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Neuroscience (SNI) Blog

'neuroscience' Neuroscience (SNI) posts

Treatment options for hemifacial spasm

Hemifacial spasm is the involuntary contractions of the muscles of the face, those innervated by the facial nerve (VII). The facial spasms are intermittent and occur on one side of the face only. Hemifacial spasm can involve the upper or lower half of the face and may progress to involve the entire half of the face. The intensity and frequency of these symptoms can increase over time and can persist even during sleep. Hemifacial spasm can be associated with vestibular dysfunction and cochlear dysfunction.
 
Hemifacial spasm is usually more common in women. The most common cause of hemifacial spasm is ...

Drug treatment and weight loss restores vision in a blinding disorder linked to obesity

As many as 100,000 Americans suffer from a disorder called pseudotumor cerebri or idiopathic intracranial hypertension that can cause permanent blindness and chronic headaches. The disease primarily strikes obese women of reproductive age with symptoms of daily headaches, visual symptoms including transient blurring or blindness, double vision, and pulsating noises in one’s head. Up to 5-10% of these patients may have permanent visual loss due to optic nerve damage.
 
A recent national trial funded by the National Institute of Health’s National Eye Institute has shown that a common water pill, acetazolamide, combined with a moderate but comprehensive dietary and lifestyle modification plan can restore and preserve vision in women with this disease. I was one of the local investigators for this trial along with Dr. Eugene May.
 
The symptoms of pseudotumor cerebri are thought to be due to high spinal fluid pressure around the optic nerves and brain due to impaired reabsorption of spinal fluid that is continuously being produced within the brain. This results in chronic headaches and swelling of the optic nerves that can lead to permanent blindness if left untreated. Patients typically are ...

Pituitary Tumors: Diagnosis and Management

The Swedish Pituitary Center at the Swedish Neuroscience Institute is one of the country’s largest centers for treating disorders of the pituitary gland – including pituitary tumors. The center brings together endocrinologists, neurosurgeons and radiation oncologists to offer a comprehensive, multidisciplinary approach to the diagnosis and treatment of these tumors.
 
Tumors in the pituitary gland are quite common and many of them are so small they may go undetected throughout life. Although 99 percent of pituitary tumors are benign, the associated symptoms can be
debilitating, especially with hormone-secreting tumors. Regardless of the type of tumor, individuals with pituitary tumors may experience headaches, blurred vision, impotence/infertility, and mood changes.

Debilitating Facial Pain May Be Trigeminal Neuralgia

All pain can be frightening, but when patients describe sharp, electric-type pain in their face, the cause may be Trigeminal Neuralgia, a treatable pain syndrome manifesting as unilateral facial pain that can be severe in intensity. The pain occurs in one or more distributions of the trigeminal nerve. The pain usually lasts for several seconds to several minutes followed by periods of being pain free. Trigeminal neuralgia pain can be triggered by sensory stimuli to the face including talking, brushing teeth, eating, and touching the face. In some cases, there is no trigger. The annual incidence of trigeminal neuralgia is approximately 4 in 100,000. The initial workup for trigeminal neuralgia may include an MRI of the brain to rule out brain tumor or MS plaques.

In many cases, trigeminal neuralgia is caused by compression of the facial nerve most commonly by the superior cerebellar artery or the anterior inferior cerebellar artery, although trigeminal neuralgia can be due to compression by a persistent permanent trigeminal artery or odioectatic basilar artery. Other causes of Trigeminal Neuralgia can include demyelinating disease (such as multiple sclerosis) and tumor. In some cases, the cause of Trigeminal Neuralgia is  ...

New Brain Stimulator Approved to Treat Epilepsy

On November 14th, 2013 the FDA gave its approval for an implanted brain stimulator to treat patients with medically refractory epilepsy. Epilepsy is one of the most common neurological disorders affecting nearly 1 in 100 Americans. This device has been under investigation for 10 years at the Swedish Neuroscience Institute (SNI) Epilepsy Center.

As principal investigator for the trial, I led  a team including Dr. Michael Doherty, Dr. Lisa Caylor and Dr. Alan Haltiner, along with the research department at Swedish to investigate the safety and effectiveness of the device through pivotal trials. The results showed that the responsive neurostimulator system (RNS) made by NeuroPace was indeed effective in treating patients with drug resistant seizures.

Why is this so significant? This device represents the first new non-medication treatment for seizures proven to be effective since 1997, and gives new hope to patients whose lives have been put on hold due to seizures. ...

Brain Aneurysm Awareness: Spreading the Word

September is National Brain Aneurysm Awareness Month and across the country, those affected by various forms of the disease raise awareness through fundraising and visibility events. Bringing a voice to the disease may seem daunting in a sea of awareness ribbons and weekend community walks—but  Swedish had the opportunity to focus a spotlight on Seattle as host for the Brain Aneurysm Foundation’s Annual Symposium. This Massachusetts-based organization is the nation’s only not-for-profit profit organization solely dedicated to providing critical awareness, education, support and research funding to reduce the incidence of brain aneurysms. Swedish Neuroscience Institute physicians teamed up with other elite physicians from across the country and others in the medical community, in addition to volunteers and Brain Aneurysm Foundation members to learn more about advances in research for the disease.

One unique component to this important event was the attendance of members of the Swedish Cerebrovascular Support Group. The group, established in 2012, brings together patients, family members and caregivers to share their experiences, with the goal of alleviating fears and concerns through education and group discussions...

Life-saving technology and getting the word out about radiosurgery

Twice last week I received phone calls from grateful family members thanking us for taking care of their loved ones when treatment options were dwindling. One patient is now 4 years past his CyberKnife treatment for inoperable lung cancer and is going strong and living life to the fullest. The other patient was recently treated and is feeling great and planning a European vacation. Both families are extremely appreciative for the care they received but both voiced frustration that they stumbled upon this treatment option by chance and that we need to do a better job of publicizing the radiosurgery modalities. As the person receiving these calls, I am thrilled to hear how our center has positively impacted so many lives but struggle with how to get the word out to those who may benefit from radiosurgery in the future. So with our patients’ stories fresh in my mind, here is an introduction to radiosurgery.

Stereotactic radiosurgery is targeted radiation therapy delivered to nearly any body part with precision while utilizing real time image guidance. The ....

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