As a neurologic and sleep disorders specialist, All island neurology work is in a unique partnership of health care, providing and interpreting your tests, serving as a consultant to your referring physician, and providing medical care for your specific neurologic and sleep disorder needs. As a neurologist her expertise includes the diagnosis and medical treatment of disorders and diseases of the nervous system, which include the brain, spinal cord, nerves, and muscles.
She has special training in Sleep Medicine. Her expert in diagnosis and treatment of a variety of sleep disorders including sleep apnea, excessive daytime sleepiness and insomnia.
Memory loss can result from degenerative processes in the brain, may result from stroke, infection, or many other medical and neurologic disease. We specialize in evaluating the causes and treatment of memory loss. Comprehensive evaluation of this common problem typically involves imaging of the brain, and other physiological tests to determine the cause, and new developments in pharmacology may result in significant improvements and delay progression.
Amyotrophic Lateral Sclerosis (ALS) is also known as Lou Gehrig’s disease, named after the famous baseball player who died of the disease. It is a progressive disease of the nervous system that destroys the motor neurons. The vast majority of cases occur sporadically.
The mean onset of ALS occurs in the patients’ 50’s and 60’s with increasing risk until the age of 74. Males are affected 1.5-1.7 times as often as females. The prevalence in the United States is 3-8 cases per 100,000 people.
Back and neck pain are some of the most common aliments in our society and come from a variety of causes. They may be responsible for significant loss of work time, family time as well as leisure activities. Pain and disability may be mild to severe and the musculoskeletal system, nervous system or a combination of both may be responsible for neck or back pain. Chronic strain or stress, injury and degenerative disease may contribute to these conditions. Treatment strategies and success are dependent on finding the particular cause such that the most effective treatment may be instituted.
Bell's palsy is a weakness (or palsy) of the facial nerve. This weakness is likely the result of swelling of the facial nerve. Patients with this condition generally present with a droop of one side of the face resulting in problems with closing the eye and mouth on that side. Bell's palsy occurs in approximately 25 out of 100,000 people. The exact cause of Bell's palsy is not known, but in many cases a viral infection may be playing a role. In places where Lyme's disease is endemic, this condition may also be involved.
Carpal tunnel syndrome is the most common entrapment neuropathy. The term "entrapment neuropathy" refers to compression of a nerve somewhere in its course after it has left the spinal cord.
The term "carpal" means wrist. If one looks at a cross section of the wrist, a tunnel in the very center is apparent. The floor of the tunnel is formed by the wrist bones, which are arranged in two U-shaped rows, one in front of the other.
A concussion is a type of traumatic brain injury (TBI) which results from a sudden blow to head. The brain bumps against the skull as a result of acceleration followed by rapid deceleration and there is a temporary disruption of normal electrical activity. While loss of consciousness (LOC) is common with concussions, one can suffer a concussion without LOC. Severity of a concussion, however, may be related to the length of unconsciousness.
Acute or chronic dizziness may result in abrupt loss or balance or ability to walk, and may result from labyrinthitis, inflammation or tumors of the inner ear structures, or central nervous system abnormalities including stroke or tumors. Evaluation often involves specific imaging modalities for diagnosis, and treatment is specialized to the cause.
Essential tremor (ET) is the most common of the movement disorders - conditions that cause involuntary movement of one kind or another. While sometimes confused with Parkinson's disease by patients, it is quite different and does not lead to the disability that can be associated with Parkinson's disease. This condition affects about 1 in 5 people over the age of 65.
Multiple Sclerosis is a disease of the central nervous system (brain, spinal cord, and optic nerve) that interferes with the brain's ability to send and receive messages. It is believed to result from immune-system dysfunction. Inflammation results in the breakdown of myelin, the protective insulation surrounding the nerve fibers of the central nervous system. Myelin is destroyed and replaced by scars of hardened patches of tissue. When the myelin is damaged, nerve impulses are not quickly and efficiently transmitted.
Problems with balance and walking can result from many types of neurological and medical disorders, but the accurate diagnosis of the cause of these problems is essential to the effective treatment. Examination and treatment may evaluated for common neurological causes such and vestibular dysfunction, neuropathy, stroke or Parkinson's disease, demyelinating diseases and others, with treatment methods depending upon cause.
