Neurology | Sanford Health

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Neurology – Palmetto Health-USC Medical Group

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Souvik Sen, MD, MS, MPH, currently serves as Chair of Neurology at Palmetto Health-USC Neurology and is a professor of neurology with the University of South Carolina School of Medicine. He joined the University of South Carolina School of Medicine in January, 2010.

Dr. Sen earned his medical degree from the University of Calcutta R. G. Kar Medical College in Calcutta, India. After completing medical training in India, he completed a Masters in Science in cardiovascular pharmacology at Wayne State University in Detroit, and then completed a medical internship at Henry Ford Hospital, also in Detroit. He completed a neurology residency at Temple University Health Science Center in Philadelphia, and a vascular neurology fellowship at Johns Hopkins University Hospital in Baltimore. After his fellowship he served as co-director and subsequently director of the stroke center at the NJ Neuroscience Institute in Edison, New Jersey. He then served as the founding director of the UNC Hospitals Comprehensive Stroke Center at the University of North Carolina in Chapel Hill. While there, he completed a Masters in Public Health with an epidemiology major.

Dr. Sen is board certified in neurology, and subspecialty board certified in Vascular Neurology. He is a recipient of the prestigious Center of Economic Excellence Stroke Chair in South Carolina, and has published in peer reviewed journals including Circulation, Stroke and the New England Journal of Medicine. He has received research funding from the American Heart Association and the National Institutes of Health. In 2004, he was nominated as a Fellow of the American Heart Association. He serves on several national and international committees, and his specific research interests include acute stroke treatment, stroke and TIA pathophysiology, stroke prevention and epidemiology.

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Neurology - Palmetto Health-USC Medical Group

News from the American Headache Society Annual Meeting: Positive Trial Results for Anti-migraine Drugs Targeting … – LWW Journals

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Robinson, Richard

doi: 10.1097/01.NT.0000521716.95578.ef

Features

In large clinical trials, researchers reported that four calcintonin-gene related peptide antibodies three that bind to the peptide itself, and one that binds to the receptor were safe and effective for reducing migraine days.

BOSTONThe mood at the American Headache Society (AHS) annual scientific meeting here in June was decidedly upbeat, with experts in the field declaring a paradigm shift and the start of a new era in the treatment of migraine. The excitement was generated by announcements of positive trial results across the board for four antibodies, from four competing companies, targeting the calcitonin gene-related peptide (CGRP) or its receptor.

Three agents eptinezumab from Alder Biosciences, fremanezumab from Teva, and galcanezumab from Lilly bind to the peptide itself, while erenumab, from Amgen, binds to the receptor. While not all the companies have submitted data for final regulatory review, all have completed large-scale trials, and all, according to results presented at the meeting, met their primary and secondary endpoints rapid, significant, and long-lasting relief of migraine with adverse-effect profiles identical or close to placebo.

We are about to enter an era where we have preventive treatments specifically for migraine. We are standing at the edge of an incredible development, predicted Peter Goadsby, MD, PhD, FAHS, professor of neurology at Kings College London and chair of the AHS science program committee.

CGRP was discovered in the early 1980s as an alternatively-spliced transcript of the calcitonin gene. Soon thereafter it was found to be abundantly produced by trigeminal nerve endings, and was elevated during migraine attacks. While the exact pathophysiological role of CGRP in migraine remains unknown, it is clear that its elevation and interaction with its receptor directly contributes to migraine intensity, through enhancing both peripheral and central nociception pathways, possibly through increasing mast cell degranulation, neurogenic inflammation, and vasodilation.

Small-molecule CGRP antagonists were developed early on, but have been limited by concerns over adverse effects, including liver toxicity. That set the stage for development of monoclonal antibodies targeting either the peptide of its receptor.

None of the four monoclonal antibodies against the CGRP system are immunomodulatory, since their target is not the immune system. A small percentage of patients, ranging from 1 percent to 14 percent, depending on the drug and the study, do carry antibodies against the monoclonal antibody, but so far none has been shown to affect the ability of the treatment to reduce migraine.

The clinical programs for the four agents have proceeded rapidly, culminating in the recently completed phase 3 trials announced at the AHS meeting.

A single dose of eptinezumab reduced migraine days by 75 percent after three months in a third of patients with chronic migraine, according to the results of a phase 2B trial presented here. The trial enrolled 616 patients who had 15 to 28 headache days per month, at least eight of which were migraine. As in each of the other studies presented at the meeting with monoclonals targeting the CGRP system, patients were primarily female, with a history of migraine often of a decade or more.

Patients received a single intravenous dose of eptinezumab (300 mg, 100 mg, 30 mg, or 10 mg) or placebo. The primary endpoint was the percentage of patients with a 75% or greater reduction in migraine days over three months.

At baseline, patients had 16 migraine days per month. The primary endpoint was achieved by 33 percent of patients in the 300-mg dose group and 31 percent of those in the 100-mg group, versus 21 percent receiving placebo (both comparisons p<0.05).

Neither of the low-dose groups were different from placebo. In a post-hoc analysis, there was a dose-dependent reduction in the severity of migraine compared to placebo as well, and the separation from placebo for frequency began to appear within the first 24 hours of treatment.

It might not just be frequency that is affected, said Jeffrey Smith, MD, lead author and senior vice president at Alder. This is an exploratory endpoint, but it may be important as well. In addition, he noted, migraine reduction was extremely rapid, with a separation from placebo beginning to appear within the first 24 hours of treatment.

Eptinezumab is now in phase 3 trials, with the final results expected in early 2018.

Sheena Aurora, MD, a medical fellow and global launch leader at Eli Lilly Company, reported that monthly injections with galcanezumab reduced headache days by an average of four days per month for six months, compared to two days for placebo, according to results from a phase 3 trial that enrolled more than 900 patients. Participants were randomized 2:1:1 to placebo or galcanezumab at 120 mg or 240 mg, delivered by subcutaneous injection once monthly for six months. At baseline, patients had about nine migraine headache days per month.

After six months, patients on placebo had a decline in mean migraine headache days of 2.25 days, while those on galcanezumab declined by 4.29 days at 120 mg and 4.18 days at 240 mg. Both were significant compared to placebo at p<0.001. Both doses outperformed placebo at each monthly assessment.

In a secondary analysis, there were significantly more patients on active treatment who achieved a 50 percent or more reduction in the number of migraine headache days 36 percent of those on placebo compared with 59 percent for those taking 120 mg and 56 percent, 240 mg as well as a 75 percent or more reduction (18 percent of those on placebo; 33 percent on 120 mg, and 34 on 240 mg. Injection-site reactions were more common in active treatment than placebo. Eli Lilly, which is developing the drug, is planning to submit data for approval to the US Food and Drug Administration (FDA) later this year.

Patients receiving a single injection of fremanezumab began to experience relief within one week of administration, and continued to experience significant reduction in migraine for up to three months compared to placebo, according to data from a phase 3 trial presented here.

The trial included three arms: placebo injections once a month for three months; a single 675 mg subcutaneous injection of fremanezumab, followed by two monthly placebo injections (designed to test the efficacy of quarterly injections); and one 675 mg injection of fremanezumab followed by two monthly injections of 225 mg fremanezumab.

The primary endpoint was the change from baseline in the number of monthly headache days of at least moderate severity over three months: 1,130 patients were randomized 1:1:1 to each of the three treatment arms.

