Neurology Q & A (2001)

Question 12/30/2001:  What are some of the early symptoms of Alzheimer's.  I read the report on this site about it. But was wondering of the signs to look for.  Can you help?
Answer:   Stage one of Alzheimer's disease is considered the mild phase and may last from two to four years or longer.  People in this stage of Alzheimer's may: say the same thing over and over; get lost easily, even in places they know well; lose interest in things they once enjoyed; have trouble finding names for common items; lose things more often than normal; undergo personality changes.
NEA Clinic
(870) 935-4150 (for appointment)

Question 12/27/2001:  I was rear ended in an accident in July, I cannot find a neurologist that takes 3rd party insurance, is there one around here? I have numbness and tingling in my hands and feet, headaches, itching and severe muscle spasms, I have also muscle loss.

Answer:   All we know to tell you is to check with the business office of neurologists to see what they require.  Because you were in an accident, a referral is usually required by the primary doctor before any specialist can intervene.

NEA Clinic

(870) 935-4150 (for appointment)


Question 12/26/2001:  On my left foot, I have numbness, all the time in my two middle toes. What could this be causing this?

Answer:  Persistent numbness or paresthesia is a common symptom of peripheral neuropathy.  However to make the proper diagnosis, it is important to have a history and physical exam.  Isolated neuropathy may just be secondary to trauma, or it may be an early manifestation of an underlying systemic disorder such as diabetes or even multiple sclerosis.  Sometimes it is helpful to get the input of the neurologists if the underlying cause is not readily apparent.

NEA Clinic

(870) 935-4150 (for appointment)


Question 12/26/2001:  I have pain in my right eye for several seconds and very drowsy about 11:00 a.m. almost everyday. Is this something to be concerned about?

Answer:  It is very difficult to say just with those symptoms.  This could be a migraine variant or even some type of neuralgia.  However with persistent symptoms you need to see your family doctor or an initial evaluation.

NEA Clinic

(870) 935-4150 (for appointment)


Question 12/11/2001:  What would cause your hands to shake (slightly) all the time?

Answer:   Persistent tremor is common to see in middle-aged to elderly individuals. The most common cause is benign essential tremor.  This is an inherited disorder, which causes a persistent rhythmic tremor that usually intensifies with intent. Writing or fine coordination movement makes this tremor worse, and when the patient is tired or nervous the tremor worsens.  Parkinsonism may also cause a persistent tremor.   This tremor is usually accompanied by a stiffness and rigidity of movement and a shuffling gait.  There are effective treatments for tremor.  See your family doctor or a neurologist for more details.

NEA Clinic

(870) 935-4150 (for appointment)

Question 11/22/2001:  My husband has been diagnosed with T-spine Neuroma. What exactly is it and is there any type of surgery that can help? He is in pain all the time, and is getting worse. He has had this problem for 16 yrs. The only doctor that he hasn't seen is a neurologist. The pain is located in 4 different places between his spine and right shoulder blade. The pain is like someone stabbing him with a knife over an over. Is there help out there?

Answer:  Neuroma are benign nerve tumors.  They can be located just about on any peripheral nerve.  If located in strategic areas, they can be painful. Usually treated with surgery if the pain is significant or if surgically possible.  Also treated medical but the patient should see a neurologist for management.

NEA Clinic

(870) 935-4150 (for appointment)

Question 11/20/2001:  An MRI was done and white spots on the brain were discovered. What kind of illnesses could this possibly denote?

Answer:  White spots on the brain can be caused from any different factors.  These spots are usually seen in individuals with a history of hypertension (high blood pressure), smolars, migraine headaches, aging and depending on the size and location - multiple fibrosis, and even small strokes.

NEA Clinic

(870) 935-4150 (for appointment)

Question 11/14/2001:  I have sharp pains, tingling, burning, and numbness in the front part of my feet when I sit down or lay down in the evenings only, what is causing this?

Answer:  You seem to be describing peripheral neuropathy.  With these symptoms you need to see your family doctor or a neurologist for an evaluation. Peripheral neuropathy may be caused by diabetes, B-12 deficiency, low thyroid stores, autoimmune diseases, or many other lesser known conditions. A nerve conduction velocity test can show changes of any nerve function. There are some medications on the market to stop the discomfort, but the main thing to do now is to try and determine the cause of this new symptom for you.

NEA Clinic

(870) 935-4150 (for appointment)

Question 11/7/2001:  My 80-year-old mother was recently diagnosed with Alzheimer's disease.  I am 55 and would like to know if there is any kind of medical test that can detect early if as her daughter I will get the disease.  I read somewhere there is some type of MRI or scan that can tell if a person has the likelihood of this condition.

