On March 31, 2014, Douglas Allison, a philanthropist and longtime resident of the Birmingham/Bloomfield Hills area passed away after a brief illness due to a stroke. In his estate plan, Douglas provided a $1 million gift to Beaumont. At the direction of Sarah, his loving wife, those funds were used to establish the Douglas F. Allison Comprehensive Stroke Program and Clinic.

As part of that generous donation, Beaumont is proud to announce the inception and construction of the Sarah H. & Douglas F. Allison Consultative Rehabilitation Suite. This 2,400-square-foot facility located in the Neuroscience Center on the campus of Beaumont Hospital, Royal Oak is designed to help stroke patients and others coping with neurological disorders regain function and enhance their quality of life. In addition to offering superior occupational, physical and speech clinical therapy, the

center addresses the emotional needs that patients and their families face during the recovery process.

The Sarah H. & Douglas F. Allison Consultative Rehabilitation Suite will feature state-of-the-art rehab equipment that will assist the clinical team in accurately assessing a patient’s functional status and recovery needs. Treatment rooms will offer consultation for balance disorders, physical and occupational therapy, speech and language assessments, vestibular

therapy and vision treatment. Patients will undergo a comprehensive evaluation following a stroke or other neurological diagnosis and will be provided with an in-depth treatment plan to regain optimal function.

The suite will also have a classroom that will host educational and support classes for both patients and their families. Stroke, traumatic brain injury, and life-altering diagnoses like Parkinson’s disease require both physical and emotional coping. This space will provide educational opportunities that expand beyond the typical medical information offered. These will include sessions on home modifications to cope with disability, support services to connect with others and pre-treatment classes to assist in preparation for any planned medical procedures.

The Allison Fund will also be used to sustain the comprehensive stroke program at Beaumont. This support will focus specifically on patient care, allowing the team to acquire and implement stroke research and database initiatives that optimize the speed of stroke treatment and produce educational materials. The Douglas F. Allison Comprehensive Stroke Program and Clinic provides a place for Beaumont’s many stroke patients to find a level of care and individualized treatment not available anywhere else in southeast Michigan.

Douglas is survived by his wife Sarah Allison, his daughter, Anne Allison, and stepchildren Kathy Tomlinson, Peter M. Beightol, Mary Jo Dougherty, Elizabeth

Colombo, Sarah Lapp and Cynthia Lapp. The entire Beaumont Neuroscience team is grateful to the Allison family for the generous donation and their support for our continued commitment to the compassionate and comprehensive care of our stroke patients.

Generous gift advances stroke treatment, rehabilitation

In this issueGenerous gift advances stroke 1treatment, rehabilitationEssential tremor 2Multiple Sclerosis Clinic 3Sinusitis 3Migraine headaches and children 4Research update 4

the NeuroReport

Sarah H. & Douglas F. Allison

Artist’s rendering of the new consultative rehabilitation suite.

News from Beaumont Neuroscience April – May 2015

“Due to the fact that his father and grandfather died

at age 70, Doug made a serious commitment to live

a healthy, longer life through proper diet, exercise and

close collaboration with his doctors,” says Sarah Allison.

“With his death just two weeks before his 90th birthday, I believe he

achieved that goal. I know Doug would be very pleased

that his gift is helping so many patients and families.”

F E A T U R E D C O N D I T I O N

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the NeuroReport

Essential tremor is the most common of movement disorders and can involve the involuntary exaggerated movement of any muscle when one tries to use it. Many people experience tremor at some point, especially when cold or nervous. This type of tremor is considered physiologic, and is not treated. When tremor interferes with daily activities, evaluation should be sought.

Familial essential tremor is caused from a genetic mutation, representing nearly half of all essential tremor patients. It involves trembling of the hands, head or voice. Most common in people over 40, the symptoms begin gradually and worsen with movement. Tremor normally occurs in one hand first, but can affect both. It can be aggravated by fatigue, emotional stress, caffeine or extremes in temperature.

Familial essential tremor is not life-threatening, but the symptoms often worsen over time. If tremors become severe, it may become difficult to accomplish normal daily activities.

Patients are advised to seek medical evaluation if they experience difficulty performing the following tasks:• holding a cup or glass without spilling• eating normally• shaving• putting on makeup• talking if the voice box or tongue is affected• writing legibly

To diagnose familial essential tremor, doctors will conduct a physical examination and review the patient’s medical history, family history and current symptoms. There are no specific tests used to diagnose essential tremor, so determining the diagnosis is often a matter of ruling out other conditions that could be causing the symptoms.

