Patient Education
ALZHEIMER’S DISEASE
Overview
Alzheimer’s disease is the most common form of dementia. The exact cause of Alzheimer’s disease is unknown. Most people who develop Alzheimer’s disease are 60 or older.
Symptoms
The earliest symptoms of Alzheimer’s disease involve memory loss and difficulty learning new information. Problems with getting lost, language, and emotional control are also common.
Diagnosis
There is no specific test for Alzheimer’s disease. The diagnosis is made primarily by history and examination. Many tests, including brain imaging and laboratory studies, are done to rule out other possible causes.
Treatment
Although currently there is no cure for Alzheimer’s disease, there are treatments available which can slow the progression of the disease.
Resources
American Academy of Neurology – aan.com
Alzheimer’s Association – alz.org
Alzheimer’s Foundation of America – alzfdn.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
AMYOTROPHIC LATERAL SCLEROSIS (ALS)
Overview
ALS, also known as Lou Gehrig’s disease, is a progressive degenerative disorder of the nervous system. ALS affects the motor neurons, which are nerve cells in the brain and spinal cord. These cells send messages to muscles throughout the body. In ALS, the motor neurons die.
Symptoms
Symptoms of ALS include weakness, problems with speaking, problems with swallowing, muscle twitches or cramps, muscle atrophy, and stiff muscles.
Diagnosis
There is no single test to diagnose ALS. The diagnosis is based on history, neurologic examination, and EMG/NCS. ALS is a difficult disease to diagnose. About 5,000 people in the United States are diagnosed with ALS each year. There are two types of ALS: sporadic and familial. The cause for sporadic ALS is unknown.
Treatment
Currently, there is no cure for ALS. For most people, there is progression of ALS resulting in death three to five years after diagnosis.
Resources
American Academy of Neurology – aan.com
ALS Association – alsa.org
Muscular Dystrophy Association – mdausa.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
BACK PAIN
Overview
Acute or short-term low back pain generally lasts from a few days to a few weeks. Most acute back pain is the result of trauma to the lower back ranging from an accident, sports injury, work around the house, lifting, twisting, etc.
Symptoms
Symptoms may range from muscle ache, shooting pain, limited flexibility, limited range of motion, and difficulty standing.
Diagnosis
The diagnosis is made primarily by history and examination. Imaging of the spine may be needed in certain clinical situations.
Treatment
Most cases of back pain will improve with conservative measures such as anti-inflammatory medications, muscle relaxants, and physical therapy. More invasive measures may be needed if conservative treatment is ineffective.
Resources
American Academy of Neurology – aan.com
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
BELL’S PALSY
Overview
Bell’s palsy is the temporary paralysis of the face caused by inflammation or damage to the facial (7th cranial) nerve. Typically the paralysis affects one side of the face but, in rare cases, both sides can be affected. It is felt that the most common cause is a viral infection. In our geographic area, Lyme disease is a relatively common cause as well.
Symptoms
The symptoms can vary from person to person ranging from mild weakness to total paralysis of the face. Other symptoms can include twitching, drooling, dry eye, impaired taste, and excessive tearing in the eye. The prognosis for recovery is generally very good. Most individuals begin to improve within 2 weeks of onset and recover completely within 3-6 months. In a few cases, the symptoms never fully resolve. In rare cases, the symptoms may recur, either on the same or opposite side.
Diagnosis
The diagnosis is made by history and examination.
Treatment
Steroids and anti-viral medication can be used to shorten the course of the disease. In cases due to Lyme disease, the appropriate antibiotic should be prescribed.
Resources
American Academy of Neurology – aan.com
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
CARPEL TUNNEL SYNDROME
Overview
Carpal tunnel syndrome (CTS) is caused by compression of the median nerve at the wrist. The risk of developing CTS is higher in those who perform repetitive tasks with their hands. CTS is also associated with pregnancy, diabetes, thyroid disease, and rheumatoid arthritis.
