Know About Mini-Strokes: It Can Save Your Life

By Annette Pinder

Did you know the rate of stroke death in WNY is 23 percent higher than the national average, and 70% higher than the entire state of New York?

That’s one reason Vernice E. Bates, M.D. and Fran M. Gengo, Pharm.D. at DENT Neurologic Institute want people in Western New York (WNY) to know about transcient ischemic attacks or TIAs. Also referred to as a mini-stroke, when a TIA occurs symptoms usually last less than 24 hours before they disappear. And, while TIAs generally do not cause brain damage, they are a serious warning sign of stroke and should never be ignored.

Symptoms of a TIA and stroke are basically the same:

· Sudden numbness or weakness of the face, arm, leg, especially on one side of the body

· Sudden confusion, trouble speaking or understanding

· Sudden trouble seeing in one or both eyes

· Sudden trouble walking, dizziness, loss of balance or coordination Causes of TIA include:

· Low blood flow at a narrow part of a major artery carrying blood to the brain

· A blood clot in another part of the body that breaks off and travels to the brain blocking a blood vessel

· Narrowing of the smaller blood vessel to the brain, blocking flow for a short period of time.

Dr. Bates explains that, “Up to 40 percent of all people who experience a TIA will go on to have a real stroke, and studies show nearly half of all strokes occur within two days of a TIA. During this time, five percent of people will have a stroke, and within three months after a TIA, 10-15 percent of people will have one.”

There is clearly a window of time where the possibility of a deadly stroke may be averted. Drs. Bates and Gengo are focusing on these patients at the new Acute TIA Program at DENT. There, these patients can be seen immediately, rather than having to undergo various lab tests and schedule an MRI. Instead, they are able to have a thorough evaluation, assessment of their medications, and an MRI. “The goal of the Acute TIA Program is to prevent people from having a future stroke, and so far, the data proves that what are doing is paying off,” says Dr. Bates.

Dr. Gengo emphasizes the importance of knowing exactly what medications a patient is taking because some may interfere with others. He explains, “There are many medications that help prevent blood clots from forming. Also, the medicine and therapy we prescribe depends on the exact cause of the TIA.” So what should someone do if they are experiencing stroke symptoms? “Call your primary care physician, and get to a hospital or emergency room immediately,” says Dr. Bates. And if you think you’ve experienced a TIA and your symptoms have disappeared, it is still important to be thoroughly evaluated as soon as possible.

WNY RESOURCE:

Dr. Bates is Medical Director for the DENT Stroke/TIA Clinic, and Dr. Gengo is Director of Neuropharmacology, and Research Director for the TIA Clinic. To learn more or to make an appointment call 716.250-2000 and visit www.dentinstitute.com.

Leroy Students and Mass Psychogenic Illness

A Personal Letter From Dr. Laszlo Mechtler and Dr. Jennifer McVige

Buffalo 08 Feb 2012

At the Dent Neurologic Institute, Drs Jennifer McVige and Laszlo Mechtler have had the privilege to examine and treat 14 of the 19 patients from LeRoy, NY. The diagnosis of Mass Psychogenic Illness (MPI) was not made without considerable input from regional and national experts. We understand the difficulty some of our patients and family members may have with our diagnosis, but it is reassuring to see that most of our patients are improving significantly over the last several

months.

Although we have not evaluated all the patients affected, we have considered many other diagnoses, such as PANDAS and neuro-toxicity due to environmental factors. With the cooperation of the New York State Department of Health and nationally recognized PANDAS specialists, we have ruled out these diagnoses.

We also feel that the media exposure has raised the national awareness of a rare form of conversion disorder, such as MPI, which has not been fully accepted or understood by the public as well as the many in the medical community. At the same time our primary responsibility is to our patients, who unfortunately have not done well with the intense community and media scrutiny. 

We do respectfully request that the media remember that we are dealing with impressionable teenagers that have understandable fears and concerns. Although it is not uncommon to have a difference of opinion by treating physicians, I would respectfully request that the patients be treated not through the mainstream media but by credible experts specializing in the field of movement disorder. In this regard, multiple international experts have made themselves available for further consultation. We have strongly encouraged that our patients take advantage of this unique opportunity.

Laszlo L. Mechtler, MD  Medical Director, DENT Neurologic Institute

Jennifer McVige, MD, DENT Neurologic Institute Pediatric Neurologist

New Breakthrough Treatment for Depression

by Annette Pinder

Depression is a devastating brain illness that affects millions of Americans, their families and even their employers. People with depression may exhibit such symptoms as problems with sleep, appetite, level of energy, and concentration. They may show a lack of motivation, unusual feelings of guilt, and experience sadness or irritability. This is now well understood to be a problem in how the brain is functioning. Despite this, many people still don’t seek treatment largely because of feelings of shame. Unlike strokes or seizures where the signs of brain dysfunction become clearly visible to us, depression is not so obvious. Perhaps this is why people think differently about depression and sometimes attach stigma to the diagnosis.

Recently, a new treatment called transcranial magnetic stimulation (TMS) was approved by the FDA for people who do not respond to treatment with an antidepressant. TMS makes use of magnetic pulses to stimulate the brain in a specific area known to be involved with depression. This treatment occurs while the individual is fully conscious right in the comfort of the doctor’s office. It is very well tolerated and produces little or no side effects at all.

The Dent Neurologic Institute’s Division of Neuropsychiatry under the direction of Dr. Horacio Capote is the sole provider of this modality in Western New York. Currently, there are approximately 200 providers across the country. Dr. Capote reports that these first 14 months of providing this treatment have been quite gratifying. “It’s been very satisfying to be able to offer such an effective treatment to people who had almost given up hope. I look forward to helping many more as word of this technology spreads.”

Read more about this treatment that has been proven to be helpful for those who are unable to respond successfully to traditional antidepressants.