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Baylor Scott & White Neurology Dallas

Welcome to Baylor Scott & White Neurology – Dallas

 
 

The experienced neurologist at Baylor Scott & White Neurology – Dallas treats patients who have a spectrum of neurological disorders in a caring compassionate manner. We offer access to patients with precise neurophysiological services and collaboration with highly trained and experienced surgeons and neuroradiology interventionists when appropriate.

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Pay Your Bill

We offer an easy, secure way to pay your HTPN bill online through MyBSWHealth.

Tools & Resources

Our services are designed with you in mind so managing your healthcare needs is as simple as possible.

  • Patient Forms
  • Appointment Information
  • MyBSWHealth
  • Pay Your Bill
  • Financial Assistance
  • Accepted Insurance

Patient Forms

To ensure that your visit to our office is as convenient and efficient as possible, we are pleased to offer our registration forms online. The patient registration form may be completed electronically and printed for better legibility or completed manually.

New Patient Registration Forms

Authorization Forms

We do not release your medical information without your authorization.

Questionnaire

EMG Procedure Form

Appointment Information

New Patient Visits

Please allow approximately one to one and a half hours for the first visit.

Making an Appointment

On your first visit, we will begin a permanent record. We will ask you to complete a new patient questionnaire, found on our Patient Forms page, prior to your appointment. Please bring your insurance card and picture identification.

Canceling an Appointment

If you are unable to keep your appointment or you are going to be late, please call our office as soon as possible. This courtesy allows us to be of service to other patients.

Emergency Care

If you have an urgent problem, please contact your primary care physician. However, if you feel it is a life-threatening emergency, call 911. Do not delay by calling the doctor's office first.

At Baylor Scott & White Neurology – Dallas, we have a strict patient confidentiality policy. Your medical record is strictly private and will not be shared with your employer, friends or relatives without your written permission.

MyBSWHealth

MyBSWHealth is an online tool where you can communicate with your providers, schedule an appointment, access and manage your family’s health.

Pay Your Bill

We offer an easy, secure way to pay your HTPN bill online through MyBSWHealth.

Financial Assistance

At Baylor Scott & White Health, we want to be a resource for you and your family. Our team of financial counselors is here to help. We encourage you to speak to a member of our team at any time – before, during or after care is received.

Accepted Insurance

Baylor Scott & White has established agreements with several types of insurances in an effort to make sure your health needs are covered.

Medical Services

Baylor Scott & White Neurology – Dallas offers expertise and treatment options conveniently located near you.

  • Stroke
  • Epilepsy/Seizures
  • Epilepsy Monitoring Unit (EMU)
  • Headache
  • Memory Disorders/Dementia
  • Movement Disorders
  • Tremors​
  • Neuropathy
  • Diagnostic of Pain
  • Diagnostic Neurology
  • Imaging

Stroke

What is a stroke?

A stroke, or brain attack, happens when blood flow to your brain is stopped. It is an emergency situation.

The brain needs a constant supply of oxygen and nutrients in order to work well. If blood supply is stopped even for a short time, this can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen.

When brain cells die, brain function is lost. You may not be able to do things that are controlled by that part of the brain. For example, a stroke may affect your ability to:

  • Move
  • Speak
  • Eat
  • Think and remember
  • Control your bowel and bladder
  • Control your emotions
  • Control other vital body functions

What causes a stroke?

A stroke is caused when blood flow to your brain is stopped or disrupted.

There are 2 kinds of stroke: ischemic and hemorrhagic.

  • Ischemic stroke - This is the most common type of stroke. It happens when a major blood vessel in the brain is blocked. It may be blocked by a blood clot. Or it may be blocked by a buildup of fatty deposit and cholesterol. This buildup is called plaque.
  • Hemorrhagic stroke - This occurs when a blood vessel in your brain bursts, spilling blood into nearby tissues. With a hemorrhagic stroke, pressure builds up in the nearby brain tissue. This causes even more damage and irritation.

Who is at risk for a stroke?

Anyone can have a stroke at any age. But your chance of having a stroke increases if you have certain risk factors. Some risk factors for stroke can be changed or managed, while others can’t.