Placebo-treated patients experienced an average of 2.5 fewer headache days per month during the study. Monthly headache days declined by 4.6 days in patients receiving monthly fremanezumab, and by 4.3 days in those receiving the single dose (both results p<0.001 versus placebo). Injection-site effects were similar in placebo and active-treatment groups.

Active treatment was associated with at least a 50% reduction in headache days in 41% of those on monthly treatment and 38% of those on quarterly treatment, versus 18% on placebo (both results p<0.001 versus placebo). Benefits emerged within one week of initial treatment.

In patients with chronic migraine, erenumab reduced monthly migraine days by 6.6 days, versus 4.2 days for placebo, according to a phase 3 study presented here. Successful phase 3 trials of erenumab for episodic migraine have been previously presented.

To test its potential in chronic migraine, defined as headache for 15 or more days per month, and migraine for eight or more days per month, investigators enrolled 667 patients, randomized 3:2:2 to monthly placebo, erenumab 70 mg or erenumab 140 mg, administered subcutaneously. The primary endpoint was the change from baseline in monthly migraine days over three months of treatment, a measure meant to account for expected month-to-month fluctuations in severity.

The researchers used the mean of the three months, rather than the reduction in the final month, because experience has shown that the response rate fluctuates somewhat from month to month, said the lead investigator, Stewart J. Tepper, MD, FAHS, professor of neurology at the Geisel School of Medicine at Dartmouth in Hanover, NH.

At baseline, patients in each group had a mean of 18 monthly migraine days. Both doses of erenumab reduced that by a mean of 6.6 days, versus 4.2 days for placebo (p<0.001 for both). Active treatment was also associated with a greater response rate, with 40 percent and 41 percent in the low- and high-dose groups experiencing a 50 percent or greater reduction in monthly migraine days, versus 23 percent for placebo (p< 0.001 for both).

Adverse event profiles were similar for active treatment and placebo, except for a small increase in injection-site pain in those receiving erenumab. The results of the trial were published recently in June in Lancet Neurology. The company has submitted data to the FDA for an indication for both episodic and chronic migraine.

The results reported for these drugs are very exciting, commented Kathleen B.Digre, MD, FAAN, professor of neurology and ophthalmology and director of the division of headache and neuro-ophthalmology at the University of Utah in Salt Lake City. The safety profile looks very promising, compared to current preventive treatments, and the speed of response is extraordinary, she said. Typically we've needed to wait four to eight weeks to see a response, whereas each of the CGRP antibodies appear to show some kind of signal by one week. That's remarkable.

David W. Dodick, MD, FAAN, professor of neurology at the Mayo Clinic in Scottsdale, AZ, said that, because of their ease of administration and tolerability, the monoclonals are likely to greatly improve adherence over current migraine preventives. This is going to be changing the way neurologists practice.

Stephen D. Silberstein, MD, FAAN, professor of neurology and director of the Headache Center at Jefferson University Hospital at Thomas Jefferson University in Philadelphia, said, I would look at them all as a group. They are all effective, and they all look safe and tolerable.

Absent head-to-head studies, he continued, it is difficult to determine what nuances there may be between these drugs. Instead, the global message from these trials is that we have a new series of drugs that are powerful and effective, and have a side-effect profile similar to placebo. For one of the most disabling of disorders, which affects millions of people in their most productive years, this allows hope.

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News from the American Headache Society Annual Meeting: Positive Trial Results for Anti-migraine Drugs Targeting ... - LWW Journals

Marshall University School of Medicine approved for neurology residency program – The Montgomery Herald

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HUNTINGTON TheMarshall University Joan C. Edwards School of Medicinehas been awarded initial accreditation by the Accreditation Council for Graduate Medical Education (ACGME) to offera neurology residency training program beginningJuly 1, 2018, Joseph I. Shapiro, M.D., dean of the School of Medicine, announced last week.

The ACGME is the national accrediting body for post-M.D. training programs in the United States.

The approval of neurology residency training here at Marshall adds a fundamental program to our offerings, Shapiro said.

In addition to giving our medical students an option to train here, the new program provides increased capacity to care for patients with neurological disease. I want to commend Drs. Paulette Wehner and Paul Ferguson, as well as their staff members, for preparing a stellar application and bringing this program to fruition.

Paulette S. Wehner, M.D., vice dean for graduate medical education at Marshall, said the four-year program will train up to three residents per year, for a total of 12 resident physicians when the program reaches capacity.

The development of an ACGME-approved residency program is a lengthy process requiring detailed annual plans, a review of faculty members and their qualifications as well as a comprehensive site visit, Wehner said. We couldnt be more pleased with todays announcement.

Neurology is the branch of medicine that studies the anatomy, functions and organic disorders of the brain and nervous system. Neurologists treat a myriad of diseases including Parkinsons, epilepsy, stroke, headaches, brain infections, Alzheimers and multiple sclerosis.

Neurology department chair Paul B. Ferguson, M.D., says the addition of neurology resident physicians means continued advancements in neurologic care for patients across the region.

The demand for neurologic care in the United States continues to increase, Ferguson said.

The incidence of stroke, Alzheimers disease and Parkinsons disease is rising, and we will now be better positioned to meet that growing need. I want to thank all of our staff in the department, particularly residency program director Justin Nolte, M.D., and residency coordinator Amanda Jones, for their significant contributions to the process.

Neurology residents will see patients at Marshall Neurology, Cabell Huntington Hospital, St. Marys Medical Center and the Huntington VA Medical Center.

With the approval of the neurology residency, the Joan C. Edwards School of Medicine now offers nine accredited residency programs and seven fellowships.

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Marshall University School of Medicine approved for neurology residency program - The Montgomery Herald

Neurology – amc.edu

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Message from the Chair, Michael Gruenthal, MD, PhD

Welcome to the Neurosciences Institute at Albany Medical Center. We are proud to be the regions first choice for the diagnosis, treatment and care of disorders and diseases affecting the brain, spine and peripheral nervous system. As members of the Albany Medical College faculty, our providers specialize in the diagnosis and treatment of specific diseases, and many are national leaders defining new standards of care.

Our multidisciplinary team of expert neurologists, neurosurgeons and physiatrists treats everyone from newborns to adults with disorders including brain tumors, epilepsy, Parkinsons disease, stroke, aneurysms, Alzheimers disease, muscular dystrophy, multiple sclerosis, ALS (Lou Gehrigs disease) and neuropathic pain.

Our achievements are many.

In addition to earning the Get With The Guidelines Gold Plus Quality Achievement Award from the American Stroke Association, Albany Medical Center is the only hospital in the region, and one of only 13 statewide, to be certified by both the New York State Department of Health as a Stroke Center and by the Joint Commission as a Primary Stroke Center with the organizations Gold Seal of Approval as an accredited institution with an advanced certification in stroke care. Along with programs at other prestigious institutions including the Cleveland Clinic and Johns Hopkins, Albany Meds Epilepsy and Human Brain Mapping Program is designated Level 4, the highest distinction authorized by the National Association of Epilepsy Centers.

Our Alzheimers Center is the Capital Regions Alzheimers Disease Assistance Center as designated by the New York State Department of Health.

And, our neuromuscular program is the only one in the area recognized by the Muscular Dystrophy Association.

With our comprehensive array of services and team of experts, Albany Medical Center is uniquely qualified to bring world-class care to people of all ages with neurological disorders.

