Category: Blog



In the U.S. there are millions of people who suffer from migraines. Migraines are often characterized by unilateral pain with sensitivity to light and noise. They will often last for hours and in some cases days. Typically, patient will take medications over the counter such as acetaminophen or ibuprofen. When headaches are minimal this will often suffice as treatment. If they occur frequently, prophylactic medications or preventives are needed to control the symptoms. Lifestyle modifications in diet and exercise are also very important as well. An alternative or adjunctive treatment to medication is botulinim toxin or Botox. This is indicated in people who suffer from chronic migraines which is defined as 15 or more migraines a month. Botox can significantly reduce the frequency and severity of migraines in many patients. Most patient feel a definite improvement after two treatments. Side effects are minimal at best if they do occur. Sometimes patient may still need to take medication in conjunction with Botox. Treatments are usually every 3 months as the effect of the injection is temporary. It is thought that the injections work by inhibiting muscle contractility and modulating nerve function. If you suffer from chronic migraines, please call our office today!



Epilepsy is a chronic disorder characterized by recurrent seizures. Seizures occur when neurons in the brain misfire. Some patients may have auras prior to the seizure which may consist of the following: changes in smell, sound, taste, vision, fear, nausea, déjà vu, and others. During the seizure, patient may stare off into space, have convulsions, or display other complex motor movements. Epilepsy can have numerous causes some of which include genetics, stroke, tumor, developmental abnormalities, metabolic disturbances, and reaction or withdrawal to medications. However, many times we do not know the reason. EEGs are often done to identify and better characterize the seizure. Sometimes this may also require ambulatory or inpatient monitoring. MRI of the brain is often done to rule out some of the causes mentioned in the above. Blood work and a physical examination is also necessary during the evaluation. Most patients respond well to medications and can live a normal life. When they are more severe, several medications may be required. Surgery and vagal nerve stimulation are more invasive methods used for patients with aggressive symptoms.


Tennis Elbow

Tennis elbow is a painful condition of the elbow that occurs due to repetitive motion of the arm and hand. The tendons involved attach to the outer or lateral part of the elbow. With recurrent injury, the tendons become chronically damaged. We typically refer to this as a tendinopathy. Contrary to popular belief, people who play tennis are not the only ones who develop this condition. It is often seen in individuals who do manual labor such as construction, carpentry, and factory work. We even see this in people who work on computers and in the restaurant industry. MRI and ultrasound can help assess the scope of injury. Traditional treatments include anti-inflammatory medications, ice, rest, and physical therapy. Symptoms can still persist despite these therapies. In the office, we find that prolotherapy and platelet rich plasma work very well. Drying needling and cold laser can also be effective treatments



Peripheral neuropathy can occur when nerves get damaged. More often than not, one experiences burning, numbness, and tingling. Over time, various part of the peripheral nervous system can be affected. Patients may have an impairment in balance which can lead to frequent falls. If the autonomic nervous system is damaged, patients often experience dizziness, changes in heart rate, as well as bowel and bladder issues. Overall, Diabetes appears to be the most common cause. Control of blood sugar is very important in treating this type of neuropathy. Other causes may include B vitamin Deficiencies, alcohol consumption, exposure to toxins, lupus and other autoimmune disease, cancer, liver and kidney disease, chemotherapy, and blood disorders.

A complete neurological examination and diagnostic testing is necessary for optimal treatment. Medication can provide symptomatic relief when needed.



Stroke is one of the leading causes of disability and death in this country. It can result in permanent disability in about 2/3 of cases. What is a stroke? It happens when there is reduced blood flow and oxygen to the brain. This can occur from a clot or hemorrhage. Warning signs may include trouble speaking, weakness on one side of the body, dizziness, changes in vision, severe headache, and trouble walking. Stroke is a medical emergency which requires prompt attention. When patients are able to get to the hospital fast enough, a medication can be given to break up the clot and minimize long term disability. The longer you wait, the greater the damage. Don’t delay treatment!


