Frequently Asked Questions
- How is a neurologist different than a brain surgeon? Do I need to have both?
- How can you tell the difference between a simple headache and a headache caused by a brain tumor or a stroke?
- Is there a way to tell while you are young that you are at risk for getting Alzheimer''s disease?
- Are all brain tumors caused by cancer?
- What is Parkinson''s disease?
- What causes Parkinson''s disease?
- Currently, what are the most effective treatments available for Parkinson''s disease?
How is a neurologist different than a brain surgeon? Do I need to have both?
A neurologist is a physician who has received special training in the diagnosis and medical treatment of diseases of the nervous system. Neurologists do not do brain surgery.
Neurosurgeons are physicians who have been specially trained to do surgery on nerves, the brain and the spinal cord.
Persons who believe they may have a neurologic condition are usually referred to a neurologist first to diagnose their condition. If it is a condition for which neurosurgery is appropriate, the patient would then be referred to a neurosurgeon. However, there are many different types of neurologic conditions, and not all of them require surgery to treat. Should you require surgery after seeing a neurologist, the Maxine Dunitz Neurosurgical Institute has an international reputation for its results in neurosurgery.
How can you tell the difference between a simple headache and a headache caused by a brain tumor or a stroke?
Headaches are among the most common medical complaints. Some people have them often, while others hardly ever have them. Both chronic and recurring headaches may be painful and distressing but rarely reflect a serious medical condition. However, a change in the pattern or nature of headaches - for instance, from rare to frequent or from mild to severe - could signal a serious problem and calls for prompt medical attention.
Headaches can have a variety of causes, including muscle tension, eyestrain or problems with the nose, throat, teeth and ears. Usually a doctor can determine the cause of a headache from the patient's medical history and a physical examination. A variety of tests can be used to detect illness that may be causing the headache, including:
- Blood tests that can identify an underlying illness
- A spinal tap, in which a small amount of fluid is taken from the spine and checked for infection or bleeding
- Scanning techniques, such as computed tomography (CT) or magnetic resonance imaging (MRI), which are used when a brain tumor, stroke or other problem is suspected
Is there a way to tell while you are young that you are at risk for getting Alzheimer's disease?
With an expected 360,000 new cases of Alzheimer's in the United States each year and a rapidly growing elderly population, the National Institutes of Health have made Alzheimer's an urgent research priority. While impressive progress has been made in researching the causes of Alzheimer's and potential genetic factors influencing the disease, there currently is no way to predict whether or not a person will get Alzheimer's when they are older.
Researchers have identified four genes associated with Alzheimer's and suspect that many more may influence the disease. One type of the disease, familial Alzheimer's disease (FAD) appears to be inherited. Only about 5% of all Alzheimer's cases are FAD. This condition occurs before the age of 65. Researchers have identified three genetic mutations that are associated with FAD.
Sporadic Alzheimer's, which can occur either before or after age 65, has no clear hereditary pattern. However researchers have indications that genetic factors may also be involved with this category of Alzheimer's. So far, however, there are no sure ways to identify whether or not a person will get Alzheimer's.
Are all brain tumors caused by cancer?
No, a brain tumor can either be benign (noncancerous) or cancerous. A tumor is a mass or growth of abnormal cells.
Brain tumors are usually classified as either primary or secondary. Primary brain tumors are ones that start in the brain and can be either benign or malignant. About 17,000 Americans a year are diagnosed with these fairly rare tumors. Secondary brain tumors, which are malignant, result from cancer that started elsewhere in the body and spread to the brain. These tumors are more common, affecting some 90,000 Americans a year.
Benign tumors are usually slow growing, easier to remove and less likely to recur compared to malignant ones. However, in a few cases, even a benign tumor can cause serious problems or be life threatening, depending where in the brain it is. Malignant brain tumors can grow rapidly and crowd or destroy nearby brain tissue.
What is Parkinson's disease?
Diagnosed in 50,000 Americans every year, Parkinson's disease is a degenerative disorder of the central nervous system. Parkinson's disease affects nerve cells (neurons) in the part of the brain that controls muscle movement, leading to symptoms, such as trembling, rigidity, difficulty walking and problems with balance and coordination. In about five to 10 percent of cases, Parkinson's disease begins before age 50. For most people, the first symptoms develop after age 50, and the likelihood of developing Parkinson's disease continues to increase with age.
Parkinson's disease is progressive, meaning the symptoms become worse over time. Although the disease may eventually be disabling, signs and symptoms usually develop gradually, and most people have many years of productive living after a diagnosis.
What causes Parkinson's disease?
Since Parkinson's disease was first described nearly 200 years ago, researchers have been intensely studying the causes of this complex disorder. Parkinson's disease develops when certain nerve cells in a part of the brain called the substantia nigra are damaged or destroyed. Normally, these cells release dopamine - a chemical that transmits signals between the substantia nigra and another part of the brain, the corpus striatum. These signals cause your muscles to make smooth, controlled movements. Everyone loses some dopamine-producing neurons as they age, but people with Parkinson's disease lose at least 60 percent of neurons in the substantia nigra.
Currently, scientists believe Parkinson's disease may result from a combination of genetic and environmental factors, including:
- Genetic factors. Research has revealed that people who have a parent, a sibling or a child who has or had Parkinson's disease are three times more likely to develop the disease themselves. If you have two such relatives with Parkinson's disease, your risk can increase as much as 10 times.
- Exposure to herbicides and pesticides can raise your risk of developing Parkinson's disease three times, but so far, no one has been able to connect a specific herbicide or pesticide to the disease.
- Medications. Drugs, such as haloperidol (Haldol) and chlorpromazine (Thorazine), which are prescribed for certain psychiatric disorders, and drugs used to treat nausea, such as metoclopramide (Reglan) and prochlorperazine (Compazine) can increase your risk of developing Parkinson's disease. The epilepsy drug valproate (Depacon) also may cause some of the features of parkinsonism. In fact, this drug is notorious for producing tremors, although these tremors are a little different from those seen in Parkinson's disease.
- Toxins. Exposure to manganese dust, the chemical MPTP - a byproduct of heroin production - among other toxins, can lead to parkinsonism. Scientists first became aware of MPTP-induced parkinsonism in the 1980s when heroin addicts using a street drug contaminated with MPTP developed all the symptoms of Parkinson's disease. Still, toxin-related cases are extremely rare.
Currently, what are the most effective treatments available for Parkinson's disease?
Recognizing the signs and symptoms of Parkinson's disease and seeking early diagnosis are essential to beginning appropriate treatment and managing symptoms for as long as possible. Unlike other serious neurologic diseases, such as Lou Gehrig's and Huntington's disease, Parkinson's disease is treatable. For a long time, the drug L-dopa was used to treat Parkinson's. Today newer drugs, including dopamine agonist medications, are also used - either alone or in combination with L-dopa.
Experiments with surgically transplanted stem cells, fetal nerve cells or genetically engineered cells to replace lost or damaged neurons are also being done. Deep brain stimulation (DBS) is another form of surgical therapy for Parkinson's disease that has had encouraging results. It involves implanting a brain stimulator, similar to a heart pacemaker, in an area of the brain called the thalamus. It has been used for the past decade to treat parkinsonian tremor, and researchers believe that implanting this device in a part of the brain called the subthalamic nucleus may help treat other aspects of the disease as well.