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Neurology - amc.edu

AMC Neurology Group – Neurology – Albany, NY – Welcome

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AMC Neurology Group, is dedicated to serving the neurological needs of Albany, New York and the surrounding communities. We strive to provide state-of-the-art diagnosis and treatment. We are doctors who offer the finest neurological care and a team who is both supportive and compassionate and puts the patient first. We offer our patients and their families superior service because we put our patients at the center of all we do.

Neurologists diagnose and treat disorders of the nervous system, which include diseases of the brain, spinal cord, nerves, and muscles. Some of the more common conditions that neurologists diagnose and treat are as follows:

The neurologists at AMC Neurology Group have expertise providing evaluation and treatment of the central nervous system and muscle disorders. We have many years of combined experience in Neuro-physiology and Neuro-rehabilitation, as well as in the use of electrodiagnostic medicine.

Neurologists may serve as consultants to other physicians and can provide long-term care to patients with chronic neurological disorders.

Our subspecialties include epilepsy and neuro-physiology, as well as electrodiagnostic medicine and neuro-rehabilitation. We also have special skill in the diagnosis and treatment of Alzheimer's disease, Parkinson's disease, neuropathy, Multiple Sclerosis (MS), migraine, and other central nervous system abnormalities.

Please bookmark this page as your home base for neurological information. All other pages of our website can be accessed on the left side navigation bar. We hope you find this information helpful in your health and medical care decisions. Please contact us with any questions or for an appointment.

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AMC Neurology Group - Neurology - Albany, NY - Welcome

The terrorist inside my husband’s brain – neurology.org

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I am writing to share a story with you, specifically for you. My hope is that it will help you understand your patients along with their spouses and caregivers a little more. And as for the research you do, perhaps this will add a few more faces behind the why you do what you do. I am sure there are already so many.

This is a personal story, sadly tragic and heartbreaking, but by sharing this information with you I know that you can help make a difference in the lives of others.

As you may know, my husband Robin Williams had the little-known but deadly Lewy body disease (LBD). He died from suicide in 2014 at the end of an intense, confusing, and relatively swift persecution at the hand of this disease's symptoms and pathology. He was not alone in his traumatic experience with this neurologic disease. As you may know, almost 1.5 million nationwide are suffering similarly right now.

Although not alone, his case was extreme. Not until the coroner's report, 3 months after his death, would I learn that it was diffuse LBD that took him. All 4 of the doctors I met with afterwards and who had reviewed his records indicated his was one of the worst pathologies they had seen. He had about 40% loss of dopamine neurons and almost no neurons were free of Lewy bodies throughout the entire brain and brainstem.

Robin is and will always be a larger-than-life spirit who was inside the body of a normal man with a human brain. He just happened to be that 1 in 6 who is affected by brain disease.

Not only did I lose my husband to LBD, I lost my best friend. Robin and I had in each other a safe harbor of unconditional love that we had both always longed for. For 7 years together, we got to tell each other our greatest hopes and fears without any judgment, just safety. As we said often to one another, we were each other's anchor and mojo: that magical elixir of feeling grounded and inspired at the same time by each other's presence.

One of my favorite bedrock things we would do together was review how our days went. Often, this was more than just at the end of the day. It did not matter if we were both working at home, traveling together, or if he was on the road. We would discuss our joys and triumphs, our fears and insecurities, and our concerns. Any obstacles life threw at us individually or as a couple were somehow surmountable because we had each other.

When LBD began sending a firestorm of symptoms our way, this foundation of friendship and love was our armor.

The colors were changing and the air was crisp; it was already late October of 2013 and our second wedding anniversary. Robin had been under his doctors' care. He had been struggling with symptoms that seemed unrelated: constipation, urinary difficulty, heartburn, sleeplessness and insomnia, and a poor sense of smelland lots of stress. He also had a slight tremor in his left hand that would come and go. For the time being, that was attributed to a previous shoulder injury.

On this particular weekend, he started having gut discomfort. Having been by my husband's side for many years already, I knew his normal reactions when it came to fear and anxiety. What would follow was markedly out of character for him. His fear and anxiety skyrocketed to a point that was alarming. I wondered privately, Is my husband a hypochondriac? Not until after Robin left us would I discover that a sudden and prolonged spike in fear and anxiety can be an early indication of LBD.

He was tested for diverticulitis and the results were negative. Like the rest of the symptoms that followed, they seemed to come and go at random times. Some symptoms were more prevalent than others, but these increased in frequency and severity over the next 10 months.

By wintertime, problems with paranoia, delusions and looping, insomnia, memory, and high cortisol levelsjust to name a fewwere settling in hard. Psychotherapy and other medical help was becoming a constant in trying to manage and solve these seemingly disparate conditions.

I was getting accustomed to the two of us spending more time in reviewing our days. The subjects though were starting to fall predominantly in the category of fear and anxiety. These concerns that used to have a normal range of tenor were beginning to lodge at a high frequency for him. Once the coroner's report was reviewed, a doctor was able to point out to me that there was a high concentration of Lewy bodies within the amygdala. This likely caused the acute paranoia and out-of-character emotional responses he was having. How I wish he could have known why he was struggling, that it was not a weakness in his heart, spirit, or character.

In early April, Robin had a panic attack. He was in Vancouver, filming Night at the Museum 3. His doctor recommended an antipsychotic medication to help with the anxiety. It seemed to make things better in some ways, but far worse in others. Quickly we searched for something else. Not until after he left us would I discover that antipsychotic medications often make things worse for people with LBD. Also, Robin had a high sensitivity to medications and sometimes his reactions were unpredictable. This is apparently a common theme in people with LBD.

During the filming of the movie, Robin was having trouble remembering even one line for his scenes, while just 3 years prior he had played in a full 5-month season of the Broadway production Bengal Tiger at the Baghdad Zoo, often doing two shows a day with hundreds of linesand not one mistake. This loss of memory and inability to control his anxiety was devastating to him.

While I was on a photo shoot at Phoenix Lake, capturing scenes to paint, he called several times. He was very concerned with insecurities he was having about himself and interactions with others. We went over every detail. The fears were unfounded and I could not convince him otherwise. I was powerless in helping him see his own brilliance.

For the first time, my own reasoning had no effect in helping my husband find the light through the tunnels of his fear. I felt his disbelief in the truths I was saying. My heart and my hope were shattered temporarily. We had reached a place we had never been before. My husband was trapped in the twisted architecture of his neurons and no matter what I did I could not pull him out.

In early May, the movie wrapped and he came home from Vancouverlike a 747 airplane coming in with no landing gear. I have since learned that people with LBD who are highly intelligent may appear to be okay for longer initially, but then, it is as though the dam suddenly breaks and they cannot hold it back anymore. In Robin's case, on top of being a genius, he was a Julliard-trained actor. I will never know the true depth of his suffering, nor just how hard he was fighting. But from where I stood, I saw the bravest man in the world playing the hardest role of his life.

Robin was losing his mind and he was aware of it. Can you imagine the pain he felt as he experienced himself disintegrating? And not from something he would ever know the name of, or understand? Neither he, nor anyone could stop itno amount of intelligence or love could hold it back.

Powerless and frozen, I stood in the darkness of not knowing what was happening to my husband. Was it a single source, a single terrorist, or was this a combo pack of disease raining down on him?

He kept saying, I just want to reboot my brain. Doctor appointments, testing, and psychiatry kept us in perpetual motion. Countless blood tests, urine tests, plus rechecks of cortisol levels and lymph nodes. A brain scan was done, looking for a possible tumor on his pituitary gland, and his cardiologist rechecked his heart. Everything came back negative, except for high cortisol levels. We wanted to be happy about all the negative test results, but Robin and I both had a deep sense that something was terribly wrong.