Risk factors for stroke that can be changed, treated, or medically managed:

  • High blood pressure. Blood pressure of 140/90 or higher can damage blood vessels (arteries) that supply blood to the brain.
  • Heart disease. Heart disease is the second most important risk factor for stroke, and the major cause of death among survivors of stroke. Heart disease and stroke have many of the same risk factors.
  • Diabetes. People with diabetes are at greater risk for a stroke than someone without diabetes.
  • Smoking. Smoking almost doubles your risk for an ischemic stroke.
  • Birth control pills (oral contraceptives)
  • History of TIAs (transient ischemic attacks). TIAs are often called mini-strokes. They have the same symptoms as stroke, but the symptoms don’t last. If you have had one or more TIAs, you are almost 10 times more likely to have a stroke than someone of the same age and sex who has not had a TIA.
  • High red blood cell count. A significant increase in the number of red blood cells thickens the blood and makes clots more likely. This raises the risk for stroke.
  • High blood cholesterol and lipids. High cholesterol levels can contribute to thickening or hardening of the arteries (atherosclerosis) caused by a buildup of plaque. Plaque is deposits of fatty substances, cholesterol, and calcium. Plaque buildup on the inside of the artery walls can decrease the amount of blood flow to the brain. A stroke occurs if the blood supply is cut off to the brain.
  • Lack of exercise
  • Obesity
  • Excessive alcohol use. More than 2 drinks per day raises your blood pressure. Binge drinking can lead to stroke.
  • Illegal drugs. IV (intravenous) drug abuse carries a high risk of stroke from blood clots (cerebral embolisms). Cocaine and other drugs have been closely linked to strokes, heart attacks, and many other cardiovascular problems.
  • Abnormal heart rhythm. Some types of heart disease can raise your risk for stroke. Having an irregular heartbeat (atrial fibrillation) is the most powerful and treatable heart risk factor of stroke.
  • Cardiac structural abnormalities. Damaged heart valves (valvular heart disease) can cause long-term (chronic) heart damage. Over time, this can raise your risk for stroke.

Risk factors for stroke that can’t be changed:

  • Older age. For each decade of life after age 55, your chance of having a stroke more than doubles.
  • Race. African Americans have a much higher risk for death and disability from a stroke than whites. This is partly because the African-American population has a greater incidence of high blood pressure.
  • Gender. Stroke occurs more often in men, but more women than men die from stroke.
  • History of prior stroke. You are at higher risk for having a second stroke after you have already had a stroke.
  • Heredity or genetics. The chance of stroke is greater in people with a family history of stroke.

Other risk factors include:

  • Where you live. Strokes are more common among people living in the southeastern U.S. than in other areas. This may be because of regional differences in lifestyle, race, smoking habits, and diet.
  • Temperature, season, and climate. Stroke deaths occur more often during extreme temperatures.
  • Social and economic factors. There is some evidence that strokes are more common among low-income people.

What are the symptoms of a stroke?

A stroke is an emergency situation. It’s important to know the signs of a stroke and get help quickly. Call 911 or your local emergency number right away. Treatment is most effective when started right away.

Stroke symptoms may happen suddenly. Each person’s symptoms may vary. Symptoms may include:

  • Weakness or numbness of the face, arm, or leg, usually on one side of the body
  • Having trouble speaking or understanding
  • Problems with vision, such as dimness or loss of vision in one or both eyes
  • Dizziness or problems with balance or coordination
  • Problems with movement or walking
  • Fainting (loss of consciousness) or seizure
  • Severe headaches with no known cause, especially if they happen suddenly

Other less common symptoms of stroke may include:

  • Sudden nausea or vomiting not caused by a viral illness
  • Brief loss or change of consciousness, such as fainting, confusion, seizures, or coma
  • TIA, called a mini-stroke

A TIA can cause many of the same symptoms as a stroke. But TIA symptoms are passing. They can last for a few minutes or up to 24 hours. Call for medical help right away if you think someone is having a TIA. It may be a warning sign that a stroke is about to occur. But not all TIAs are followed by a stroke.

Get help FAST

FAST is an easy way to remember the signs of a stroke. When you see these signs, you will know that you need to call 911 fast. FAST stands for:

F - Face drooping. One side of the face is drooping or numb. When the person smiles, the smile is uneven.

A - Arm weakness. One arm is weak or numb. When the person lifts both arms at the same time, one arm may drift downward.

