare certainly sounds like a good idea, how do you know what is quality healthcare and what is not?
Quality healthcare can have several meanings. Most healthcare quality organizations rate medical care based on the absence of certain obvious mistakes, such as giving the wrong drug or operating on the wrong body part, or by measuring how well ...
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Monday, July 06, 2009
A highly functional person might lose contact with his/her environment and fall to the ground with violent convulsions for 1-2 minutes; then be confused and disoriented for several minutes or hours. The brain function will recover and a new person emerges with his/her full strength, alertness and intelligence.
Another person might become motionless, mute, and slip into a prolonged blank stare for 1-2 minutes and recover quickly with no recollection of what just happened. Yet ...
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Friday, June 26, 2009
Harvey Cushing, the father of modern neurosurgery, had nine of his first ten craniotomy patients die after surgery. It was devastating to him. He questioned whether we should be doing operations on the brain, but he pushed on and in doing so developed many of the techniques and knowledge about the brain that we still use to this day.
Obviously, many of the tools we use in the Operating Room have changed, but the spirit ...
Every other Friday at 7:30 am, individual cases are presented and discussed at multidisciplinary tumor conferences. Physicians representing all neuro-oncology specialties attend the conferences, which review each patient’s diagnostic imaging films, pathology and overall status. The group discusses available forms of treatment and shares recommendations before reaching a consensus regarding the best treatment approach for each patient.
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