On May 28th, he was diagnosed with Parkinson disease (PD).

We had an answer. My heart swelled with hope. But somehow I knew Robin was not buying it.

When we were in the neurologist's office learning exactly what this meant, Robin had a chance to ask some burning questions. He asked, Do I have Alzheimer's? Dementia? Am I schizophrenic? The answers were the best we could have gotten: No, no, and no. There were no indications of these other diseases. It is apparent to me now that he was most likely keeping the depth of his symptoms to himself.

Robin continued doing all the right thingstherapy, physical therapy, bike riding, and working out with his trainer. He used all the skills he picked up and had fine-tuned from the Dan Anderson retreat in Minnesota, like deeper 12-step work, meditation, and yoga. We went to see a specialist at Stanford University who taught him self-hypnosis techniques to quell the irrational fears and anxiety. Nothing seemed to alleviate his symptoms for long.

Throughout all of this, Robin was clean and sober, and somehow, we sprinkled those summer months with happiness, joy, and the simple things we loved: meals and birthday celebrations with family and friends, meditating together, massages, and movies, but mostly just holding each other's hand.

Robin was growing weary. The parkinsonian mask was ever present and his voice was weakened. His left hand tremor was continuous now and he had a slow, shuffling gait. He hated that he could not find the words he wanted in conversations. He would thrash at night and still had terrible insomnia. At times, he would find himself stuck in a frozen stance, unable to move, and frustrated when he came out of it. He was beginning to have trouble with visual and spatial abilities in the way of judging distance and depth. His loss of basic reasoning just added to his growing confusion.

It felt like he was drowning in his symptoms, and I was drowning along with him. Typically the plethora of LBD symptoms appear and disappear at random timeseven throughout the course of a day. I experienced my brilliant husband being lucid with clear reasoning 1 minute and then, 5 minutes later, blank, lost in confusion.

Prior history can also complicate a diagnosis. In Robin's case, he had a history of depression that had not been active for 6 years. So when he showed signs of depression just months before he left, it was interpreted as a satellite issue, maybe connected to PD.

Throughout the course of Robin's battle, he had experienced nearly all of the 40-plus symptoms of LBD, except for one. He never said he had hallucinations.

A year after he left, in speaking with one of the doctors who reviewed his records, it became evident that most likely he did have hallucinations, but was keeping that to himself.

It was nearing the end of July and we were told Robin would need to have inpatient neurocognitive testing done in order to evaluate the mood disorder aspect of his condition. In the meantime, his medication was switched from Mirapex to Sinemet in an effort to reduce symptoms. We were assured Robin would be feeling better soon, and that his PD was early and mild. We felt hopeful again. What we did not know was that when these diseases start (are diagnosed) they have actually been going on for a long time.

By now, our combined sleep deficit was becoming a danger to both of us. We were instructed to sleep apart until we could catch up on our sleep. The goal was to have him begin inpatient testing free of the sleep-deprived state he was in.

As the second weekend in August approached, it seemed his delusional looping was calming down. Maybe the switch in medications was working. We did all the things we love on Saturday day and into the evening, it was perfectlike one long date. By the end of Sunday, I was feeling that he was getting better.

When we retired for sleep, in our customary way, my husband said to me, Goodnight, my love, and waited for my familiar reply: Goodnight, my love.

His words still echo through my heart today.

Monday, August 11, Robin was gone.

After Robin left, time has never functioned the same for me. My search for meaning has replicated like an inescapable spring throughout nearly every aspect of my world, including the most mundane.

Robin and I had begun our unplanned research on the brain through the door of blind experience. During the final months we shared together, our sights were locked fast on identifying and vanquishing the terrorist within his brain. Since then, I have continued our research but on the other side of that experience, in the realm of the science behind it.

Three months after Robin's death, the autopsy report was finally ready for review. When the forensic pathologist and coroner's deputy asked if I was surprised by the diffuse LBD pathology, I said, Absolutely not, even though I had no idea what it meant at the time. The mere fact that something had invaded nearly every region of my husband's brain made perfect sense to me.

In the year that followed, I set out to expand my view and understanding of LBD. I met with medical professionals who had reviewed Robin's last 2 years of medical records, the coroner's report, and brain scans. Their reactions were all the same: that Robin's was one of the worst LBD pathologies they had seen and that there was nothing else anyone could have done. Our entire medical team was on the right track and we would have gotten there eventually. In fact, we were probably close.

But would having a diagnosis while he was alive really have made a difference when there is no cure? We will never know the answer to this. I am not convinced that the knowledge would have done much more than prolong Robin's agony while he would surely become one of the most famous test subjects of new medicines and ongoing medical trials. Even if we experienced some level of comfort in knowing the name, and fleeting hope from temporary comfort with medications, the terrorist was still going to kill him. There is no cure and Robin's steep and rapid decline was assured.

The massive proliferation of Lewy bodies throughout his brain had done so much damage to neurons and neurotransmitters that in effect, you could say he had chemical warfare in his brain.

One professional stated, It was as if he had cancer throughout every organ of his body. The key problem seemed to be that no one could correctly interpret Robin's symptoms in time.

I was driven to learn everything I could about this disease that I finally had the name of. Some of what I learned surprised me.

One neuropathologist described LBD and PD as being at opposite ends of a disease spectrum. That spectrum is based on something they share in common: the presence of Lewy bodiesthe unnatural clumping of the normal protein, -synuclein, within brain neurons. I was also surprised to learn that a person is diagnosed with LBD vs PD depending on which symptoms present first.

After months and months, I was finally able to be specific about Robin's disease. Clinically he had PD, but pathologically he had diffuse LBD. The predominant symptoms Robin had were not physicalthe pathology more than backed that up. However you look at itthe presence of Lewy bodies took his life.

The journey Robin and I were on together has led me to knowing the American Academy of Neurology and other groups and doctors. It has led me to discover the American Brain Foundation, where I now serve on the Board of Directors.

This is where you come into the story.

Hopefully from this sharing of our experience you will be inspired to turn Robin's suffering into something meaningful through your work and wisdom. It is my belief that when healing comes out of Robin's experience, he will not have battled and died in vain. You are uniquely positioned to help with this.

I know you have accomplished much already in the areas of research and discovery toward cures in brain disease. And I am sure at times the progress has felt painfully slow. Do not give up. Trust that a cascade of cures and discovery is imminent in all areas of brain disease and you will be a part of making that happen.

If only Robin could have met you. He would have loved younot just because he was a genius and enjoyed science and discovery, but because he would have found a lot of material within your work to use in entertaining his audiences, including the troops. In fact, the most repeat character role he played throughout his career was a doctor, albeit different forms of practice.

You and your work have ignited a spark within the region of my brain where curiosity and interest lie and within my heart where hope lives. I want to follow you. Not like a crazed fan, but like someone who knows you just might be the one who discovers the cure for LBD and other brain diseases.

Thank you for what you have done, and for what you are about to do.

Susan Schneider Williams serves on the Board of Directors for the American Brain Foundation (americanbrainfoundation.org) but reports no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the author, if any, are provided at the end of the editorial.

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The terrorist inside my husband's brain - neurology.org

Department of Neurology – Department of Neurology – Home

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I would like to take a moment to welcome you to the Department of Neurology at Saint Louis University School of Medicine. I am certain you will find this information both helpful and informative.