Symptoms
The symptoms of CTS usually begin with numbness and pain in the hand or wrist. Initially, the symptoms are typically intermittent and at night. The pain can radiate up the arm. As the symptoms worsen, they can become more consistent and also occur during the day. The symptoms can progress to include decreased grip strength.
Diagnosis
CTS is diagnosed by history, examination, and EMG/NCS.
Treatment
Initial treatment usually involves resting the affected hand, a wrist splint, and anti-inflammatories. If conservative measures are not effective, surgical decompression may be considered.
Resources
American Academy of Neurology – aan.com
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
DEMENTIA
Overview
Dementia is not a specific disease. Dementia refers to a collection of symptoms that can be caused by a number of disorders that affect the brain. People with dementia have impaired intellectual functioning that interferes with normal activities. Some of the diseases that can cause the symptoms of dementia are Alzheimer’s disease, vascular dementia, Lewy body dementia, frontotemporal dementia, Huntington’s disease, and Creutzfeldt-Jakob disease. Alzheimer’s disease is the most common form of dementia.
Symptoms
Memory loss is a common symptom of dementia but memory loss alone does not lead to a diagnosis of dementia. A person must have 2 or more brain functions that are impaired to diagnose dementia. Other symptoms of dementia can include personality changes, language dysfunction, loss of emotional control, loss of executive function, impaired mood.
Diagnosis
There is no specific test for dementia. The diagnosis is made primarily by history and examination. Many tests, including brain imaging and laboratory studies, are done to rule out other possible causes.
Treatment
Currently there is no cure for dementia. There are medications available for Alzheimer’s disease and some other progressive dementias which can slow the progression of the disease.
Resources
American Academy of Neurology – aan.com
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
EPILEPSY
Overview
Epilepsy is a neurologic condition where a person has recurrent unprovoked seizures. A single seizure does not mean that a person has epilepsy. Seizures are episodes of altered function because of abnormal electrical discharges in the brain.
Symptoms
The most visible sign of epilepsy is a seizure. Most seizures are brief lasting seconds to minutes. There are many types of seizures. Some of the symptoms and behaviors that can occur during a seizure include: convulsions, staring, repetitive movements or behaviors, and decreased awareness of what is going on.
Diagnosis
There are many different causes of epilepsy and in many cases no cause is found. Epilepsy is diagnosed by neurologic examination, imaging of the brain usually an MRI, and an EEG.
Treatment
Multiple medications are available for the treatment of epilepsy.
Resources
American Academy of Neurology – aan.com
Epilepsy Foundation – epilepsyfoundation.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
ESSENTIAL TREMOR
Overview
Essential tremor is a repetitive, involuntary, rhythmic trembling of one or more parts of the body. Essential tremor is the most common form of abnormal tremor. Essential tremor affects about 10 million Americans. Essential tremor is commonly hereditary and in those cases may be referred to as familial tremor.
Symptoms
Hand tremor is most common but the head, arms, voice, tongue, legs, and trunk may also be involved. There may also be mild gait disturbance. The tremor is typically intention or postural tremor. Intention tremor occurs at the end of a voluntary movement. Postural tremor occurs when a body part is held in one position.
Diagnosis
The diagnosis of tremor is made primarily by history and examination. Many tests, including brain imaging and laboratory studies, are done to rule out other possible causes.
Treatment
There is no cure for essential tremor but there are treatments available to help manage the tremor.
Resources
American Academy of Neurology – aan.com
International Essential Tremor Foundation – essentialtremor.org
Tremor Action Network – tremoraction.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
HEADACHE
Overview
There are four types of headaches: vascular, muscle contraction (tension), traction, and inflammatory. The most common type of vascular headache is migraine. Muscle contraction headaches involve the tightening or tensing of the facial and neck muscles. Traction and inflammatory headaches are typically symptoms of other disorders.
Symptoms
The specific symptoms of headache are variable depending on the type of headache.
Diagnosis
The diagnosis is made by history and neurologic examination. In some cases, imaging of the brain may be needed.