Answer:   MRI studies do not make the diagnosis of AD.  There is a genetic test available, but it is not a 100% confirmation of a diagnosis.  The best way to know if you are at risk is to get mental examinations and follow up with your physician or to be evaluated by a neurologist.

NEA Clinic

(870) 935-4150 (for appointment)

Question 11/2/2001:  How long after ceasing Lupron and Casodex does the PSA return to a true reading? Or the medication leaves the body?

Answer:  The PSA is a protein produced by prostate cancer cells.  One of the uses of the PSA is to follow response to treatment in men who have metastatic prostate cancer.  Lupron and Casodex represent hormonal therapy for metastatic disease.  If the PSA declines while on this therapy it represents a response to treatment and if the PSA rises, it often means the cancer is growing. There is no "true reading: for the PSA after stopping therapy.  Hopefully, the PSA will remain stable, which would indicate no disease progression.

NEA Clinic

(870) 935-4150 (for appointment)

Question 10/13/2001:  My mother has been diagnosed with Alzheimer's disease.  She has short-term memory loss.  I have been told there are "stages" of the disease.  Can you tell me what to expect during each stage and how I will recognize the stage?  Also, is there a physician in the Jonesboro area who treats Alzheimer's patients?

Answer:  In Jonesboro Alzheimer's Disease is primarily managed by the Internists & Neurologists.  There are 3 stages of Alzheimer's Disease:

Stage 1-Mild Alzheimer's Disease: Duration 2-4 years or longer. People in this stage of Alzheimer's may:    

1. Say the same thing over & over.

2. Get lost easily. 

3. Lose interest in things they once enjoyed.

4.  Have trouble finding names for common items.

5.  Lose things more often than normal. 

6. Undergo personality changes.

Stage 2-Moderate Alzheimer's Disease:  Duration 2-10 years.  People in this stage of Alzheimer's may:    

1. Become more confused about recent events. 

2. Experience difficulty with simple daily activities (such as dressing)

3. Argue more often than usual.

4. Believe things are real when they are not.

5. Pace about.

6. Often require close supervision.

7. Display anxiety or depression.      

Stage 3-Severe Alzheimer's Disease:  Duration 1-3 years or longer.  At this stage people with Alzheimer's disease cannot do things on their own anymore. They may no longer be able to:

1.  Use or understand words. 

2.  Recognize who they are in a mirror.

3. Recognize family members.

4. Care for themselves at all

Question 9/22/2001:  My right hand goes to sleep frequently. At first I thought it was a short in my computer mouse. I felt a tingling sensation. Later it started going to sleep no matter what I was doing. Any answers?

Answer:  The most common cause of the hand "going to sleep" is carpal tunnel syndrome.  With overuse of the hand/wrist there is inflammation of the median nerve as it passes through the canal at the wrist.  See your doctor, he may need to do a nerve conduction velocity test for the diagnosis.  In the meantime-rest your wrist, wear a wrist splint and take an anti-inflammatory agent. 

Question 8/27/2001:  On 8-19-01 I was diagnosed as suffering from TIA, which caused me to lose the use of my left side. I was placed on Plavix 75mg daily. I am regaining the use of my leg and foot and am now able to walk, not pretty to see, but I’m walking.... my question concerns my arm and hand, I do not seem to be regaining the use of these. Is this normal and will it just take time to regain? My carotids and heart were checked the end of June and were fine, no blockages or buildups. My primary does not seem concerned but I am greatly.

Answer:  Since your weakness has persisted over 24 hours, you had a stroke, and not a Transient Ischemic Attack (TIA).  As you recover from your stroke it is not unusual for the lower extremities to recover first.  It may take many weeks or months for a full recovery.  Plavix is an anti-platelet drug to prevent further strokes.  We don't know the full extent of your initial evaluation, but if you are not satisfied in the scope of the evaluation, then you need to see a Neurologist.  The focus should be to prevent any further strokes. 

Question 8/26/2001:  What can a sufferer of Charcot-Marie-Tooth disease do about the severe and chronic fatigue cause by it? The fatigue is the hardest thing to battle for me.

Answer:  As you know, this disease is a slowly progressive, inherited disorder characterized by wasting of muscle tissue in the feet and legs, then hands and arms, which is the result of progressive damage to the nerves.  Although disabling, the disease does not shorten the life span. There is no cure for this disease.  Treatment is aimed at maximizing independence.  Orthopedic Surgery or DME such as braces, etc. may maximize the ability to walk.  Vocational counseling, occupational therapy or physical therapy may be needed to improve muscle strength.  Mild SSRI anti-depressants may also be helpful to increase seratonin and reduce fatigue. 

Question 8/15/2001:  I have been the same weight for years; 205 to 220, losing and gaining it back but now I stay dizzy a lot. I almost fell twice yesterday. What caused that?  I have trouble keeping my balance. My doctor seems to think I am just old. I am worried.