S - Speech difficulty. You may see slurred speech or difficulty speaking. The person can't repeat a simple sentence correctly when asked.

T - Time to call 911. If someone shows any of these symptoms, call 911 right away. Call even if the symptom goes away. Make note of the time the symptoms first appeared.

How is a stroke diagnosed?

Your healthcare provider will take a complete health history and do a physical exam. You will need tests for stroke such as brain imaging and measuring the blood flow in the brain. Tests may include:

  • CT scan of the brain. An imaging test that uses X-rays to take clear, detailed images of the brain. A brain CT scan can show bleeding in the brain or damage to brain cells caused by a stroke. It is used to find abnormalities and help find the location or type of stroke.
  • MRI. This test uses a combination of large magnets, radiofrequencies, and a computer to make detailed images of organs and structures in the body. An MRI uses magnetic fields to find small changes in brain tissue that help to find and diagnose stroke.
  • CTA (computed tomographic angiography). An X-ray image of the blood vessels. A CT angiogram uses CT technology to get images of blood vessels.
  • MRA (magnetic resonance angiography). This test uses MRI technology to check blood flow through the arteries.
  • Doppler sonography (carotid ultrasound). A test that uses sound waves to create pictures of the inside of your carotid arteries. This test can show if plaque has narrowed or blocked your carotid arteries.

The following heart tests may also be used to help diagnose heart problems that may have led to a stroke:

  • Electrocardiogram (ECG). This test records your heart’s electrical activity. It shows any irregular heart rhythms that may have caused a stroke.
  • Echocardiography. This test uses sound waves to create a picture of your heart. This test shows the size and shape of your heart. It can check if the heart valves are working properly. It can also see if there are blood clots inside your heart.

How is a stroke treated?

Your healthcare provider will create a care plan for you based on:

  • Your age, overall health, and past health
  • The type of stroke you had
  • How severe your stroke was
  • Where in your brain the stroke happened
  • What caused your stroke
  • How well you handle certain medicines, treatments, or therapies
  • Your opinion or preference

There is no cure for stroke once it has occurred. But advanced medical and surgical treatments are available. These can help reduce your risk for another stroke.

Treatment is most effective when started right away. Emergency treatment after a stroke may include:

  • Clot-busting medicines (thrombolytics or fibrinolytics). These medicines dissolve the blood clots that cause an ischemic stroke. They can help reduce the damage to brain cells caused by the stroke. To be most effective, they must be given within 3 hours of a stroke occurring.
  • Medicines and therapy to reduce or control brain swelling. Special types of IV (intravenous) fluids are often used to help reduce or control brain swelling. They are used especially after a hemorrhagic stroke.
  • Neuroprotective medicines. These medicines help protect the brain from damage and lack of oxygen (ischemia).
  • Life support measures. These treatments include using a machine to help you breathe (a ventilator), having IV fluids, getting proper nutrition, and controlling your blood pressure.
  • Craniotomy. This is a type of brain surgery that is done to remove blood clots, relieve pressure, or repair bleeding in the brain.

What are the complications of having a stroke?

Recovery from stroke and the specific ability affected depends on the size and location of the stroke.

A small stroke may cause problems such as weakness in your arm or leg.

Larger strokes may cause parts of your body to not be able to move (be paralyzed). Larger strokes can also cause loss of speech or even death.

What can I do to prevent a stroke?

Know your risk for stroke. Many stroke risk factors can be changed, treated, or medically modified. Some things you can do to control your risk factors are listed below.

Lifestyle changes

A healthy lifestyle can help reduce your risk for stroke. That includes the following:

  • Stop smoking, if you smoke.
  • Make healthy food choices. Be sure to get the recommended amounts of fruits, vegetables, and whole grains. Choose foods that are low in saturated fat, trans fat, cholesterol, salt (sodium), and added sugars.
  • Stay at a healthy weight.
  • Be physically active.
  • Limit alcohol use.

Medicines

Take your medicines as instructed by your healthcare provider. The following medicines can help prevent stroke:

  • Blood-thinning medicines (anticoagulants) help prevent blood clots from forming. If you take a blood thinner, you may need regular blood tests.
  • Antiplatelets, such as aspirin, are prescribed for many stroke patients. They make blood clots less likely to form. Aspirin is available over the counter.
  • Blood-pressure medicines help lower high blood pressure. You may need to take more than one blood-pressure medicine.
  • Cholesterol-lowering drugs make plaque less likely to build up in your artery walls, which can reduce the risk for stroke.
  • Heart medicines can treat certain heart problems that increase your risk of stroke.
  • Diabetes medicines adjust blood sugar levels. This can prevent problems that lead to stroke.

