CADASIL or “cerebral autosomal dominant arteriopathy and subcortical infarct leukoencephalopathy” is likely not something you hear about every day. It is indeed a rare diagnosis and in the course of my career I have seen only two cases of this condition. BUT…a recent article regarding the possibility that some cases of CADSASIL may be mistaken for multiple sclerosis (MS) gives us reason enough to discuss the differences and the importance of obtaining a proper diagnosis in any illness. 

The means to making an earlier diagnosis in cases of Parkinson’s disease (PD) may be as accessible as our skin. According to a recent publication, research has shown that a skin biopsy has the potential for use in identifying Parkinson’s, as well as Alzheimer’s and other neurodegenerative diseases (also known as synucleinopathies) perhaps well before irreparable damage to the brain tissue has occurred. 

Inflammation – it’s at the root of every disease. So it stands to reason that in the case of neuropsychiatric disorders we also must look first for autoimmune-driven mechanisms in in every patient we see. I believe this should be part of the differential diagnosis just as it is when we do a workup for any other stated or suspected health issues.

By far the most widely used insecticides today in the home, businesses, agriculture and other settings, according to data from the Centers for Disease Control and Prevention (CDC), organophosphates have long been known to cause detrimental health effects. Despite the risks, these poisonous substances continue to be used and a recent publication in JAMA Neurology spotlights an especially disturbing case of neurotoxicity post-exposure to organophosphates that shows the lingering and potentially irreversible effects.1

The last few months have seen numerous investigations regarding the pandemic-level development of COVID and its wide-ranging array of symptoms that can vary significantly from one individual to the next. Now, findings from a recent study that explore the erratic mechanisms this virus possesses that can overtake our body, and in some cases our brain, point to what’s known as a bradykinin storm.*

Recently I experienced firsthand the effects of forest fires burning in Colorado.  I had never seen or felt anything quite like this. The smoky haze is almost palpable, skies are tinged with a drab color that is far removed from the blue we expect. Wildfires in California are especially bad now, in a year that was already marked by unprecedented events. David Salesin captured this shot in Sausalito the other morning around 10 am, looking out towards San Francisco. What is typically a vantage point of picture-postcard beauty is now sadly a reminder of not only the current terrible situation, but also that our planet is becoming more and more toxic every single day.

I’ve just spent the last week seeing our clinic filled with our PANS and PANDAS patients. As grateful as we are to be here for them, it is so troubling that we are seeing more and more of these children - and equally disturbing how long it took for many of them to get to us. While estimates indicate that 1 in 150 children have one of these disorders, I believe the numbers are in fact much higher. So often these diagnoses are missed because of the complexity of symptoms that can overlap with other conditions as well as the lack of familiarity with the disorders by parents and practitioners alike.

Alarming obesity rates and disease incidence point to a need for change….Research led by Queen Mary University of London, U.K. estimates that childhood and adolescent obesity is projected to contribute up to 14 percent of overall risk of multiple sclerosis (MS) by the year 2035.
The study, involving researchers from Queen Mary University of London, Barts Health NHS Trust, and the University of Oxford, used published literature from the U.K., U.S., Russia and Australia, to estimate and project based on observational analysis of data the proportion of MS incidence that could be attributed to two modifiable risk factors: smoking, and childhood and adolescent high BMI.1

While people may suffer from seasonal mold allergies when levels are high, mold-related illness may be something you’ve heard is “all in your head. And indeed, that’s an accurate statement, but not in the way you think! The problem with mold exposure and subsequent neurological illness is that often we assume just because we can’t readily see something that it doesn’t exist. Yet in the face of more chronic neurotoxic factors that are impacting our environment from multiple sources, we must talk about how to recognize the symptoms of this harmful exposure so we can be better prepared to treat it accordingly.

Always looking for ways to enhance our immune system responses, we were extremely interested in a recent study that noted promising results using both vitamin C (ascorbic acid) and quercetin as a potential antiviral protocol in combination with other prescribed medications. If you aren’t familiar with quercetin, this is simply a plant-based flavonoid, found naturally in some vegetables, seeds or grains and widely available as a nutraceutical supplement as well.

Perhaps at no other time in our recent history has there been a better reason to stop and look at the path our health may have taken. Certainly, the COVID 19 events over the last few months have indeed forced us to regroup and rethink some of the most basic things – from washing our hands and avoiding too-crowded settings, to donning a face covering and, oh, yes, washing our hands!! We know that these things may be necessary now and some are just common sense measures that we may already have been doing. But, we also have to ask – why aren’t we hearing nearly as much, if at all, about things that may increase the risk of COVID 19, not to mention the risk of numerous other health conditions?

You’ve undoubtedly heard of the Mediterranean diet, long-touted for its healthy eating principles that include a plant-based focus with lots of vegetables, fruit, whole grains, fish and especially, the healthy benefit of olive oil! The tenets of this diet have been found to not only reduce the risk of heart disease, but there is increasing evidence it also can positively contribute to healthier aging and cognitive function.1

We talk about the benefits of “food as medicine” and recent study findings point to the validity of following the “Prudent diet,” a long-established protocol founded upon consuming fresh vegetables and fruits, legumes, whole grains, fish and lean poultry. In a paper published in the Multiple Sclerosis Journal (July 2020) the study found that diagnosed multiple sclerosis (MS) patients who followed this type of dietary plan evidenced a 46% lower risk of relapse for multiple sclerosis.

Odds are you or someone you know suffers from migraine…according to information from the Migraine Research Foundation affects nearly ONE IN FOUR households. That means in one of every four homes, someone is likely to be afflicted with this often-disabling disorder. Those are really stunning statistics, especially in light of some new research that has come to light.

We know the current times in which we live hold many uncertainties, for some more than others. From dramatic lifestyle changes to heightened stress, we’ve had to deal with so much over the last few months – and we’re not sure just how long this new way of living may last.

But for many people, there is an additional hardship of isolation, whether we call it social distancing or physical distancing, and separation from others that has impacted every demographic from young to older groups alike.

Oh, if only da Vinci’s words could be our mantra for encouraging us to get enough rest! By now we are all very acquainted with the need to obtain a sufficient amount of quality sleep, ideally from seven to eight hours nightly (or at least more nights than not). But despite medical advice and numerous studies attesting to the value of sleeping well, we still don’t seem to have made it a priority. And now, findings from a recent study published in JAMA Neurology indicates that premature death is more likely to affect poor sleepers.

Imaging technologies are often an integral and necessary part of a comprehensive assessment in order to diagnose many neurological conditions. But when does something designed to be beneficial become too much of a good thing?

Patients with multiple sclerosis (MS) are estimated to receive more magnetic resonance imaging (MRI) studies than perhaps any other diagnosis.

With the research-evidenced knowledge that immune-mediated dysfunction is a very real concern, we all should strive more than ever to improve our immune health and take the offensive against any infection, whether that’s Covid 19 or other illnesses.

In a recent study, “Autoantibody Biomarkers for Basal Ganglia Encephalitis in Sydenham Chorea and Pediatric Autoimmune Neuropsychiatric Disorder Associated With Streptococcal Infections,” findings indicate that the Cunningham Panel has diagnostic AND clinical relevance.* The goal of the study “was to determine if anti-neuronal biomarkers, when used as a group, confirmed the acute disease in Sydenham chorea (SC) and pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS).”