Headache is one of the most frequent reasons for medical consultation. The most prevalent headache type is tension headache, which is usually mild, unassociated with significant disability, managed without physician input, and responsive to over-the-counter analgesics (if treatment is required at all). On the other hand, when patients need to consult a primary care physician because of headaches, the most common diagnosis is migraine.
Migraine affects approximately 12% of the United States population. Epidemiological studies suggest that migraine is incorrectly diagnosed in roughly 50% of cases. Doctors and patients contribute to this misdiagnosis problem. Of the roughly 50% of misdiagnosed patients who actually have migraine, 40% of those are misdiagnosed with sinus headaches and 30% are misdiagnosed with tension headaches. Correct diagnosis is essential so that appropriate, successful treatment can be offered and also to avoid inappropriate and unnecessary treatments.
Neuropathy is more appropriately named peripheral neuropathy or polyneuropathy. Peripheral neuropathy refers to malfunction of the ends or peripheral part of many nerves, usually in the lower extremities. Peripheral neuropathy is not a disease of the brain or the spinal cord. The nerve endings most commonly affected are in the toes or the feet.
There are many causes of peripheral neuropathy, including medical disease, exposure to toxins or chemicals, infections and inherited diseases. The two most common causes of peripheral neuropathy are diabetes mellitus and exposure to alcohol. Other causes which are not as seen as commonly include vitamin B12 deficiency, Lyme disease and lead poisoning. In 30 to 40% of the patients who present with peripheral neuropathy, no exact cause can be discovered. In these cases, the peripheral neuropathy is termed "idiopathic" which means there is no known cause.
Parkinson's disease is a common movement disorder resulting in limb rigidity, resting tremor, small step gait or shuffling, facial masking, and other features. Variations may also result in other associated symptoms such as dementia, abnormal eye movements, hypotension, and others. Diagnostic evaluation often involves brain imaging and clinical kinetic testing.
Physician sees Patients 16 and older
Tourette syndrome (TS), a neurological movement disorder is named after a French physician, Gilles de la Tourette. At the end of the nineteenth century, Tourette described 9 patients who exhibited uncontrollable movements and vocalizations. Poorly understood for nearly 100 years, TS was long thought to be a purely psychiatric or an emotional disorder. It was not until the late 1960's and early 1970's that physicians realized that these patient's symptoms improved when given medication that blocked the action of dopamine in certain parts of the brain. This observation, along with other modern studies of genetics, neurochemistry, neuropharmacology and brain imaging has led researchers and clinicians to recognize that the underlying cause of TS is biological, in large part due to genetically caused abnormalities in brain neurotransmitters and receptors. It is thought that TS may be present in as many as 1 in 100 people, with most cases being very mild. Intensive worldwide research is underway to find the genes responsible for TS. It is hoped that genetic study of the disorder, along with other research efforts will ultimately provide more effective treatment, and perhaps a cure for those most severely affected.
When the brain is functioning typically, brain cells communicate with one another by way of seemingly random electrical activity, in order to control the body's movements.
A seizure is produced when the electrical activity of thousands to millions of brain cells fire simultaneously. Epilepsy is the disorder primarily characterized by the tendency to have recurrent seizures.
A single seizure does not necessarily suggest that one has epilepsy. 300,000 people have a first seizure each year and 200,000 new cases of epilepsy are diagnosed yearly. Approximately 2.7 million Americans have epilepsy and, over a lifetime, approximately 10% of Americans will have at least one seizure.
Stroke and TIA Evaluation and Treatment
Stroke and Transient Ischemic Attacks (TIAs) result in abrupt neurologic dysfunction and may result in disability. Evaluation and treatment is designed to identify causes of cerebrovascular disease, provide appropriate treatment, and structure preventative measures to avoid further vascular events.
Home Sleep testing
- Sleep Apnea
- Restless Legs Syndrome Insomnia
Jet lag syndrome
Shift work disorder
Delayed sleep phase syndrome
Advanced sleep phase syndrome
Non 24 sleep disorder