Surgery

Several types of surgery may be done to help treat a stroke, or help to prevent one. These include:

  • Carotid endarterectomy. Carotid endarterectomy is surgery to remove plaque and clots from the carotid arteries, located in the neck. These arteries supply the brain with blood from the heart. Endarterectomy may help stop a stroke from occurring
  • Carotid stenting. A large metal coil (stent) is placed in the carotid artery much like a stent is placed in a coronary artery.
  • Surgery to repair aneurysms and AVMs (arteriovenous malformations). An aneurysm is a weakened, ballooned area on an artery wall. It is at risk for bursting (rupturing) and bleeding into the brain. An AVM is a tangle of arteries and veins. It interferes with blood circulation and puts you at risk for bleeding.
  • PFO (patent foramen ovale) closure. The foramen ovale is an opening that occurs in the wall between the 2 upper chambers of the heart. This opening usually closes right after birth. If the flap does not close, any clots or air bubbles can pass into the brain circulation. This can cause a stroke or TIA (transient ischemic attack). However, experts are still debating whether the PFO should be closed.

Living with a stroke

How a stroke affects you depends on where the stroke occurs in your brain. It also depends on how much your brain is damaged.

Many people who have a stroke are left with paralysis of one of their arms.

Other problems can include having trouble with:

  • Thinking
  • Speaking
    Swallowing
  • Doing simple math such as adding, subtracting, or balancing a checkbook
  • Dressing
  • Showering
  • Going to the bathroom

Some people may need long-term physical rehabilitation. They may not be able to live in their home without help.

Support services are available to help with physical and emotional needs after a stroke.

When should I call my healthcare provider?

Strokes can happen again. Call your healthcare provider if you have symptoms that seem like a stroke, even if they don’t last long.

If you have repeated damage to your brain tissue, you may be at risk for life-long (permanent) disabilities.

Key points about stroke

  • A stroke happens when blood flow to your brain is stopped. It is an emergency situation.
  • It can be caused by a narrowed blood vessel, bleeding, or a clot that blocks blood flow.
  • Symptoms can happen suddenly. If someone is showing any sign of a stroke, call 911 immediately.
  • You have a better chance of recovering from a stroke if emergency treatment is started right away.
  • How a stroke affects you depends on where the stroke occurs in your brain, and on how much your brain is damaged.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

Epilepsy/Seizures

Baylor University Medical Center at Dallas is a level 3 Epilepsy center. At Baylor Scott & White Neurology - Dallas, our comprehensive specialists team includes an epileptologisst, neurologists, neurosurgeons and a full team to run our Epilepsy Monitoring Unit (EMU). We are dedicated to care for our patients with a spectrum of neurological disorders with an experienced neurologist in a caring compassionate manner.

What is a seizure?

A chemical imbalance or structural abnormality in the brain can result in abnormal electrical activity that results in clinical symptoms called seizures. The symptoms depend on the part of the brain involved falling along a spectrum ranging from mild sensory symptoms, staring spells, confusional spells, motor movements, generalized convulsions, and more. Seizures may be provoked by general systemic conditions or may be part of a disorder known as epilepsy.

What is epilepsy?

Epilepsy is the occurrence of two or more seizures in a person which has not been provoked by other systemic illnesses or circumstances. Epilepsy is a fairly common condition which occurs in 0.5% to 1% of the population. Epilepsy is a very treatable condition and many patients with epilepsy can live very normal lives.

What are epilepsy medications?

Epilepsy medications are used to suppress the abnormal electrical activity in the brain to prevent seizures. There is a long list of epilepsy medications which have been designed and created over the last century. Some medications are ideal for certain seizure types while others have a broader spectrum of utility. Seizure medications are often picked based on the seizure type, the presence of other diseases, side effects, and cost.

What is intractable epilepsy?