Answer:  Balance disorders are important to evaluate.  If you have had a significant change in your balance, you may need to be evaluated by a neurologist. Many medical conditions may present in this fashion.

Question 8/13/2001:  I was told that I have a cyst on my pineal gland and my basal ganglia.  My doctor told me that we would watch and wait. I will have another MRI in 6 months to see if the cyst has grown.  Is this normal? Or should I get a second opinion?

Answer:  Our Neurologist said that they would have to see the MRI of the brain in order to answer this question. 

Question 8/13/2001:  6 months ago I had a procedure done for hydrocephalus, which did not place a shunt in my head. I still have the symptoms that I had before the surgery and my headaches are getting worse.  My question is how long should I give the surgery, before I go back

Answer:  You need to go back to your doctor now.

Question 8/6/2001:  I have daily headaches. Lately I have had sudden sharp pains hitting me just above the right eye. On several occasions I have become very hot internally followed by nausea and dizziness to the point of passing out.

Answer:  Daily headaches with associated symptoms may represent migraine syndrome.  You need to have a neurology evaluation. 

Question 8/3/2001:  I'm not sure what category this problem should be put in. Hopefully, if this is not an ENT matter you can tell me where to turn next. My son who's 20, sleeps so soundly that he has lost several jobs because of it. We have tried everything that we could think of. He has had 3-4 alarms set with different sounds, sleeps right through all of them. When we go and try and get him, he looks at us and talks to us, saying he will get up, but doesn't remember us talking to him. Our mornings are very stressful!!!

Answer:  Apparently the individual may be suffering from a sleep disorder. The presentation is slightly atypical for seizure activity, but still needs to be ruled out.  Recommendation-sleep study with MSLT and possibly and EEG.

Question 8/1/2001:  My mother-in-law has been diagnosed with Alzheimer’s and she is also having strokes that are affecting her memory.  She is very quickly progressing it seems and she has an appointment in Little Rock on September 12 with an Alzheimer’s specialist, but she seems to be getting worse so much quicker that we thought she should see a doctor sooner than that.  Do you know of anyone that she could possibly see before September?

Answer:  Ask her family doctor to contact our Neurology department at 935-4150 to see if they could see her.  With progressive dementia, she needs to see a neurologist. 

Question 7/26/2001:  What is primary seizure disorder and what does clinical correlation mean?

Answer:  Primary seizure disorder is just a diagnosis description used for epilepsy.  There are many types of seizures.  "Secondary" causes of seizures might include hypoglycemia (low blood sugar), hyponatremia,(low blood sodium), Acidosis(high blood acid levels) or hypoxia (low blood oxygen levels).  In primary seizure disorder, all of these secondary causes have been ruled out and the patient has epilepsy.   Clinical correlation means that the causes of the seizures have been evaluated in the face of the patients presenting signs, symptom, and diagnosis findings. 

Question 7/25/2001:  An MRI revealed fluid in the right side of the mastoid part of my brain.  Should I be concerned? The MRI was done because of migraines?

Answer:  The MRI shows mastoiditis; maybe if the patient is not symptomatic, follow conservatively.  If the patient is symptomatic (headaches, fever, generalized pain) may need to see a Neurosurgeon. 

Question 6/29/2001:  My husband has been getting these awful headaches everyday for about three weeks now. About three years ago he had a plate put on the left side of his head and I was wondering if that is causing his headaches?

Answer:  Your husband’s headaches are most likely a tension variety headache and the surgical placement of the plate has no bearing at this time for his headaches. 

Question 6/28/2001:  My 66 year old sister says she had polio as a small child and it is now returning.  It is affecting her lungs, muscles in throat and her legs.  What is the possibility of this happening?

Answer:  There are two schools of thought on this diagnosis.  Some believe that it doesn't exist.  There is however, no clear studies that show activation of an old virus or culture of the old virus so other causes for its problems should be sought first. 

Question 6/24/2001:  My husband is having a numbness feeling on the right side of his face. Could you tell me what maybe causing it? Once in awhile his left arm hurts a little. But he has never had the face feel numb. Should he take aspirin or what?

Answer:  Many things can cause face numbness other than stroke.  So, with continued symptoms, you need to see a neurologist or your family doctor for a diagnostic evaluation. 

Question 5/18/2001:  Would that also be why I periodically have a spell of "shakiness"?  I will sometimes without warning feel like I just get shaky - I never know when it will start, it doesn't last too long, and then I never know what makes the feeling go away.

Answer:  "Shakiness" means different things to different people.  If you mean that you feel as though you are about to "pass-out" then you may be having hypoglycemia (low blood sugar).  If you are having a tremor, then there are other considerations.  You will need to see your doctor to get some direction on which way to go to pursue diagnosis.

