Dec

19

2012 Neurology Game Changers, Which Foods Are Best for the Brain?

Dietary advice is common practice in cardiology and primary care, but recently food and drink have become important considerations for neurologists, too. Diet is inextricably linked to conditions such as heart disease, obesity, and diabetes. However, what we consume also seems to have significant implications for the brain: Unhealthy diets may increase risk for psychiatric and neurologic conditions, such as depression and dementia, whereas healthy diets may be protective. 2012 saw coffee and berries warding off dementia, caffeine supplements improving motor function in Parkinson’s and the Mediterranean diet reducing the odds of developing Parkinson’s. Lycopene-rich tomatoes and the flavanones in citrus fruits were found to protect against ischemic stroke. As for what not to eat, a study published in January in Stroke supported previous work linking red meat consumption with higher stroke risk, while diets high in carbohydrates and sugar reportedly raise the risk for mild cognitive impairment and dementia in the elderly. A 2009 study published in the Archives of General Psychiatry found that people who follow Mediterranean dietary patterns — that is, a diet high in fruits, vegetables, nuts, whole grains, fish, and unsaturated fat, (common in olive oil and other plant oils) — are up to 30% less likely to develop depression than those who typically consume meatier, dairy-heavy fare. The olive oil-inclined also show a lower risk for ischemic stroke and are less likely to develop mild cognitive impairment and Alzheimer disease, particularly when they engage in higher levels of physical activity.

All data derived from Medscape, 2012.

Oct

6

So what is vestibular rehabilitation therapy, a.k.a.VRT?  Think about it like this.  Suppose you just had shoulder surgery.  Would you be all better, or would you now need to do physical therapy to rehabilitate your shoulder back to normal function?  Without rehab such as this, I can tell you that you will never regain normal use of your shoulder.  Well the same is rue of the vestibular labyrinth.  Whenever you have any affliction that causes any type of dizziness or vertigo, without vestibular rehabilitation therapy exercises, it is highly unlikely that you will just return to normal function.

Is There a Difference Between Physical Therapy and Vestibular Rehabilitation Therapy?

Yes.  Physical therapy involves exercise therapy primarily for the trunk and limbs.  This can oftentimes be useful for individuals with increased fall risk and imbalance.   However, it should not be confused with vestibular rehabilitation therapy which concerns itself with rehabilitation of the vestibular labyrinth, brain and oculomotor system.

How Does Vestibular Rehabilitation Therapy Work?

Just like physical therapy makes muscles grow stronger and more coordinated, vestibular rehabilitation therapy is a method of habituating neurons of the central nervous system, (primarily the brain), and the vestibular system so that neurologic function  may be enhanced thus improving the function of the balance systems. Because neurons respond and grow very differently than does muscle tissue however, vestibular rehabilitation therapy must be done very specific to your needs.  This is to say that a canned approach will not work.  Two individuals with the same exact problem may respond very differently to vestibular rehabilitation therapy depending on the extent of involvement of their disorder, their overall health going into treatment, and their level of stamina in their ability to perform the exercises in the first place. If this is not taken into consideration in the therapy plan, the treatment is destined to fail and will in all likelihood even worsen the patients status.  I see this all of the time in my own practice as it is a common occurrence and reason for referral to my office in the first place.

Jun

28

So why is it that one can go to ten different specialists, get no diagnosis or effective treatment , and that same individual can then come to see me and get better in a few days?  Am I just very lucky?  Is it the power of suggestion?  Well, I can tell you, that’s not it.

Here is why.  Most specialists do what they do very well.  They excel in and have vast studies preparing for their particular area of expertise.  However, most human suffering is not always textbook.  That is to say that when a doctor studies disorders, they do not always match up with what we might see in our offices.  Further, most doctors tend to be trained such that they are examining you with a goal of matching up your symptoms with illnesses that are referenceable in a medical textbook.  Many disorders can be diagnosed in this manner; however, the vast majority of human suffering is not from these “named” diseases.  It is from “shades of grey” symptoms that do not typically match up well with any disorder, yet are real symptoms for the patient.  Since the doctor cannot find any disease that matches your conditions symptoms, you are simply told to “learn to live with it”, or worse, “it’s all in your head.”  Few doctors examine patients cumulatively just trying to get a grasp of what might be realistically happening with that person rather than just trying to find the matching diagnosis code to send to the insurance carrier.  Well when you think about this, you can see how easy it is to have no idea of what may be happening to explain your symptoms.  It is easy to see how all of the individuals with disorders that fall into the “shades of grey” area are just going to be brushed off as being odd or unrealistic problems.

The reason why my office has so much success in this area, is because when I examine patients, I do not have a predisposed opinion of what disease I am trying to rule out.  I look at them for what they are, a human being with symptoms, and I use logic to rationalize what neurophysiology is not working properly, and more importantly, what could be done to fix it.  My office has had great success treating patients with difficult disorders in this regard.  Because of our success, we routinely see patients who come from other states and spend a week with me so that they may get better.