When a patient who has epilepsy has been compliant on two or more seizure medications and their seizures remain uncontrolled that patient is said to have intractable epilepsy. Occasionally a patient who is thought to have intractable epilepsy may actually have other conditions that mimic seizures which are why the medications were not working. These patients need to be evaluated in an epilepsy monitoring unit to confirm their seizure type or the possibility of an alternative diagnosis. Once a patient has been confirmed to have epilepsy which is originating from a specific part of the brain and that this epilepsy is intractable they may be considered for epilepsy surgery.

What is epilepsy surgery?

Epilepsy surgery involves evaluation for localization of a seizure focus in a patient who has intractable epilepsy. Once we are able to see that the focus is localized the patient is further evaluated to see if there is any eloquent or important brain function in that region. If that part of the brain is confirmed through careful testing to have very little function, it can often be safely removed. The success of epilepsy surgery has varied from 40% to 90% in different patient populations. Evaluation for epilepsy surgery does not require a patient to go on and have surgery and not all patients who are evaluated are found to be surgical candidates. Other surgical implanted devices are being used to reduce the frequency of seizures such as vagal nerve stimulator’s, deep brain stimulators, and responsive neural stimulators when intractable patients are found to not be surgical candidates.

How do I know if I am epilepsy surgery candidate?

Patients who have intractable epilepsy localized to a specific focus in the brain may be a candidate for epilepsy surgery. Careful evaluation of a patient's history, imaging, and electroencephalograms by an experienced epileptologist is necessary in conjunction with a neurosurgical evaluation. Epilepsy surgery is not taken lightly and involves a team approach to the patient, involving a well-trained epileptologist, neurosurgeon, psychologist, technicians involved with patient monitoring, and many other support staff.

What else needs to be considered when treating epilepsy?

Apart from surgery and medications, epilepsy care also involves addressing issues such as employment, ability to travel, safety, cognitive slowing due to disease or medications themselves, and financial constraints. Each patient is an individual and their care should be carefully discussed with his or her physician and no one treatment is universal for all.

What do I do if my family member has a seizure?

Make sure the patient's airway is clear by laying them on their side and lean them forward so if anything is in their mouth it wall fall out. Make sure they're in a place where they will not get hurt and move items that may injure them away from them. There is no reason to put anything in the mouth of a patient having a seizure and this has been shown to be dangerous. If your loved one is known to have epilepsy and you are familiar with your loved one's spells you should call 911 in the following circumstances: he or she has a seizure that lasts more than two minutes, has repeated back to back seizures, is not waking up from the spell, shows any difficulty with breathing, or you feel unsure of the circumstances. For a patient who has never had a seizure before, call 911 right away.

Women who have epilepsy

Careful consideration of epilepsy medication should be given in any woman in her reproductive years. The seizure disorder and or the medications can have an effect on a fetus or breastfeeding baby and medications should ideally be adjusted prior to pregnancy. Most women with epilepsy are able to have normal children with careful guidance.

What is brain mapping?

Brain mapping is the process by which abnormal seizure foci of the brain are localized and normal function is localized as well. Noninvasive brain mapping begins with a careful history and physical exam and includes neuropsychological evaluations, MRI, CT, SPECT scan, functional MRI, and rarely Magnetoencephalography. More invasive procedures may be necessary such as Wada evaluations and direct brain recordings and stimulations.

Epilepsy Monitoring Unit (EMU)

Your neurologist may have asked that you have further work up for your spells which involves an elective admission to the Epilepsy Monitoring Unit (EMU) at Baylor University Medical Center at Dallas (BUMC) which is located at 3500 Gaston Avenue, on the 3rd floor of the Truett building. You will have to be driven by someone else to and from your hospital stay. During this visit you will be asked to stay in a monitored room where you will have a continuous electroencephalogram (EEG) with simultaneous video recording for the purpose of capturing your spells.

The evaluation of a patient's spells in an EMU is the gold standard for figuring out if a patient's spells are related to epilepsy or not. Up to half of patients admitted to the EMU are found to have other types of spells that are not epilepsy and may well have been the reason that the medications had not been working in the past. Patients who do have epilepsy may have further classification of their epilepsy type and their medications adjusted accordingly. Finally some patients with epilepsy can be evaluated for various surgical options. After your visit, a full report will be sent to your regular neurologist with our findings and recommendations.