Treatment
There are various options for the acute treatment of headache depending on the type of headache. In patients with frequent headaches, there are treatments available for the prevention of headaches.
Resources
American Academy of Neurology – aan.com
American Migraine Foundation – americanmigrainefoundation.org
National Headache Foundation – headaches.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
MIGRAINE
Overview
A migraine is a recurring moderate to severe headache. The exact cause of migraine is unknown. It appears to be an inherited biochemical disorder in the brain.
Symptoms
The pain is typically throbbing and unilateral. There can also be sensitivity to light, sound, and/or odors. Nausea and/or vomiting may accompany a migraine.
Diagnosis
There is no medical test for the diagnosis of migraine. The diagnosis is made by history and neurologic examination. In some cases, imaging of the brain may be needed.
Treatment
There are many options for the acute treatment of migraine. In patients with frequent migraines, there are several medications available for the prevention of migraines.
Resources
American Academy of Neurology – aan.com
American Migraine Foundation – americanmigrainefoundation.org
National Headache Foundation – headaches.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
MULTIPLE SCLEROSIS
Overview
Multiple sclerosis (MS) is a neurologic disorder that affects the central nervous system (CNS), which includes the brain and spinal cord. In MS, the body’s immune system attacks the nerves in the CNS. The cause of MS is unknown. The most common type of MS is relapsing-remitting MS which means the symptoms come and go. The symptoms can last from days to weeks.
Symptoms
The symptoms of MS can include visual changes, dizziness, weakness, numbness, loss of balance, and incoordination.
Diagnosis
MS is diagnosed by history, neurologic examination, MRIs of the brain and spinal cord, and sometimes a spinal tap.
Treatment
Currently, there is no cure for MS. There are several medications available which can slow the progression of MS and also reduce the number of attacks.
Resources
American Academy of Neurology – aan.com
Multiple Sclerosis Association of America – msassociation.org
Multiple Sclerosis Foundation – msfocus.org
National Multiple Sclerosis Society – nmss.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
MYASTHENIA GRAVIS
Overview
Myasthenia gravis (MG) is a neuromuscular disorder that causes muscle weakness. The muscles commonly affected are those controlling the eyelids, eye movement, breathing, swallowing, the face, and the shoulders. MG is an autoimmune disorder in which the body produces antibodies that destroy the acetylcholine receptor. The acetylcholine receptor allows signals to be transmitted from nerves to muscles. The destruction of the acetylcholine receptor leads to muscle weakness.
Symptoms
The symptoms of MG vary from person to person but can include, drooping of the eyelids, problems with eye movements, double vision, difficulty with speech, difficulty swallowing, difficulty breathing, weakness of the face, weakness of the arms, and fatigue. MG usually does not reduce life expectancy and most people with MG are able to manage their symptoms.
Diagnosis
MG is diagnosed by history, neurologic examination, blood tests for acetylcholine antibodies, and EMG/NCS.
Treatment
Currently, there is no cure for MG but treatment is available that can effectively manage the symptoms.
Resources
American Academy of Neurology – aan.com
Myasthenia Gravis Foundation of America – myasthenia.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
MYOPATHY
Overview
A myopathy is a neuromuscular disorder in which the primary symptom is muscle weakness. Myopathies can be inherited or acquired. Inherited myopathies include the muscular dystrophies. Acquired myopathies include dermatomyositis and polymyositis.
Symptoms
The symptoms of myopathy can include muscle weakness, muscle cramps, stiffness, and spasm.
Diagnosis
Myopathy diagnosed by history and neurologic examination. Additional testing may include EMG/NCS, laboratory studies, muscle biopsy, and genetic testing.
Treatment
The treatment depends on the specific type of myopathy.
Resources
American Academy of Neurology – aan.com
Muscular Dystrophy Association – mda.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
NARCOLEPSY
Overview
Narcolepsy is a chronic neurological disorder caused by the bran’s inability to regulate sleep-wake cycles normally. People with narcolepsy experience irresistible bouts of sleep.
