#neurologist leesburg

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Understanding Bell's Palsy by Dr. Sarbjot Dulai | Neurology Associates Leesburg VA

Bell's Palsy is a medical condition that results in temporary weakness or paralysis of the facial muscles. While the exact cause is not definitively known, it is commonly associated with factors that may compromise the facial nerve. The condition is typically characterized by a sudden onset and can significantly impact a person's facial appearance and expressions. However, most individuals experience a full recovery, often without treatment, although recovery times can vary from weeks to months. It's always recommended to consult healthcare professionals for proper diagnosis and management.

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Painful and progressive, Carpal Tunnel Syndrome is the most prevalent entrapment neuropathy. Studies show that it affects around 3-6% of adults in the overall population.

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Breathing troubles during sleep can be a warning sign for sleep apnea, so consult a neurologist in Leesburg ASAP to receive a diagnosis and launch treatment.

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A Brain Scan May Predict Alzheimer’s. Should You Get One?

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Juli Engel was delighted when a neurologist beneficial a PET scan to find out whether or not amyloid — the protein clumps related to an elevated threat of Alzheimer’s illness — was accumulating in her mom’s mind.

“My inside response was, ‘Yay!’” mentioned Ms. Engel, 65, a geriatric care supervisor in Austin, Tex., who has been making nearly month-to-month journeys to assist her mom in Florida. “He’s utilizing each software to attempt to decide what’s occurring.”

Sue Engel, who’s 83 and lives in a retirement group in Leesburg, Fla., has been experiencing reminiscence issues and different indicators of cognitive decline for a number of years. Her daughter checked off the warning indicators: her mom has been financially exploited, suffered an insurance coverage rip-off, prompted an auto accident.

Medicare officers determined in 2013, shortly after PET (positron emission tomography) amyloid imaging grew to become out there, that they lacked proof of its well being advantages. So exterior of analysis trials, Medicare doesn’t cowl the scans’ substantial prices ($5,000 to $7,000, the Alzheimer’s Affiliation says); personal insurers don’t, both.

Juli Engel thinks Medicare ought to reimburse for the scan, however “if essential, we’ll pay for it out of pocket,” she mentioned.

Her mom already has an Alzheimer’s analysis and is taking a generally prescribed dementia drug. So she most likely doesn’t meet the standards developed by the Alzheimer’s Affiliation and nuclear medication consultants, which name for PET scans solely in circumstances of unexplained or uncommon signs and unclear diagnoses.

However as proof mounts that mind harm from Alzheimer’s begins years earlier than individuals develop signs, anxious sufferers and their households might begin turning to PET scans to be taught if they’ve this biomarker.

They’ve few alternate options. Scientists at Washington College in St. Louis introduced on Thursday that they’ve developed a blood take a look at for amyloid that may predict the event of plaques within the mind, however it’s years away from use in docs’ places of work.

Some consultants worry PET scans provide few advantages, at substantial prices. “There are many incentives, together with monetary incentives, for doing extra testing and interventions,” mentioned Dr. Kenneth Langa, a researcher on the College of Michigan and creator of a current article in JAMA Inside Medication about analysis of early Alzheimer’s illness. “My hope is we’ll suppose arduous in regards to the unintended downsides.”

What downsides? Amyloid plaques happen generally in older individuals’s brains, however not everybody with amyloid will develop dementia, which most likely entails a number of components. Nor does a detrimental PET scan imply somebody received’t develop dementia.

Biostaticians on the College of California, Los Angeles, have calculated 75-year-old man with amyloid has a 17.2 % lifetime threat of growing Alzheimer’s dementia; for a girl that age, with an extended life expectancy, the determine is about 24 %.

That’s primarily as a result of Alzheimer’s charges climb steeply at older ages, when individuals develop extra more likely to die of different causes earlier than they will develop signs. (With further biomarkers, or with the situation referred to as gentle cognitive impairment, the lifetime threat rises.)

However older individuals can also be among the many 30 % or so of these with amyloid deposits who, for unexplained causes, retain regular cognition.

“If we begin treating everybody with preclinical Alzheimer’s, we’ll deal with lots of people who would by no means have gone on to have dementia in any respect,” Dr. Langa mentioned.

Furthermore, what remedies would these be? A number of trials have failed to seek out medicine that forestall, reverse or sluggish Alzheimer’s illness, maybe as a result of these remedies had been launched too late within the illness’s course.