Because your visit at the EMU may be limited to a few days, it is vital that we do our best to try to capture your typical spell. For this reason, you may be asked to reduce your sleep, have lights flashed, or be asked to breath fast at intervals and your medications may be reduced prior to the admission.

During your stay you will be admitted under the care of an epileptologist who will supervise a team of nurses and technologist specifically trained for your visit.

Your regular neurologist will need to get pre-authorization for your stay in the EMU from your insurance company and refer you to us. You will get a call from Baylor Scott and White Neurology Dallas (469.800.7680) to schedule your visit. On occasion, some patients may need to see Dr. Shamim in the clinic prior to their admission, if their neurologist requests.

Smoking is not permitted in the EMU and nicotine patch can be provided during your stay. Wifi is available in the EMU room.

On the Day of Admission to the EMU

You are asked to report to the Admissions office on the ground floor of the Jonsson Building at Baylor University Medical. Entrance to the Jonsson building is from Junius Street and visitor parking is across the street from Admissions also on Junius street. After you have been checked into admissions you will be directed to go to the EMU on the 3rd floor of the Truett building which can be reached internally without going back to your car.

Headache

Chronic Daily Headache

Chronic daily headaches are headaches that occur at least fifteen days out of the month. They are common in people who have a history of episodic migraines. Symptoms include:

  • Pain on both sides of the head
  • Increased pain with physical activity
  • Sensitivity to light
  • Nausea or vomiting

Tension-type chronic headaches have a pressing sensation, while a migraine chronic headaches have a throbbing or pulsing feeling. Patients suffering from this condition often have an underlying headache at all times, yet they also suffer from episodic migraines regularly. Physicians attempt to prevent pain by prescribing medications that will not give the patient a rebound headache; these include beta-blockers, antidepressants, or anti-seizure medications. It is often helpful to educate patients about headaches and the importance of attention to routine as well.

Cluster Headache

Cluster headaches are one of the most painful headaches and are usually felt on one side of the head or behind one eye. They cause a drooping eyelid, nasal congestion, watery eyes, or enlarged pupils. Cluster headaches have a cyclical pattern, occurring multiple times over a few weeks, then not again for months or even years. Patients suffering from these headaches are often more comfortable pacing or moving around rather than being still. Physicians have many treatments that aim to prevent or lessen this pain; this ranges from various medications to nerve blocks or local anesthetics.

Menstrual Migraine​

A menstrual migraine is a migraine that occurs during a woman's menstrual cycle. Migraines are related to hormone levels, so when a woman's estrogen drops before she begins her period, she is more likely to develop a migraine. Physicians recommend taking non-steroidal anti-inflammatory medications, though the specific selection depends on the pain level of the migraine. These should be taken two days before the menstrual cycle begins and continued until it is finished.

Migraine​

Migraines are severe headaches often accompanied by nausea, vomiting, and heightened sensitivity to sound and light. The cause of migraines is unknown, but it is believed to be a combination of genetic and environmental factors. Patients experiencing migraines are often most comfortable in a dark, quiet place. To treat migraines, physicians prescribe pills ranging from ibuprofen to more intense medications such as triptans. In addition, caffeine is sometimes helpful to relieve pain.

Rebound Headache​

Rebound headaches are headaches that occur as a response to an overuse of headache medication. If a patient takes a headache medicine daily or for a long period of time, they can develop a headache as the effects of the medication wear off. This is often a sign of a rebound headache. To treat this issue, physicians will help the patient reduce or stop the intake of the problematic medication. The headaches will likely get worse before they improve. Physicians can prescribe preventive headache medications for the future that will not cause rebound headaches.

Status Migraine​

A status migraine is a migraine that lasts for over 72 hours. Status migraines sometimes require hospital visits in order to prevent dehydration from vomiting; physicians can insert an IV for rehydration and pain medication. If a patient suffers migraines regularly, there are preventive medications that can be prescribed to try to avoid the onset of a migraine.

Memory Disorders/Dementia

Dementia refers to a progressive worsening of a person's cognitive function. The most common type of dementia is Alzheimer's Disease. At this time there is no cure for Alzheimer Disease, but medications do exist that help give some symptomatic relief. It is important to figure out what kind of dementia a patient has since some dementias have specific treatments and can even be stopped from getting worse. In addition, knowing the specific diagnosis helps families and patients allocate their resources to better care and to help define expectations.