Symptoms
The symptoms of narcolepsy include excessive daytime sleepiness (EDS), sleep attacks, cataplexy, vivid hallucinations during sleep onset or awakening, and sleep paralysis. Cataplexy is the sudden loss of voluntary muscle tone. Cataplexy can occur spontaneously but is more often triggered by sudden strong emotions such as fear, anger, stress, excitement, or humor. Sleep paralysis is the temporary inability to move or speak while falling asleep or waking.
Diagnosis
Narcolepsy diagnosed by history, neurologic examination, and sleep studies including an overnight polysomnogram and MSLT.
Treatment
Currently, there is no cure for narcolepsy but medications are available to treat EDS, sleep attacks, and cataplexy.
Resources
American Academy of Neurology – aan.com
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
Narcolepsy Network, Inc. – narcolepsynetwork.org
National Sleep Foundation – sleepfoundation.org
PARKINSON’S DISEASE
Overview
Parkinson’s disease (PD) is a movement disorder which results from the loss of a neurotransmitter in the brain called dopamine. Each year about 50,000 people are diagnosed with PD. About 4-6 million people have the disease worldwide.
Symptoms
The symptoms of PD include tremor, rigidity, stiffness, poor balance, poor coordination, shuffling gait, and slowness of movements. Typically there is gradual progression of symptoms with PD.
Diagnosis
There is no medical test that can diagnose PD. PD is diagnosed by history and neurologic examination. Additional testing may be done to rule out other causes for the symptoms.
Treatment
Currently there is no treatment that can cure or slow the progression of PD. There are several medications available which can help control the symptoms from PD. There are also surgical options available for the treatment of PD.
Resources
American Academy of Neurology – aan.com
National Parkinson Foundation, Inc. – parkinson.org
Parkinson’s Disease Foundation – pdf.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
PERIPHERAL NEUROPATHY
Overview
Peripheral neuropathy results from damage to the peripheral nerves. There are many forms and causes of peripheral neuropathy. The most common cause of peripheral neuropathy is diabetes. Other common causes include poor nutrition, alcohol abuse, certain drugs or toxins, autoimmune processes, inflammatory disorders, and genes. Sometimes a specific cause cannot be identified.
Symptoms
The early symptoms can include tingling, numbness, burning, stabbing pain, shock-like pain, muscle cramping, or sensitivity to touch. Over time the nerve damage can worsen. Later symptoms can include weakness, muscle atrophy, and loss of balance.
Diagnosis
The diagnosis of peripheral neuropathy is made by history, neurologic examination, and EMG/NCS.
Treatment
Depending on the cause of peripheral neuropathy, there may be treatment available for neuropathy itself. Many times treatment focuses on symptomatic management.
Resources
American Academy of Neurology – aan.com
Foundation for Peripheral Neuropathy – foundationforpn.org
The Neuropathy Association – neuropathy.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
RESTLESS LEGS SYNDROME
Overview
Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move them.
Symptoms
The symptoms of RLS include throbbing, pulling, creeping, or other unpleasant sensations in the legs as well as an uncontrollable urge to move them. The symptoms occur primarily at night and typically with sitting or lying down.
Diagnosis
RLS is diagnosed by history and neurologic examination. Additional testing including labs, sleep study, and EMG/NCS may be done to rule out other causes for the symptoms.
Treatment
Currently there is no cure for RLS. There are several medications available which can help control the symptoms from RLS.
Resources
American Academy of Neurology – aan.com
National Sleep Foundation – sleepfoundation.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
SLEEP APNEA
Overview
Sleep apnea is a common sleep disorder characterized by brief disturbances in breathing during sleep. The most common type of sleep apnea is obstructive sleep apnea (OSA) which is caused by the relaxation soft tissue in the back of the throat blocking the passage of air. Central sleep apnea is caused by irregularities in the brain’s normal signals to breathe.
