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Neuroscience (SNI) Blog

'neuroscience' Neuroscience (SNI) posts

Study Makes Waves in Treating Essential Tremor

The treatment of neurologic disease took a major step forward this past week with the publication of a clinical trial that used ultrasound waves to treat Essential Tremor.  Essential tremor affects about 10 million people in the USA and can be extremely disabling. For patients that fail medical therapy invasive surgical options are considered, including deep brain stimulation (DBS). DBS surgeries involve drilling a hole in the skull and implanting an electrode into structures deep in the brain to turn off the unwanted signals that cause the tremor.

A study of 15 patients lead by Dr. Jeff Elias (University of Virginia) was published in the New England Journal of Medicine this week and describes how researchers used ultrasound waves to effectively treat Essential tremor non-invasively – no cutting or drilling:

 

Treating Arteriovenous Malformations to Remove the Risk of Rupture

An arteriovenous malformation (AVM) in the brain is a relatively rare condition – occurring in less that 1 percent of the population. It can, however, be neurologically morbid in young adults ages 15 to 20, who are at the greatest risk for hemorrhage and least likely to exhibit symptoms. About 2 to 4 percent of all AVMs each year hemorrhage.

An AVM’s tangled mass of blood vessels, which forms in utero, produces multiple direct connections between arteries and veins without the normal, intervening capillaries. Symptoms often are not present until later in life or until after the AVM ruptures.

A small number of congenital syndromes, such as Sturge-Weber, Rendu-Osler-Weber, ataxia telangiectasia, and Wyburn-Mason, are associated with AVMs. Once formed, extrinsic factors, such as arterial shunting, growth factors and intracranial hemorrhage, may alter the size and shape of an AVM.

The most common types of AVMs are:

Do you know the symptoms of a brain aneurysm?

It’s easy to get caught up in day-to-day demands and ignore changes in our health. It may not be wise, however, to dismiss those changes as symptoms of a hectic life. Blurred vision, dizziness or headaches that don’t get better can signal something serious.

Anywhere from 1 to 6 percent of Americans have a brain aneurysm but don’t know it. An aneurysm is a blister-like bulge on the wall of a blood vessel. It can go unnoticed for a long time. If it’s not treated, the pressure of the blood weakens the vessel, and the aneurysm grows like a balloon filling with air. If the aneurysm bursts, it causes a stroke.

An aneurysm can put pressure on nerves or tissue in the brain, which may cause:

  • Headache or neck pain
  • Vision problems, enlarged pupil, drooping eye lid
  • Numb face
  • Severe drowsiness

If you have a brain aneurysm, your doctor may ...

Carotid Stenosis: What you need to know

Carotid stenosis is a build of up plaque in the large arteries that supply the brain with blood. This buildup of plaque increases the risk of transient ischemic attack (TIA) and stroke. Risk factors for carotid artery stenosis include hypertension, hyperlipidemia, obesity, and tobacco use. Symptoms of carotid artery stenosis include facial droop, weakness or numbness on one side of the face and body, slurred speech, garbled speech, gait instability, dizziness, and visual disturbances including blurred vision, loss of vision and double vision.

Carotid artery stenosis can be diagnosed with several diagnostic studies including carotid ultrasound, MR angiography (MRA), CT angiography (CTA), and cerebral angiogram.

Treatment options for carotid artery stenosis vary depending upon the severity of stenosis, history of TIA or stroke, and...

Current Exercise Concepts for People with Parkinson’s Disease

Research over the last several years has shown the positive benefits of exercise for people with Parkinson’s disease. Participants in physical therapy exercise programs demonstrate improved reaction time and balance, increased endurance and augmented strength. These gains in function can result in decreased falling, more energy to get around the home or community, and ultimately a better quality of life.

 

Evidence also points to HOW you exercise as an important variable in slowing the disease process. Concepts such as neural priming, movement visualization, whole body exercise, and intensity of practice all contribute to functional gains for people with PD.

 

Come to Swedish/Issaquah on April 22 to hear about these concepts AND get a chance to practice these exercises in class. The event is FREE. Please...

How much tremor is too much?

Tremor is a normal physiologic reaction to anxiety or stress, but it is not normal to have a tremor when performing typical daily activities.

 

People who develop a tremor while eating, drinking, writing or doing other common activities may have a movement disorder called Essential Tremor. This is actually the most common movement disorder, and can affect up to 4% of people over age 40. People who have this disorder can take medications to help minimize the tremor, but they don't often reduce the tremor by more than about half. Deep brain stimulation (DBS) is an excellent treatment option for people with severe tremor, and can nearly eliminate the tremor in many patients. Many patients aren't sure when their tremor is severe enough to warrant surgery, and much of our conversation in the office is to help answer this question.

There is no one answer that is right for everyone, but for me it has to do with how well someone is actually doing in their daily life:

 

The Goal of DBS (Deep Brain Stimulation) Surgery

I met with several patients this week to discuss their personal journey to making the decision to pursue DBS surgery. Not surprisingly, they were well educated about their disease and treatment options.

Each patient reminded me that there is a lot of information and misinformation about surgery for movement disorders.

The most important advice I can give any patient or family is...

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