Bells Palsy

Bells Palsy is a condition that usually develops from a viral infection affecting the facial nerve. Initially, most people will feel pain behind their ears or a sense of numbness or pulling. They may notice difficulty drinking out of a glass. Alarmingly, they will also notice their face drooping over to one side. Some believe they may be having a stroke; however, this condition does not extend beyond one side of the face. Symptoms may last a few weeks for most people with complete resolution. However, there are a small percentage of individuals who will have residual deficits. At the time of onset, it is important to seek immediate medical care to treat the condition. This may include antibiotics and steroids for about a week to help hasten recovery. Patients will likely need to wear an eye patch and use eye drops during this time.

If there additional symptoms such as weakness, changes in speech, blurred or double vision, difficulty with walking, and numbness than further evaluation would need to be done for possible stroke.
Bell's Palsy


Trigeminal Neuralgia

Facial pain commonly is caused by a condition called trigeminal neuralgia. This is a condition where one of the nerves in the face, that supplies sensation, becomes irritated. Patient commonly feel intermittent sharp, lancinating pain. At times, brushing ones teeth or touching the face can set the pain off. More often than not, older patients typically present to the office. However, I have seen this condition in younger patients as well typically after some dental work. The cause of the nerve impairment is variable but may be caused by contact of a blood vessel with the nerve, possible tumor, multiple sclerosis, and dental work. Treatment can be done successfully with medication most of the time. Accupuncture can also provide some relief. Surgical decompression is the last resort.



Headaches can be caused by a wide variety of conditions. One of the more common causes of headaches is migraine. Typically, one feels intense pain with nausea as well as sensitivity to light or noise. These headaches may have prodrome or aura prior to their onset. Patients may complain of visual disturbances, dizziness, numbness and even focal weakness. Triggers for migraines variable but may include stress, menstrual cycle, certain food, and smells. When symptoms are severe, most people will take an over the counter medication such as tyelenol or ibuprofen. These medications may or may not relieve the symptoms. The relief may only be short-lived as well. A preventive medication may be necessary if the headaches are frequent. Seeing a neurologist at this point makes a lot of sense. A thorough evaluation and appropriate medical and non-medical treatment can provide tremendous relief.

Please call our office today at 973-928-3288.



When people think of concussions, they have a tendency to think of sports-related injuries. Nowadays, we hear a great deal about it due to what we have seen happen in the NFL. Although, it’s quite common to see this issue in the sports arena, we also see it frequently in other areas such as car accidents, construction sites, falls at work, and even injuries sustained in the house. Some people even tell me that they injured themselves because “I have always been clumsy”. Regardless of what caused the trauma, most patients suffer from memory problems, headaches, dizziness, mental fogginess, and neck pain. For most people, symptoms will resolve after a few weeks. For others, symptoms may continue to linger. Repeated head trauma can lead to a condition called chronic traumatic encephalopathy which causes significant cognitive and psychiatric issues. It is very important to have a formal evaluation which includes a comprehensive physical examination. At times, further evaluation with appropriate imaging and other diagnostic modalities are necessary. If the injury is sports related, athletes will likely need to sit out for a period of time before they can resume play. They should be monitored during this time. The road to recovery can be difficult but there are ways to optimize recovery. 12648975-magnetic-resonance-image-MRI-of-the-brain-Stock-Photo-scan

Please call our office today at 973-928-3288.




Do Your Hands Shake?

Shaking of the hands or other body parts can occur for a variety different reasons. Common reasons may simply be consumption of caffeinated beverages, anxiety, or side effects to medications. At other times, tremors can be caused by more serious issues such hyperthyroidism, seizures, liver, and kidney dysfunction. Essential tremor is also very common condition seen in the office. Most people notice this when they are trying to do something with their hands such as holding a newspaper or glass of water. This tremor can also spread to other areas of the body as well. Fortunately, most patient’s respond well to medications.

When it comes to tremors, people often worry about Parkinson’s. This is neurodegenerative disorder that is not curable but definitely treatable. Patient’s with this disorder can have other symptoms such sleep disturbances and difficulty with balance. Not sure of what’s causing you to shake? Please call our office at 973-928-3288 for an evaluation.