Symptoms
The symptoms of sleep apnea can include excessive daytime sleepiness, restless sleep, snoring,, morning headaches, difficulty concentrating, forgetfulness, irritability, changes in mood, etc. Sleep apnea is more likely to occur in men and in people who are overweight or obese.
Diagnosis
The diagnosis of sleep apnea is made by history, examination, and a sleep study.
Treatment
Depending on each case, treatment may include changes in lifestyle, continuous positive airway pressure (CPAP), surgery, or medications. Patients with untreated sleep apnea can be at risk for stroke, TIA, and heart disease.
Resources
American Academy of Neurology – aan.com
American Sleep Apnea Association – sleepapnea.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
National Sleep Foundation – sleepfoundation.org
SLEEP DISORDERS
Overview
Many sleep disorders are brain disorders that cause interruptions in sleep patterns. Sleep disorders prevent people from getting enough sleep. The brain regulates sleep and is the only organ known to require or benefit from sleep. Untreated sleep disorders not only affect the quality of life but can also cause serious safety problems and medical issues. Most sleep disorders fall into one of these categories: Circadian rhythm disturbances, hypersomnia, insomnia, narcolepsy, sleep apnea, restless legs syndrome, REM sleep behavior disorder, and parasomnias.
Symptoms
Symptoms of sleep disorders can include fatigue, inability to fall asleep at night, inability to stay asleep at night, excessive daytime sleepiness, loud snoring, sleep attacks, sleepwalking, and sleep terrors.
Diagnosis
The diagnosis of sleep disorders requires a careful history, examination, and often a sleep study.
Treatment
Treatment varies and is based on the specific sleep disorder involved.
Resources
American Academy of Neurology – aan.com
American Sleep Apnea Association – sleepapnea.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
National Sleep Foundation – sleepfoundation.org
Narcolepsy Network – narcolepsynetwork.org
Restless Legs Syndrome Foundation – rls.org
STROKE
Overview
A stroke is caused by the sudden loss of blood flow to the brain or bleeding in the brain. Strokes can be either hemorrhagic or ischemic. Risk factors for stroke include high blood pressure, diabetes, high cholesterol, heart disease, smoking, and family history.
Symptoms
The symptoms of stroke can vary depending on which part of the brain is affected. The symptoms of stroke can include weakness, numbness, confusion, trouble speaking, changes in vision, loss of balance, dizziness, loss of coordination, or severe headache. The sudden onset of any of these symptoms should be evaluated on an emergent basis.
Diagnosis
Stroke is diagnosed by history, examination, and brain imaging. People that have had a stroke are at a higher risk of having another stroke.
Treatment
For patients with ischemic stroke who meet certain criteria, a clot-busting drug (tPA) can improve outcomes when given up to four-and-a-half hours after symptoms began. Other treatments are directed at reducing the risks of complications, optimizing recovery, and preventing future strokes. For hemorrhagic stroke, treatment could include: drugs that lower blood pressure, surgery to remove blood from the brain or decrease pressure on the brain, surgery to fix damaged blood vessels, insertion of a coil to block off bleeding blood vessels, and drugs that prevent or reverse brain swelling.
Resources
American Academy of Neurology – aan.com
American Stroke Association – strokeassociation.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
National Stroke Association – stroke.org
SYNCOPE
Overview
Syncope is a medical term used to describe a temporary loss of consciousness due to the sudden decline of blood flow to the brain. Syncope is commonly referred to as fainting or passing out. There are several types of syncope including vasovagal syncope, carotid sinus syncope, and situational syncope. Syncope can be a symptom of heart disease or an abnormal heart rhythm. Syncope is typically not primarily a sign of a neurological disorder but may indicate a risk for certain neurological disorders.
Symptoms
Prior to passing out there usually can be dizziness, lightheadedness, and nausea. The skin may be cold and clammy. After fainting a person is usually unconscious for a minute or two but will revive and return to normal.
Diagnosis
The diagnosis of syncope is based on history and examination. Further cardiac and/or neurological evaluation may be needed depending on the specifics of each case.