So if you have been told to “learn to live with it”, or have been going from doctor to doctor without answers, you are my best patient.  We always offer a complementary consultation if you prefer one prior to examination as we understand that you may have many questions simply out of years of frustration in dealing with the medical system.

Apr

3

After having completed specialty postdoctoral neurology course work a few years back in the treatment of children as well as adults with neurobehavioral disorders such as ADD, ADHD, autism, etc, I did not incorporate a plan to attract these types of patients into my office immediately.  Until recently, my office has largely focused in the management of patients with balance and movement disorder syndromes, such as vertigo, dizziness, dystonia, imbalance/fall risk, and patients with other brain injuries such as head traumas associated with accidents.  Recently however, in light of the endemic problems in school systems associated with children with ADD ADHD and other learning disabilities, we decided to incorporate patients with neurobehavioral disorders into our daily practice.  Since the inception of this program, we have taken in several patients with a diagnosis of ADD ADHD, most of whom have been children and most of whom had similar patterns exemplifying the disorder.  Our findings have been congruent with the findings of similar programs in other states in that we have met with a very high level of success.  These children no longer need to be medicated; their teachers have called us to see what we are doing as the children are notably improved, with demonstrable change in behavior and academia, etc.  As a result of our successes here, we are increasing the number of children that we accept into our program.  If you or someone you know is interested in our program, you can start by going to www.dcneuro.net/ADD.htm. From there, you can access a free informational report on the disorder, and also submit an electronic consultation form, which I personally will review.  If we feel you are a candidate for our program, we will let you know, (we will let you know either way).  Because we are currently limiting the number of children we accept into our program, even if we accept you, you may have to be placed on a waiting list, with which we appreciate your understanding.  Our office invests a great deal of time into this program and we spend 30 minutes to an hour with each patient.  As such, we must limit the number of participants.  If you prefer, you may contact my office directly at (723) 229-5250, and ask for Debbie.

Mar

31

In the past decade, prescriptions for Ritalin, a stimulant medication commonly used for attention deficit hyperactivity disorder (ADHD), increased five-fold, with 90 percent of all prescriptions worldwide consumed in the United States. As many parents grow leery of the traditional drug approach to ADHD, promising results with non-drug treatments that focus on postural stability, nutrition and lifestyle changes that affect brain activity are emerging.  Some children may simply have difficulty learning certain subjects, but the current system, in a sense, prompts school officials to encourage their parents to have the children diagnosed with ADHD.  The higher the number of disabled kids in the school, the more funding the school can apply for.  Some teachers might also have difficulty with students who have a different style of learning. If the child is a visual learner and the teacher is not, perhaps the child is not being taught in a way he or she can learn from. Before diagnosing the child with ADHD, several questions need to be answered, such as is the child too active? Bored?  Does the child suffer with dyslexia or a different learning pattern? It can be a behavior problem, problems at home, or frustrations with the teacher’s style. If we went to a conference where the speakers taught in a way we can’t learn, we would be frustrated and would misbehave, we’d get up and leave or chat to the person sitting next to us.  The traditional medical model, however, seems to follow the cookie-cutter principle. The diagnosis of ADHD is based on a questionnaire. But this is not enough.  True ADHD patients have other signs, tics, tremors, balance or postural problems, or unusual sensitivity to touch, movement, sights, or sounds. Unfortunately, although medications can keep ADHD under control, they don’t cure it. Eighty percent of patients have ADHD features in adolescence, and up to 65 percent maintain them in adulthood. Our office offers a non-drug and non-invasive integrative functional neurologic rehabilitative treatment alternative for ADHD patients that targets the underlying problems, not just symptoms.  Motor activity, especially development of the postural muscles, is the baseline function of brain activity. Anything affecting postural muscles will influence brain development. Musculoskeletal imbalance will create imbalance of brain activity, and one part of the brain will develop faster than the other, and that’s what’s happening in ADHD patients.  Chiropractic neurologists are trained to identify the under-functioning part of the brain and find treatments to correct the problem, to help that hemisphere grow.  On every patient, we perform a brain function exam. We test visual and auditory reflexes through, for example, flashing light in the eye, or asking patients to listen to music in one or the other ear.  When the problem is identified, patients are placed on a treatment program, and most of the therapies can be done at home. Patients are asked to smell certain things several times a day … or wear special glasses. We also focus on their individual problems. Some children, for example, have difficulty with planning, organization, and coordination, so they benefit from timing therapies.  They learn to clap or tap to the metronome, perform spinning and balancing exercises.  Although currently no studies comparing chiropractic neurological and drug treatment for ADHD are available, chiropractic neurologists are compiling the data. We test children before they start the treatment and then every three months. Within the first three months, the children get a two grade level increase on average, which is pretty dramatic.  With children on medications, the improvement in academic performance is short term and lasts only as long as they take the medication. Our programs change brain function and the improvement doesn’t go away.