Question 5/6/2001:  I had a myelogram and follow up CT scan done because of an injury to my back.  The report said "diffuse annular intervertabral disc bulge at L4-5 with effacement of anterior thecal sac and encroachment of neural foramina bilaterally" What does this mean?

Answer:  This means that you have degenerative-disc disease of the lumbar spine.  There is bulging of the disc material between lumbar vertebrae number 4 and 5 with pressure on the nerves as they exit the spinal canal. This is not a ruptured disc, but it can cause pain much like a ruptured disc.  Just because you have this anatomy, doesn't mean you need back surgery.  What happens next depends on your physical exam and the course of events over the next few weeks. 

Question 4/29/2001:  Where can I go in this area to be evaluated for post polio syndrome?

Answer:  Post-polio syndrome is usually referred to the Neurologists and also to the rehabilitation medicine specialists.

Question 4/4/2001:  I am doing a report on epilepsy. And my mom has it too and I would like all the info you have on it please.

Answer:  Epilepsy is not a single disorder, but covers a wide spectrum of problems characterized by unprovoked, recurring seizures that disrupt normal neurological function.  Epileptic seizures occur when a group of nerve cells in the brain become activated simultaneously, emitting sudden and excessive bursts of electrical energy.  This of neurons can occur in various locations in the brain, and depending on the location, have a wide range of effects on the sufferer---from brief moments of confusion to minor spasms to loss of consciousness.  The nerves themselves may be damaged or problems might occur in neurotransmitters (chemical that act as messengers between nerve cells).  If you are doing a report on Epilepsy, I would suggest you click on and search Epilepsy. 

Question 3/26/2001:  Can you tell me the causes of and cures for a cluster headache.

Answer:  Cluster headaches last between 30 and 45 minutes, but the relief people feel at the end of an attack is usually mixed with dread as they avoid a reoccurrence.  Clusters can strike several times a day for several weeks.  They tend to occur more in spring and fall.  They may strike at any age, but usually start between age 20 and 40.  Unlike migraines, cluster headaches are more common in men and do not run in families.  The typical male with these headaches is tall, muscular with a rugged facial appearance. The skin is usually coarse and resembles an orange peel. Studies of cluster patients show that they are likely to have hazel eyes and they tend to smoke and drink alcohol.  Paradoxically, both nicotine, which constricts arteries and alcohol, which dilates arteries may cause clusters.  Research studies have turned up several clues as to the cause of cluster headaches, but no answers.  One clue is found in the thermograms of untreated cluster patients, which show a "cold spot" of reduced blood flow above the eye.  The sudden start and brief duration of cluster headaches can make them difficult to treat; however scientist have identified the anti-migraine drug Ergotamine Tartrate can subdue a cluster.  Some cluster patients can prevent attacks with Propranolol or Methysergide or even Lithium Carbonate.  Intranasal cocaine hydrochloride has even been used in severe cases.  Rapid inhalation of oxygen through a mask for 5-15 minutes has helped some.  This is a difficult condition to treat. 

Question 3/12/2001:  What would cause sharp pains to shoot to the top of your head and the right eye to twitch?

Answer:  It is not really possible to answer your question without more details or an exam.  It may be appropriate with these complaints to see a Neurologist. 

Question 3/10/2001:  What are your tips for migraines?  I have them really bad and so does my grandmother.  Non-medical or drug remedies please.

Answer:  Migraine or vascular headaches usually have a "trigger".  Knowing what may cause your headache is the first way to be successful in managing this condition.  In general, get plenty of sleep; avoid MSG, cheese, red wine, and excessive caffeine in your diet.  Try not to skip meals.  Wear sunglasses when in bright sunlight.  Avoid cigarette smoke and bright lights.  Most women are likely to have migraines around their menstrual period, so take Aleve or Ibuprofen to decrease inflammation.  Otherwise, you need to see your doctor to have a specific plan for you to be able to live with migraines.  There are some great new drugs for this painful condition.

Question 3/5/2001:  I have been having migraine headaches for a little over a year now, and in the past two months they seem to be more frequent. The last really bad headache seemed to be more on the left side of my head, and behind my left eye. I also had blurred vision.

Answer:  Many new treatment options are new available for migraine patients. The new drugs may decrease both the frequency and intensity of the headaches. Many primary care doctors as well as neurologists may be able to help you.

Question 2/23/2001:  How does muscular dystrophy kill its victims?

Answer:  Muscular dystrophy causes progressive weakness over time. Therefore respiratory illness (pneumonia) is the primary cause of death. However, you need to know that there are many kinds of muscular dystrophy, and some do NOT shorten the life span.