Saint Louis University School of Medicine has a long history of excellence in teaching, research and patient care. Saint Louis University established the first medical school west of the Mississippi River in 1836. In 1929, Mother Marie Kernaghan became the first woman to graduate from Saint Louis University with a Ph.D. Her degree was in physics. In 1932, the University opened the Firmin Desloge Memorial Hospital, later named Saint Louis University Hospital. Dr. Gilbert Chaddock was the first neurologist of record at Saint Louis University. He was the main consulting neurologist in the 1930s.

Our institution is rooted in tradition while looking forward to growing in new and exciting ways. Saint Louis University Hospital is now a part of SSM (Sisters of St. Mary) which will create even more diversity in patient care and in teaching experiences for our students and residents. Although our primary inpatient service is at SSM Health Saint Louis University Hospital, we also have a partnership with Saint Louis John Cochran VA Medical Center and Cardinal Glennon Childrens Medical Center.

As a graduate of Saint Louis University School of Medicine in 1997 and completing a fellowship in Child Neurology at Saint Louis University in 2007, I know first-hand of the amazing faculty, students, residents and staff we have in the Department of Neurology. Our department is dedicated to our patients, students, and residents. We strive to provide the best care possible for our patients while committing to teaching our students and residents so they will become experts in the field of neurology. I am looking forward to all that we will accomplish in the future and I encourage you to peruse our website for further information about our department.

Sincerely,

Sean Goretzke, MD

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Department of Neurology - Department of Neurology - Home

Neurology – IU School of Medicine

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Under the leadership of Professor and Chairman Robert M. Pascuzzi, M.D., the IU School of Medicine Department of Neurology's core mission is to advance neurological health in Indiana and beyond through innovation and excellence in education, research and patient care.

The department's foundation of values includes:

The Department of Neurology is located in the new IU Health Neuroscience Center, a state-of-the-art outpatient center that unites all the specialties that involve nervous system disorders Neurology, Neurosurgery, Psychiatry, Physical Medicine and Rehabilitation, Neuropsychology, and Neuroradiology. It is also home of the main outpatient Neurophysiology (EEG, EMG and Evoked Potentials) laboratory at IU Health. The adjoining Indiana University Neurosciences Research building enables clinicians, basic scientists and physician scientists in the neurosciences to collaborate in research, education and patient care in an environment that is rarely achieved in academic medicine.

IU Health Neuroscience Center

Goodman Hall, Suite 4700

355 W. 16th Street

Indianapolis, IN 46202

Phone: (317) 948-5450

FAX: (317) 963-7533

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Neurology - IU School of Medicine

Dr Leah Kroeger – Prince William Neurology – Manassas, Va

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9625 Surveyor Court, Suite 110

Manassas, Virginia 20110

Monroe Building

Next to Prince William Hospital

Prince William Neurology

9625 Surveyor Court, Suite 110

Manassas, Virginia 20110

(703) 257-7180 phone

(703) 257-7129 fax

contactus@princewilliamneurology.com

Dr. Kroeger is a terrific physician. She always makes time to see me quickly, listens to my needs and helps me navigate my complicated symptoms.

- Margaret, Gainesville VA

I confidently refer my patients to Dr. Kroeger. They always come back with excellent feedback and progress. - Family Medicine Physician

Whether new or long-term, all my patients have personal 24/7 access to me and can make appointments quickly and on their schedule.

My missionis high quality care with empathy and compassion. Ilisten well, perform thorough exams and deeply value patient relationships.

I've practiced privately in Manassas for nearly 10 yearsafter being educated in state at William & Mary, The Medical College of Virginia and Georgetown.

Top Doctor: Washingtonian 2015, Northern Virginia Magazine 2014 and Washington Consumers Checkbook 2014

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Dr Leah Kroeger - Prince William Neurology - Manassas, Va

Neurology in Louisville, KY | Louisville Physicians

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Patients who experience neurological challenges are faced with an array of complex decisions concerning their care and treatment. The care and support required extends far beyond the needs of the patient because with neurological disorders, family members and loved ones also experience changes that impact their daily lives. UofL Physicians-Neurology, formerly known as University Neurologists PSC,compriseshighly trained neurologists in Louisville who specialize in conditions that negatively affect the brain and nervous system as a result of injury or disease. Additionally,UofL Physicians - Child Neurology has a team of specialists trained specifically in pediatric neurology. At UofL Physicians-Neurology, we diagnose and treat disorders that affect the brain, spinal cord, muscles and nerves throughout the body. Our array of specialized clinical services, including evaluation and management, second opinions for complex cases and diagnostic testing allows us to provide services for both minor disorders and patients who are critically ill.

The UofL Physicians - Neurology clinical subspecialties include: general neurology, stroke, epilepsy, movement disorders, neurodegenerative diseases, multiple sclerosis, neuromuscular disease, clinical neurophysiology, headache, sleep disorders, and child neurology.

UofL Physicians - Neurologys multidisciplinary staff of more than 20 clinical faculty and over 35 department members strives to provide patient-focused, world-class medical care for the entire spectrum of neurological diseases. As researchers and teachers at the University of Louisville School of Medicine, we have a passion and commitment to develop new treatments and cures for neurologic diseases. Our clinical research in stroke and multiple sclerosis are among the fastest growing programs in the country, enrolling patients in important clinical trials with potentially life-saving treatments. Our research in movement disorders, particularly in progressive supranuclear palsy and Parkinsons disease, is internationally recognized as the leading work in this subspecialty of neurology. The programs at UofL Physicians-Neurology involve a worldwide interdisciplinary network of collaboration aimed at developing preventive and corrective treatments for neurological disorders.

Find neurologists in Louisville by viewing the Our Physicians tab.

University of Louisville Physicians Child Neurology offers comprehensive diagnostic and treatment services for infants and children with disorders of the nervous system. Our specialists are devoted to promoting the optimal care and welfare of children with neurological and neurodevelopmental disorders. These disorders include epilepsy, cerebral palsy, mental retardation, learning disabilities, complex metabolic diseases, nerve and muscle diseases and a host of other highly challenging conditions.

The child neurologists at UofL Physicians are specially trained physicians who have followed up their four-year medical school education training in pediatrics, general neurology, and pediatric neurology.

UofL Physicians child neurologists diagnose, treat and manage the following conditions:

For more information on Child Neurology, visithttps://www.uoflphysicians.com/child-neurology.

Correct diagnosis of neurologic disorders in older adults can be difficult because signs of disease may mimic normal signs of aging. Also, patients frequently have more than one neurologic problem at once. It can be challenging to find the best treatment once such a problem has been diagnosed.

The team of professionals at the UofL Physicians Neurology practice is led by Dr. Robert Friedland, a nationally and internationally recognized expert, researcher and physician committed to identifying groundbreaking treatments that address the clinical and biological issues associated with Alzheimers and related diseases.

Under Dr. Friedlands leadership, the practice performs an initial comprehensive evaluation, which includes a detailed history and mental status examination; standardized cognitive, functional and depression testing; pertinent neurological and physical examination; laboratory testing; neuroimaging; and referral for neuropsychological testing and for consultation by other team members as necessary. The team identifies risk factors for future cognitive decline and protective factors that may slow future cognitive decline.

Patients then receive a holistic individualized treatment plan, which aims to reduce the impact of risk factors while promoting protective factors along with neuroprotective and cognition-enhancing drugs and supplements.