Outcomes from a unique strategy, an infusion drug being examined in older individuals with amyloid however with out cognitive impairment, stay a number of years away.

“As a clinician, would I like amyloid details about my symptomatic sufferers? Sure,” mentioned Dr. Ronald Petersen, a neurologist and director of the Mayo Clinic Alzheimer’s Illness Analysis Heart. “Am I going to have the ability to do one thing about it? Not at current.”

The medicine accepted for Alzheimer’s, primarily Aricept and Namenda, have modest advantages in some sufferers for a restricted time. Neither has been proven efficient for gentle cognitive impairment, typically a precursor to dementia.

But a lately printed research, undertaken to supply Medicare with extra info in hopes of reversing its reimbursement determination, exhibits that constructive amyloid PET scans result in far better use of those and different drugs.

The Concepts research (the title is shorthand for “Imaging Dementia — Proof for Amyloid Scanning”) analyzed the therapy of 11,409 Medicare beneficiaries with gentle cognitive impairment or dementia (common age: 75) nationwide. PET scans detected amyloid in 55 % of the sufferers with gentle impairment and 70 % of these with dementia; these outcomes influenced their circumstances in a number of methods.

The largest change: hovering prescriptions. About 40 % of these with gentle impairment had been taking Alzheimer’s medicine; after a PET scan that detected amyloid plaques, the proportion greater than doubled. In these with dementia, use of dementia medicine climbed from 63 to 91 % after a constructive PET scan.

Stopping these medicine after a detrimental scan occurred much more not often, “a quite common dynamic in medication,” Dr. Langa identified. “As soon as a therapy is began, it’s arduous to cease it.”

The second spherical of the Concepts research will assess whether or not these modifications led to raised well being. Have been sufferers much less more likely to go to emergency rooms or to be hospitalized? Did prices rise or fall?

The researchers anticipate to publish these findings early subsequent yr. In the event that they present that sufferers benefited, the Alzheimer’s Affiliation will ask Medicare to rethink its earlier determination and canopy PET scans for the subset of sufferers with atypical or unexplained signs.

These questioning broader entry fear, nonetheless, about “indication creep,” when a drug or take a look at accepted for sufferers with a selected situation turns into used for others. In addition they fear about crushing prices for Medicare.

“Even when a scan value zero , I wouldn’t suggest it,” mentioned Dr. Ken Covinsky, a geriatrician on the College of California, San Francisco. “Do you actually need to know that you’ve got amyloid in your mind, years forward of cognitive issues that will by no means develop?”

Proponents of constructing PET scans extra extensively out there argue that figuring out their amyloid standing might encourage sufferers to make life-style modifications. Stopping smoking, exercising and consuming extra healthily are all discovered to cut back dementia, even amongst these at larger genetic threat. Maybe, too, sufferers will probably be extra more likely to start advance care planning.

“These are good issues to do whether or not you have got amyloid or not,” Dr. Covinsky argued.

For now, prices most likely forestall many individuals from looking for PET scans for analysis. If Medicare pays — and probably even when it received’t — extra sufferers might discover methods to be scanned.

“You’ll all the time have individuals who use it inappropriately, however hopefully we will preserve that to a minimal” by educating docs, mentioned Maria Carrillo, chief science officer on the Alzheimer’s Affiliation.

However in the end, “we’re not right here to inform individuals what to do,” she added. “There are individuals who actually need that validation, and that’s a private determination.”

Juli Engel could also be amongst them.

As soon as the neurologist paperwork her mom’s incapacity, she will take steps to stop Sue Engel from driving, and to maneuver her into assisted dwelling when wanted. As a geriatric care supervisor, “I do know the trajectory of this illness,” she mentioned.

As a result of she additionally is aware of that each her maternal grandparents had Alzheimer’s, she is contemplating her personal future, too. Does she have amyloid in her mind?

Her household is stuffed with scientists, and “it’s our bent to need to know these items,” she mentioned. “I believe we’re entitled to that.”

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Characterized by involuntary rhythmic muscle contractions, tremors can affect various parts of the body

Tremors are a common neurological condition that can cause a variety of symptoms, including muscle stiffness, speech abnormalities, and impaired balance. These involuntary shaking movements can significantly impact daily activities and quality of life.

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