There are some dementias that can be treated and often times be stopped from getting worse. It is important to be evaluated for these other types of dementias to ensure we do not miss a treatable type of dementia. Typical work up starts with a detailed and careful history. In fact, a good history usually has most of the answers. Further details can be gathered with Computed Tomography or Magnetic Resonance Imaging and blood work. Rarely, some patients will need spinal fluid evaluations, electroencephalograms, and various Positon Emission Tomographic testing.

Your primary care physician may refer you to a neurologist if you are not following the typical pattern that most Alzheimer disease patients exhibit. The neurologist may offer additional work up as described above and may help guide you to more recent treatment trends. Dementia research is ongoing and new trials are being developed each year.

Movement Disorders

Movement disorders occur when muscles move uncontrollably or don't move when you want them to. The symptoms of a movement disorder largely depend on the type of condition you may have. People may have varying degrees of symptoms associated with the severity of the movement disorder and depending on the type of neurological issue.

Tremors​

Tremor is an involuntary shaking movement that is repeated over and over. Tremors can be caused by conditions or medicines that affect the nervous system, including Parkinson's disease, liver failure, alcoholism, mercury or arsenic poisoning, lithium, and certain antidepressants. Side effects from other medicines can also cause tremors. There are some differences between essential tremor and tremor caused by Parkinson's disease. If a cause is discovered, the disease will be treated rather than the tremor.

Parkinson’s disease

Parkinson’s disease is a condition that affects control over your movements. It’s caused by a lack of dopamine, a chemical that helps the nerve cells in your brain communicate with each other. When dopamine is missing from certain areas of the brain, the messages that tell your body how to move are lost or distorted. This can lead to symptoms such as shaking, stiffness, and slow movement. There’s no cure for Parkinson’s disease. But proper treatment can help ease symptoms and allow you to live a full, active life.

Changes in the brain

Dopamine is produced in a small area of the brain called the substantia nigra. For reasons that aren’t yet clear, the nerve cells in this region that make dopamine begin to die. This means less dopamine is available to help control your movements. When healthy, the substantia nigra makes enough dopamine to help control your body’s movements.

Symptoms of Parkinson’s disease

Parkinson’s symptoms often appear gradually. Some may take years to develop. Others you may not have at all. Below are the most common:

  • Shaking (resting tremor) can affect the hands, arms, and legs. Most often, the shaking is worse on one side of the body. It usually lessens when the limb is used.
  • Slow movement (bradykinesia) can affect the whole body. People may walk with short, shuffling steps. They can also feel “frozen” and unable to move.
  • Stiffness (rigidity) occurs when muscles don’t relax. It can cause muscle aches and stooped posture.
  • Other symptoms include balance problems, small handwriting, soft voice volume, constipation, reduced or “flat” facial expression, and sleep problems. Memory loss or other problems with thinking may also occur later in the progression of the disease.

How is Parkinson’s diagnosed?

There is no single test for Parkinson’s disease. The diagnosis is based on your symptoms, medical history, and a physical exam. You may also have tests to help rule out other problems. These may include blood tests to look for diseases that cause similar symptoms. They can also include brain-imaging tests, such as an MRI of the brain

Neuropathy

A disease or dysfunction of one or more peripheral nerves, typically causing numbness or weakness, usually in the hands and feet.

Diagnostic of Pain

Baylor Scott & White Neurology - Dallas​ is a multi-disciplinary neurology clinic that specializes in diagnostic of pain.

Diagnostic Neurology

The Neurodiagnostics Department at BUMC offers routine electroencephalograms and extended evaluations on elective and acutely ill patients in the epilepsy monitoring unit (EMU) as well as in the Intensive Care Units (ICU). We have a six bed expandable EMU and capability of portably monitoring patients in most beds in the hospital. Awake craniotomy brain stimulation, Wada evaluations, and Epilepsy cortical mapping are also available.

Evoked potentials, transcranial dopplers, electromyograms, and nerve conduction studies are available and overseen by subspecialist.

Imaging

Magnetic Resonance Imaging, Computed Tomography, and Positron Emission Tomography are performed routinely by nuclear medicine and neuroradiology. A highly trained neuroradiology team is available for acute and elective interventions including aneurysm coiling, acute stroke thrombectomy, carotid stenting, and diagnostic angiograms at BUMC.

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