Epilepsy is diagnosed in 125,000 Americans each year. Finding the experts required to address the condition can be frustrating. With epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions and behavior or sometimes convulsions, muscle spasms and loss of consciousness.

Even mild seizures may require treatment because they can be dangerous during activities such as driving or swimming. Treatment which generally includes medications and sometimes surgery usually eliminates or reduces the frequency and intensity of seizures. Many children with epilepsy even outgrow the condition.

The UofL Physicians Epilepsy Program provides comprehensive diagnosis and management for people with epilepsy. Our team of specialists includes epileptologists, epilepsy fellows, neurosurgeons, neuroradiologists, nurses and EEG technologists committed to providing the best possible care for people with epilepsy. We treat the entire person taking in to consideration age, health and lifestyle to address a treatment that is the most effective for the patient. Education is the key to treating this condition, and our experts invest the time required to assist the patient and their families to fully understand the recommended treatment.

List of Services:

Headaches can range from minor headaches that last a few minutes to intense migraines that may be debilitating. The UofLPhysicians - Comprehensive Headache Program promotes excellence in patient care to individuals with headache and facial pain throughout the Kentuckiana region.

UofL Physicians - Parkinson's Disease and Movement Disorders, in partnership with Frazier Rehab and Neuroscience Institute, provides state-of-the art, comprehensive care to patients and families with movement disorders.

For more information, visit the UofL Physicians - Parkinson's Disease and Movement Disorders page or theUofL Medical School's Neurology page.

The University of Louisville Physicians - Neuromuscular Program provides a full complement of services ranging from clinical assessment, laboratory testing and electrodiagnosis to biopsy and histology of nerve and muscle. Currently, several clinical trials are in place for investigation of new and novel therapies of nerve, muscle and neuromuscular junction disorders.

When it comes to minimizing the effects of stroke, immediate care is vital. The University of Louisville Physicians Neurologists led two nationally recognized stroke Centers set up to make sure stroke patients receive rapid, comprehensive care; University Hospital Stroke Center and The centers offer in-house stroke team available 24 hours a day, seven days a week. Combining technology, therapy and treatment, patients receive the most comprehensive care in the region. Examination, laboratory studies, cardiac tests, and state-of-the-art imaging studies can be performed within minutes of a patient's arrival in the Emergency Care Center. A full range of medical and rehabilitation services is instantly available, from a team that includes neurologists, critical care physicians, interventional neuroradiologists, neurosurgeons, and cardiologists as well as nutritionists, physical therapists, speech-language pathologists, diabetic coordinators, and stroke nurses.

To find out more about the University of Louisville Physicians - Stroke programs please visit University Hospitals Stroke Center.

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Neurology in Louisville, KY | Louisville Physicians

Unusual symptoms – Neurology – MedHelp

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HI! I was reading all the comments and wanted to advise those who have not had one to have a spinal tap and an eye exam of the optic nerve. I have had all of the symptoms and more and was diagnosed with intracranial hypertension five years ago. I also have lupus and am in the process of being worked up for myathenia gravis.

If you can, have a spinal and brain MRI - I never got a spine one. If you are on dierutics remember that they can make you feel dizzy and tingly as can hypothyrodism and heart problems, and a few other diseases that arn't neuro based. I would advise an echocardiogram as well.

I had lupus for yeears before being diagnosed with the IH and theentire time I had the IH i kept telling them about my muscle burning and fatigue, terrible fatigue after exhertion and by the end of the day unable to even use muscles, tingling and so on and it's not until now that an EMG was done and the MG blood tests. EMG was not normal -s till don't have the blood work back.Lupus can also cause many and mostof the symptoms here but is an easy blood work up.

MS can be very deceptive for years and eyars and years but many ,many things including chronic fatigue and fibromyalgia and IH can cause your symptoms.

I havea friend with severe chronic fatigue and she has all of the symptoms including bowel problems and sleep apnea and orthstatic hypotension (another cause of dizzyness).

These things can be really hard to diagnose.

A spinal tap is good because if you have MS the cells will show up in the fluid and if you have IH you brain pressure will read too high.

Symptoms of IH

Papilledema (have you had your eyes checked for optic nerve damage)

pressure severe headache behind the eyes, vomiting, nausea, dizzyness, ear ringing, whooshing, pins and needles, fatigue, muscle fatigue blurry, double vision, visual disturbances )hallucinations), some of us have more serious neurological defects such as memory loss, confusion, trouble walking and excercising and so on - even breathing. (not everyone has all of the symptoms but everyone has increased pressure and papilledema)

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Unusual symptoms - Neurology - MedHelp

Nerve Conduction Test Side Effect? – Neurology – MedHelp

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I found this post when I was looking for an answer to this very question, after waking up around 3am with a foot and leg cramp (right side) following a nerve conduction test the previous day (the test was only on my hands which were not touching any other part of my body).My whole body felt sore. I went back to sleep and arose at my normal hour. My right shoulder/neck felt like it had been hit with a baseball bat...very stiff and sore. Right hand and forearm was also very sore and painful.I had no such symptoms before the test. In fact, I was feeling remarkably pain-free except for some pain and stiffness in my hands.My right hand was deemed "moderate" nerve damage and the left was "mild to moderate."The median nerve runs the length of the arm through the carpal tunnel so it makes sense to me that I would experience shoulder and neck pain after the nerve had been stimulated by the test.The leg pain seems strange, although I have had chronic issues off and on with my right side...neck/shoulder pain, leg pain (mid-thigh, large muscle), right hand/wrist.I'm sure it is all connected somehow but I am not an expert on anatomy.It was good to know that I am not alone, however, I was not warned at all that there would be any side effects.I feel bad for people who had much worse side effects (crawling to the bathroom).Since my nerve conduction study was only on my hands and only moderately painful I can just imagine the impact of a nerve conduction study that was either more intense (voltage?) and/or on a larger muscle group.I find the crawling part completely believable based on my limited experience.I feel like I've been in a fender bender where I got hit with "moderate" force (20-30 mph)...just enough time to see it coming, tense, and really feel it the next day.

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Nerve Conduction Test Side Effect? - Neurology - MedHelp

Neurologists Dr. David W. Morledge, M.D. | Dr. Hana …

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When choosing a physician, it is important to make an informed choice. This involves knowing the qualifications, training and experience of your physician.

The physicians at Austin Neurological Clinic are neurologists who are specially trained in today's modern diagnostics, treatments, procedures and equipment.

As a board-certified neurologist, Dr. David W. Morledge has practiced at Austin Neurological Clinic since 1990 and also currently serves as the Medical Director of the Brain Injury Program at Texas Neuro Rehab Hospital.

With special interests in movement disorders, multiple sclerosis and traumatic brain injuries, Dr. Morledge holds hospital affiliations at St. David's Medical Center, Heart Hospital and Texas Neuro Rehab Center, among others. He previously served as the Chairman of Neurosurgery/Neurology at St. David's Medical Center.

Dr. Morledge graduated with his medical degree and completed his internship in Internal Medicine at Texas Tech University Health Science Center. He then completed a residency in Neurology at Arizona Health Science Center.

In addition to his practice experience, Dr. Morledge is also a member of several professional organizations, including:

His work has been published in relevant medical journals, and he has also served as a sub-investigator for several different research studies. Dr. Morledge has been recognized as a Texas Super Doctor by Texas Monthly Magazine every year since 2004.