Treatment options vary and individuals with mild symptoms may not require any form of treatment. However, there are helpful treatment options for those who experience problems completing normal daily activities:• Beta blockers are normally prescribed to treat high blood

pressure, but are shown to reduce tremors in some people.• Anti-seizure medications are frequently used in people who

cannot take or are not helped by beta blockers.• Botox injections may relieve tremors that affect the face,

head or voice.Physical therapy strengthens muscles and improves

coordination through the use of light wrist weights or adaptive equipment like heaver utensils and wider, heavier writing tools.

Deep brain stimulation (DBS) surgery is an alternative treatment option for those with severely disabling tremors who are unresponsive to medication. During DBS, the surgeon inserts an electrode into the area of the brain responsible for the tremors. Once in place, the electrode is connected to a small stimulator device, usually located in the upper chest area, by a wire implanted under the skin. The stimulator sends pulses to the electrode, which stops the brain from producing tremors.

With multiple treatments available, there is no reason for familial essential tremor patients to deal with their condition in silence. “Most tremors are easily controlled with medication,” says movement disorders neurologist Danette Taylor, D.O. “Patients shouldn’t be resigned to ‘just living’ with their tremor.” A thorough evaluation by a movement disorders specialist will ensure the best option for each patient.

Various treatments available for essential tremor

S E R V I C E H I G H L I G H T

Familial essential tremor is not life-threatening,

but the symptoms often worsen over time.

C O N T A C T I N F O R M A T I O N

Search “Beaumont Neuroscience”

For more information: 855-8-NEURO1 (855-863-8761)

To make an appointment, call 800-633-7377.

neurosciences.beaumont.edu

For specialists like Danette Taylor, D.O., diagnosing essential tremor is often a matter of ruling out other conditions that could be causing the symptoms.

Editorial TeamFernando Diaz, M.D., Ph.D.Daniel Menkes, M.D. Renee HerbertGretchen HofmannAndrea MotleyLori SheridanRachael Wade

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F E A T U R E D C O N D I T I O N

The Multiple Sclerosis Clinic at Beaumont Hospital, Royal Oak is led by

Rebbeca Grysiewicz, D.O., a board-certified neurologist who is committed to providing the highest level

of diagnosis and long-term care for individuals with multiple sclerosis.

Diagnosing MS can be a challenging process, as patients often experience unusual and worrisome symptoms that

may be similar to the warning signs of other diseases. The initial symptoms can be mild, generalized or even sporadic.

Currently, there is no definitive single laboratory test to confirm MS, so diagnosis may require a thorough and detailed neurological examination including medical history, MRI imaging, and lab work such as blood and spinal fluid tests.

The clinic’s treatment plans include preventive medical therapies as well as abortive therapy in the case of a flare-up. Although medications are available to help with many symptoms, they may only be part of the answer. Physical and occupational therapy are

very helpful in improving and maintaining normal function. The Multiple Sclerosis Clinic offers patients the ability to be evaluated and receive treatment in one location.

“Patients are able to be evaluated by services such as physical, occupational and speech therapy during the initial visit,” says Dr. Grysiewicz. “This is helpful for patients with limited mobility to have access to these services in one location. The treatment of MS requires a multidisciplinary approach, and access to various subspecialists at the same time is more convenient for patients. It also further enhances physician and patient communication.”

Multiple Sclerosis Clinic offers latest diagnostics, treatments

P R A C T I C E S P O T L I G H T

the NeuroReportS E R V I C E H I G H L I G H T

Sinusitis is a common condition with 37 million cases diagnosed in the United States each year.

Best defined as inflammation of the tissue inside the nose as well as the paranasal sinuses, sinusitis can lead to any number of issues, including nasal congestion, runny nose, decreased sense of smell, facial pain or headache, post-nasal drip and cough, bad breath or tooth pain.

Although sinusitis can sometimes be simple to treat, other cases are far more complex and require the expertise of a specialist to achieve optimal results. An accurate diagnosis is the first and most important step in getting better.

Otolaryngologist Daniel Rontal, M.D., says “chronic sinusitis is defined by symptoms lasting three or more months without remission. It can be tough to diagnose as so many other diseases can masquerade as sinusitis. Evaluation begins with a thorough history as well as a complete ear, nose and throat exam.”

In addition to this, endoscope technology allows otolaryngologists to see areas deeper inside the nose and achieve a more accurate diagnosis. Imaging, typically a CT scan, can also be helpful as it allows the ENT to see the structure of the sinuses as well as see through the bones for a better understanding of what is happening.