Treatment
Treatment varies based on the specific causes of syncope.
Resources
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
TIA
Overview
A transient ischemic attack (TIA) is caused by the sudden loss of blood flow to the brain. By definition, the symptoms of TIA resolve within 24 hours. In fact, most TIAs last less than an hour. The risk factors for a TIA include high blood pressure, diabetes, high cholesterol, heart disease, smoking, and family history.
Symptoms
The symptoms of a TIA can vary depending on which part of the brain is affected. The symptoms of a TIA can include weakness, numbness, confusion, trouble speaking, changes in vision, loss of balance, dizziness, loss of coordination, or severe headache. The sudden onset of any of these symptoms should be evaluated on an emergent basis.
Diagnosis
TIA is diagnosed by history and examination. Brain imaging is done to rule out a hemorrhage or stroke. Imaging of the cervical and/or intracranial blood vessels may be done to evaluate for possible stenosis. A TIA can be a warning sign for a future stroke. About one-third of those who have a TIA will have a stroke sometime in the future.
Treatment
Depending on the etiology of the TIA, antiplatelet agents, such as aspirin, or blood thinners may be prescribed. If significant carotid stenosis is found, surgery or stenting may be needed.
Resources
American Academy of Neurology – aan.com
American Stroke Association – strokeassociation.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
National Stroke Association – stroke.org
TREMOR
Overview
Tremor is a repetitive, involuntary, rhythmic trembling of one or more parts of the body.
Symptoms
Tremor is characterized as rest tremor, intention tremor, or postural tremor. Rest tremor occurs when the affected body part is at rest. Intention tremor occurs at the end of a voluntary movement. Postural tremor occurs when a body part is held in one position.
Diagnosis
The diagnosis of tremor is made primarily by history and examination. Many tests, including brain imaging and laboratory studies, are done to rule out other possible causes. There are many causes of tremor. Tremor can be one of the many symptoms of a brain disease, such as Parkinson’s disease. Rest tremor is a common symptom of Parkinson’s disease. When tremor is the only symptom, the most common cause is essential tremor. Intention and postural tremor are common symptoms of essential tremor. Essential tremor affects about 10 million Americans. Essential tremor is commonly hereditary and in those cases may be referred to as familial tremor. Other causes of tremor can include thyroid abnormalities, hormonal abnormalities, medications, and caffeine.
Treatment
Depending on the cause of tremor, there are treatments available to manage the tremor.
Resources
American Academy of Neurology – aan.com
International Essential Tremor Foundation – essentialtremor.org
Tremor Action Network – tremoraction.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
TRIGEMINAL NEURALGIA
Overview
Trigeminal neuralgia (TN) is a neurologic disorder which affects the trigeminal (5th cranial) nerve resulting in neuropathic pain. TN may be the result of a blood vessel pressing on the trigeminal nerve as it exits the brainstem. TN can also occur in patients with multiple sclerosis. Rarely, TN can result from a tumor or AVM compressing the trigeminal nerve. TN can also result from injury to the trigeminal nerve from facial trauma, stroke, oral surgery, or sinus surgery.
Symptoms
TN results in severe, sudden, burning or shock-like pain of the face. It is typically unilateral. The pain is usually brief lasting seconds to minutes but can occur repeatedly. The pain can be triggered by contact of the cheek, brushing teeth, eating, drinking, talking, or exposure to the wind.
Diagnosis
TN is diagnosed by history and examination. An MRI of the brain is usually done to rule out tumor or multiple sclerosis as possible causes.
Treatment
There are various medications which can relieve the pain from TN. There are surgical and other invasive options available if conservative measures are ineffective.
Resources
American Academy of Neurology – aan.com
Facial Pain Association – fpa-support.org
National Institute of Neurological Disorders and Stroke – ninds.nih.gov
Member, American Society of Neuroimaging
Disclaimer
The information contained on this website is for informational purposes only. It is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment, or with any questions you may have regarding a medical condition.