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Dr. Hana Aubrechtova is a general neurologist, providing comprehensive care at the Austin Neurological Clinic. She is a board-certified neurologist in the Czech Republic. She is also board certified in Acupuncture.

Dr. Aubrechtova received her medical degree from Charles University in Prague and the Faculty of Medicine in Pilsen, Czech Republic. She then completed a Neurology residency in the Czech Republic and became certified in acupuncture for neurological conditions. Dr. Aubrechtova practiced in Europe for four years before coming to the US.

Upon her arrival, Dr. Aubrechtova completed an internship at the Metrowest Internal Medicine Program in Framingham, Massachusetts and a Neurology residency at Virginia Commonwealth University Health Systems in Richmond, Virginia. Her diverse and heterogeneous training gave her a wealth of experience in the field of Neurology. She has also been trained for muscle chemodenervation using toxins like Botox and Myobloc, providing a variety of therapeutic injections for muscle pain and spasm relief.

In addition to her practice experience, Dr. Aubrechtova is involved in professional and community organizations, including:

Dr. Aubrechtova keeps up-to-date on the latest neurological advances by attending annual conferences and other meetings. She is affiliated with St. Davids Medical Center and Heart Hospital of Austin.

Visit Dr. Aubrechtova's personal website http://www.neurologyaustin.com

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Dr. Montgomery Verona is glad to have joined Austin Neurological Clinic and relocate back to Austin Texas in September 2010. He graduated from Southwestern University in Georgetown Texas in 1982, and completed his medical school/Neurology residency at University of Texas Medical Branch in Galveston Texas finishing in 1990.

Dr. Verona has been in private practice most recently in Evansville, Indiana. He was certified in 1993 by the American Board of Psychiatry and Neurology and recertified by the same in 2010. He has been an active memberof the American Academy of Neurology since 1990.

He enjoys helping adults with their neurological problems including NCV/EMG and EEG testing. He also enjoys spending time with his family and friends, biking/hiking trails, music, mountains, and medical mission trips.

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Sarah Granger is a board certified Adult Clinical Nurse Specialist with a focus in Neurology. Shereceived her undergraduate degree in Biology at St. Edward's University. While there, she had the incredible opportunity to study abroad in Australia for7 months.

Sarah continued her education at University of Texas and received her Master's Degree.During rotations,she immediately felt drawn to Neurology, especially stroke.Because her stepfather had suffered from a stroke, she was determined to help other strokepatients and their families.

An avid researcher and learner,Sarah enjoys attending conferences anddocumenting case studies. Several of herarticleshavebeen publishedin the Texas Neurological Society newsletter.

Sarah and her husband, alocal dentist, enjoyplaying tennis, traveling, and making beignets together.

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Neurologists Dr. David W. Morledge, M.D. | Dr. Hana ...

Hereditary Motor Syndromes – Neuromuscular Disease Center

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Home, Search, Index, Links, Pathology, Molecules, Syndromes, Muscle, NMJ, Nerve, Spinal, Ataxia, Antibody & Biopsy, Patient Info

SMA Spinal cord Anterior roots are atrophic

ALS-SOD1 (A4V): Tongue atrophy

l Exon 1; Ala4Val Most common mutation Rapid onset & progression (1.0 yrs) Frequently only lower motor neuron signs

l Exon 2; His46Arg @ Cu binding site of SOD Onset: Late; Legs Bulbar unusual Slow progression (17 yrs)

l Exon 2; 6 bp deletion(G27/P28) 65 Mutation reduces transcription Low levels of mutant SOD1 protein Philipino founder Low penetrance Disease duration: 4.3 years

l Exon 4; Leu84Val Lower motor neuron only Rapid progression (1.5 yrs) ?Earlier onset in males

l Exon 4; Asp90Ala Onset: 20 to 94 yrs; Legs; Preparetic phase Leg cramps; Myalgia; Painful paresthesia Bladder dysfunction Progression: Slow; Legs Arms Inheritance Recessive: Finnish (2.5% carriers) Dominant: Clinically variable Incomplete penetrance

l Exon 4; Ile104Phe Variable intrafamilial clinical features Age of Onset: 6 yrs - asymptomatic Course: 2 to 14 yrs until bulbar signs Limb onset: arms or legs

l Exon 4; Ile113Thr Reported in Sporadic ALS patients Relatively common; Low penetrance Late Onset: Mean 59 years Course: Variable; 2 to 20 years

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Hereditary Motor Syndromes - Neuromuscular Disease Center

Dizziness/foggy feeling – Neurology – MedHelp

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I don't know if I'm in the right place or not, but if I'm not, please forgive me.

Several months ago, I began to have what I call "spells."It feels like something in my spine that gets weak and then I feel very light headed as though I'm going to pass out.

I've had 5 major spine surgeries - 2 lumbar and 3 cervical, the last being for spinal cord compression at the C3/C4 levels.I've also had a total hip replacement.Because of these chronic conditions, I'm currently a patient in a Pain Management Clinic at Walter Reed Army Medical Center, in Washington, D.C.I'm treated with MS Contin 30 mg, MS Contin 15 mg, 2 percocet at bedtime, 100 mg of elavil before bed.In May of this year, I became very depressed and was given Wellbutrin and Trazadone.These spells started after that.

Most recently, I've had cataract surgery on both my eyes.Upon recovery from the cataract surgery, when my doctor (ophthalmologist) was examining my eyes, he found that my optic nerve is swollen and immediately sent me to other doctors who agreed that it was swollen and told me I need to see a neurologist right away and the swollen optic nerve meant an increased level of pressure in the brain.My initial physician wanted these other folks to determine if I have papilledema or pseudo papilledema.The second physician I saw, as I said above, said that I needed to see a neurologist right away.

I had a brain stem stroke in 1988 and tomorrow, I'm going to see the neurologist who treated me for that.I'm a military dependent and wanted to keep my care at Walter Reed, but for some reason, they've dropped the ball on this and thus I decided to see the physician who treated my stroke simply because of the doctor's sense of urgency.I seem to remember at that time that something was said about my optic nerve, but I cannot remember what.I do remember that I was given cortisone to try to bring my vision back to normal after the stroke.However, I'm sure they have my records archived and can easily find out.It didn't, but it did get normal over a period of time by itself.I had double vision then.When I mentioned this to the second ophthalmologist (the one who told me to see a neurologist), he said no, this is more recent than that - meaning this swelling.I don't know how he could know that.

Anyway, as I said above, the only unusual symptom I've had are my weak spells and I've been told that I get very pale during them.It almost feels as though my blood pressure rises and then suddenly drops.

I would appreciate any comments you may have regarding my condition.

Margaret Roosa

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Dizziness/foggy feeling - Neurology - MedHelp

WAKE NEUROLOGY, PLLC | Wellness-based practice …

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Hives and other chronic and itchy skin rashes can be one of the reactions that you may manifests as a result of a gluten allergy. Since you cant be allergic to your own skin, the allergy or intolerance must actually lie with the gluten you consume.

People with gluten allergies may suffer from any number of unpleasant symptoms, triggered by their bodies inability to properly digest gluten. The symptoms can range in frequency and severity and may include migraines and lethargy, to gastrointestinal problems such as diarrhea or constipation, to skin problems. Going on a life-long gluten-free diet is the only method of managing this condition.