Treatment for sinusitis often begins with medication tailored to a patient’s individual condition. If this is not effective, sinus surgery may be recommended. Sinus surgery is usually performed through the inside of the nose with no external incisions needed. The goal is to not only

open the sinuses to allow the infection to drain, but also

to allow irrigation into the sinus cavities to resolve inflammation.

Sinus surgery has a high rate of success,

with quality of life studies showing great improvement after surgery.

Sinusitis: Common condition, difficult diagnosis

C O N T A C T I N F O R M A T I O N

Rebbeca Grysiewicz, D.O.

New Neuroscience Center now open in Royal OakBeaumont Health System has opened a new $22 million Neuroscience Center offering a consolidated and comprehensive approach to Neuroscience care for children and adults in one convenient location. The new facility has physicians specializing in adult and pediatric neurology, neurosurgery and reconstructive surgery to evaluate a patient’s condition and recommend the best medical or surgical treatment option.

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the NeuroReportP E D I A T R I C C O R N E R

“My head hurts!” It’s a complaint just about every parent has heard at one time or another. You may ask yourself, why does my child have a headache? Could it be a symptom of something else?

Migraines are the most common type of headache that affects children. Migraine headaches typically start as

mild head pain, and then significantly worsen. Children are often nauseated and may vomit during the migraine. They often avoid bright lights and loud sounds.

Sleep tends to help alleviate the pain. Some children report a warning sign before the head pain starts. This is called an “aura,” which may consist of seeing wavy, bright lines or dark and light spots several minutes prior to or during the headache. Teen girls may experience more migraine headaches around their menstrual cycles.

Several features of migraine headache in children are different than those found in adults. This may result in confusion in diagnosis. For example, migraine head pain is often on both sides of the head as opposed to one side seen in adults. Young children may have difficulty describing that bright lights and or loud noises may bother them. It may be difficult for the child to describe what the headache feels like. “Often we request children to draw on paper what the headache feels like. This may be helpful with diagnosis as well as monitoring,” says Dr. Elizabeth Leleszi, medical director of the Beaumont Children’s Hospital Pediatric Headache Clinic.

The migraine headache may last anywhere from 2 to 72 hours (at times longer) which may differ in the adults. Notify your primary care physician if the headache starts after hitting his or her head, awakens them from sleep, has a fever, reports neck pain/stiffness, balance issues, or causes them to be confused. Seek medical attention if headache occurs more than once a month, or the child is less than 3 years old. The primary care provider may refer your child to a pediatric neurologist who would be able to provide further evaluation and determine if other testing is necessary.

If the child has been diagnosed with migraine, several things may be done to help treat the head pain. Allow him or her to rest in a dark, quiet room. Encourage sleep. Give medications as directed by the doctor. Look for potential migraine triggers, which may include certain foods, stress, and lack of hydration. Keep a daily headache diary and bring it to the next doctor’s appointment.

Migraine headaches and children

New fund honors Dr. Daniel PieperNeuroscience is honoring Dr. Daniel Pieper with the establishment of the Daniel R. Pieper, M.D., F.A.C.S. Fund for Skull Base and Radiosurgery. The fund perpetuates Dr. Pieper’s impressive legacy and personal mission to bring compassionate healing to those struggling with conditions that require neurosurgical and radiosurgical intervention. It builds upon his pioneering surgical achievements and reputation for providing improved outcomes to continue the outstanding level of skill and compassion for which he is so well known and respected. For information on contribution, please contact 248-551-5481.

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Daniel Arndt, M.D., section head of Pediatric Neurology, has a recent publication as part of the Pediatric Critical Care EEG Consortium, a research consortium comprised of 11 pediatric epilepsy centers across the country. Dr. Arndt and other authors published a study reporting a model for predicting seizure occurrence in critically ill children in the pediatric intensive care unit. Their research was featured as an innovative model for predicting seizures at the American Epilepsy Society’s 68th Annual Meeting in Seattle in December 2014.

Neuro-Oncology neurologist, Denise Leung, M.D., was recently published in the Journal of the National Comprehensive Cancer Network for an article titled “Role of MRI in Primary Brain Tumor Evaluation.” Along with her colleagues in the field, Dr. Leung highlighted research exploring the predominant aspects of MRI for brain tumors, the standard sequences, the criteria to determining treatment response, and some advanced aspects currently available in the field.

R E S E A R C H U P D A T E