People with gluten allergies produce extraneous amounts of the IgA antibodies as a reaction to gluten in their systems. This reaction is considered an autoimmune response to what the body perceives to be an invasion by a foreign and unrecognisable substance. The body creates special antibodies to attack the gluten proteins; however, in the process it also begins to attack its own protein tissues. In some people the body deposits the antibodies into the skin. These antibodies are triggered when the gluten, which is absorbed into the bloodstream, is circulated around the body and deposited in the dermis (skin). This interaction results in eruptions on the skin that manifest as a blistering, burning and itchy rash known as Dermatitis Herpetiformis.

While Dermatitis Herpetiformis can affect any area of the body, it is mainly located on the scalp, elbows, buttocks, knees, legs and back. Research shows that Dermatitis Herpetiformis is not a common reaction to gluten, and it affects more men than women. People with Dermatitis Herpetiformis should get tested for gluten enteropathy, the most common form of celiac disease.

An elimination diet is the only way to control Dermatitis Herpetiformis. Even then, once you have gone gluten-free it may still take months, or even years, until the Dermatitis Herpetiformis completely resolves.

Can a gluten-free diet help your psoriasis?

With gluten-free diets getting more and more attention these days, you may wonder if going gluten-free would help reduce your psoriasis symptoms.

The jury is still out on this topic, but, in some cases, eliminating glutena complex protein found in wheat, barley and ryedoes seem to help reduce psoriasis. In a smaller number of cases, eliminating gluten can lead to dramatic improvements. However, following a gluten-free diet, which is very restrictive, is a major commitment. Its not a step you should take unnecessarily. Is gluten-free right for you?

To understand whyand ifeliminating gluten might be right for you, its important to understand why and how gluten can cause problems for some people.

Gluten allergy: Experts estimate that up to 2 million people in the U.S. may suffer from an allergy to gluten, which is found in bread, pasta, crackers and other baked goods made from wheat, barley, or rye. Less obvious are processed foods, from lunch meats to salad dressings, that can also contain this potentially problematic protein.

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WAKE NEUROLOGY, PLLC | Wellness-based practice ...

AANS – AANS Home Page

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Research Finds Tetanus Shot Improves Patient Survival According to a recent study published in the journal Nature, researchers from Duke Cancer Institute used a tetanus booster to prime the immune system in order to enhance the effects of vaccine therapy for lethal brain tumors, dramatically improving patient survival. The researchers built the study on earlier findings that glioblastoma tumors harbor a strain of cytomegalovirus (CMV) that is not present in the surrounding brain tissue, creating a natural target for an immune therapy. To read more about this study, click here.

Raman Technique Helps Surgeons Excise Brain Cancer A research team led by engineer Frdric Leblond of Montreal Polytechnique and neurosurgeon Kevin Petrecca, MD, PhD, of McGill University, also in Montreal, developed a Raman probe that can distinguish between normal cells and cancer cells. Its method, published in a recent issue of Science Translational Medicine, showed it could find previously undetectable cancer cells in the brains of glioma patients. Unlike other medical imaging techniques, Raman provides information on molecules, which could allow for faster characterization of tissue types. To read more about this technique, click here.

New Tumor-targeting Agent Treats Variety of Cancers A recent study published in the journal Science Translational Medicine found a new class of tumor-targeting agents that can seek out and find dozens of solid tumors, even illuminating brain cancer stem cells that resist current treatments. Years of animal studies and early human clinical trials show that this tumor-targeting alkylphosphocholine (APC) molecule can deliver two types of "payloads" directly to cancer cells; a radioactive or fluorescent imaging label, or a radioactive medicine that binds and kills cancer cells. One of the studys lead co-authors, John S. Kuo, MD, PhD, FAANS, who was initially skeptical, says "It is a very broad cancer-targeting agent both because of the many cancers that test positive, and its ability to detect cancer throughout the body. The APC analogs revealed clusters of cancer in patients that were small, asymptomatic and previously undetected by physicians." To read more about this study, click here.

Thank You for Attending the 83rd AANS Annual Scientific Meeting With the theme Neurosurgerys Founding Principles, the 83rd American Association of Neurological Surgeons (AANS) Annual Scientific Meeting welcomed more than 3,000 medical attendees to Washington, D.C., to celebrate and reflect on both the history and future of neurosurgery. For additional post-meeting information and resources, including online recordings, official photography from the sessions and the presidential address of 2014-2015 AANS President Robert E. Harbaugh, MD, FAANS, click here.

Introducing 2015-2016 AANS President, H. Hunt Batjer, MD, FAANS The American Association of Neurological Surgeons (AANS) has named Texas-based neurosurgeon H. Hunt Batjer, MD, FAANS, as its 2015-2016 president. His appointment was announced during the 83rd Annual Scientific Meeting, held in Washington D.C. May 2-6, 2015. As president of the AANS, I serve both the specialty and public interest. Neurosurgery cannot be performed by other health-care providers; by guiding health policy concerning the need for the highest-quality neurosurgical care and by ensuring continued patient access to neurosurgeons, neurosurgery will maintain its essential position in our evolving health-care system. The AANS leadership and staff will ensure that our members receive the highest quality continuing education, keeping members on pace with the dramatic technological advances that will allow us to treat currently non-curable disease, stated Batjer. To read more, click here.

Missed the Historical Vignettes Presented in Washington, D.C.? What can be learned from the founders of the United States of America and from those who shaped the specialty of neurosurgery? Written, recorded and edited by fellow neurosurgeons, these short films, presented before each Plenary Session during the 2015 AANS Annual Scientific Meeting in Washington, D.C., explore the lives and accomplishments of the neurosurgical founding fathers and their guiding principles. View the historical vignettes here.

Using the Polio Virus to Kill Cancer For the past year, producers from CBS 60 Minutes program have been following glioblastoma patients and reporting on their participation in a new clinical Phase I trial from Duke University, which uses the polio virus to help kill glioblastoma tumors. The trial is the result of more than 25 years of research by Dr. Matthias Gromeier, a molecular biologist. Although its still in a phase I stage of the study, using the virus is a promising new approach in the expanding field of cancer immunotherapy. To watch the two-part 60 Minutes segment, click here.

The Teenage Brain: A Neuroscientist's Survival Guide to Raising Adolescents and Young Adults Teens cannot control impulses and make rapid, smart decisions like adults can but why? Research into how the human brain develops helps explain. The author of The Teenage Brain, a neuroscientist and mother of two boys who are now in their 20s, wrote the book to explore the science of how the brain grows and why teenagers can be especially impulsive, moody and not very good at responsible decision-making. To read more about this book, click here.

AANS and CNS Identify Five Unnecessary Neurosurgery Tests, Procedures As part of an initiative to encourage physician and patient conversations related to their treatment options, the American Association of Neurological Surgeons (AANS) and Congress of Neurological Surgeons (CNS) released a list of specific neurosurgical tests or procedures that are commonly ordered, but not always necessary. As part of Choosing Wisely, an initiative of the ABIM Foundation, the list identifies five targeted, evidence-based recommendations that can support physicians by working with their patients to make wise choices about their care. To read the recommendations, click here.

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Imagine X Functional Neurology Santa Barbara Terrific Five Star Review by Jake K. – Video

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Imagine X Functional Neurology Santa Barbara Terrific Five Star Review by Jake K.
http://ixneuro.com/ (805) 962-1988 Imagine X Functional Neurology Santa Barbara reviews New Review I started seeing Dr. Adam a few weeks ago for shoulder pain and migraines. I have suffered...

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Imagine X Functional Neurology Santa Barbara Terrific Five Star Review by Jake K. - Video