Dr. Michael Joseph Olek, DO

The most common causes of tingling in the lower extremities are medications, compression, alcohol, vitamin deficiency, diabetes, infection, kidney disease, peripheral artery disease, repetitive strain, and anxiety. I would recommend that you see your primary care physician so they could check you for the above symptoms and may consider a consult with a neurologist in the future.

Michael J. Olek, DO

After the primary care physician/pediatrician has ruled out the common causes of numbness.

80 to 85 percent of people who undergo limb amputation develop some degree of phantom limb.

There are many causes of nerve damage in the leg including trauma, nerve entrapment, Diabetes, Alcohol, Chemotherapy, Heavy metal toxicity, Vitamin B12 deficiency and many where we cannot find a cause. I would suggest following with a neurologist who can perform and EMG and laboratory testing to help find your specific cause.

Michael J. Olek, DO

There are several studies showing that anti-depressants permanently alter the brain. The controversy comes in because no one is sure if that is a good think or a bad thing. It is very difficult to measure neurotransmitters in the brain and even harder to track small electrical impulses. I would consult with your physician to see if there are alternatives to anti-depressants and would not just stop them cold turkey. This is an interesting question and with more research a better answer may be found.
Thank you for this question.

Michael J. Olek, DO

Botox.

Michael J. Olek, DO

What is blepharospasm?

Blepharospasm is a rare condition that causes your eyelid to blink or twitch. You can’t control it. This is called involuntary blinking or twitching. The twitching is caused by a muscle spasm around your eye. Blepharospasm is just one of several reasons your eyes might twitch. More common reasons include minor things, such as being tired or high caffeine use. Serious reasons might include neurological diseases. Blepharospasm affects women more than men. It may run in families.

Symptoms of blepharospasm

Symptoms of blepharospasm include repeated, uncontrolled eye twitching or blinking. The twitching often happens during times you are overly tired, stressed, or anxious. It can also happen when you are exposed to bright light and sunlight. It might get better when you are sleeping or concentrating on a task. The uncontrollable twitching can become worse over time. Eventually, you may feel as if it’s difficult to open your eyelids. As the condition progresses, your eyelids may be closed for several hours at a time. Spasms can develop in your face, as well.

What causes blepharospasm?

Blepharospasm is caused by abnormal brain function in the part of your brain that controls muscles. Doctors aren’t sure why this happens. Symptoms can be triggered by something as minor as stress and being overly tired. Or they could be triggered by a neurological condition. Such conditions would include Tourette syndrome or Parkinson’s disease. Some medicines can make blepharospasm worse. Be sure to tell your doctor about any medicines you are taking.

How is blepharospasm diagnosed?

Your doctor will examine you and ask about your symptoms. He or she will ask you about your medical history. If he or she suspects your eyelid twitching is caused by anything more than stress or being tired, they may refer you to a specialist for a neurological exam. Such an exam might include imaging tests of your brain and eyes. These could include X-ray, magnetic resonance imaging (MRI), or computed tomography (CT) scans. These scans allow doctors to look inside your body.

Can blepharospasm be prevented or avoided?

Blepharospasm cannot be prevented or avoided.

Blepharospasm treatment

There is no cure for blepharospasm. There are several treatments to ease your symptoms.

Some injection-type medicines, such as botulinum toxin (Botox), can treat muscle conditions. These medicines temporarily weaken the muscles of the eyelids. The medicine is injected with a needle under the skin of the eyelid. Some oral medicines are available to treat blepharospasm symptoms. However, they don’t last long, and the symptoms usually return.

A surgical procedure called a myectomy can treat symptoms. This surgery removes some of the muscles and nerves within the eyelid. Treatments also may depend on the underlying cause of your blepharospasm. For example, medicines used to treat Parkinson’s disease may ease the eye twitch.

Some people use alternative treatments. These could include biofeedback, acupuncture, hypnosis, chiropractic care, and nutritional therapy. These have not been proven to be effective treatments.

Living with blepharospasm

Blepharospasm is a lifelong disorder. Talk to your doctor about how to ease your symptoms. Also, consider keeping a journal to track when the twitching occurs. You may notice it happens during exposure to bright lights, times of stress, or when you are overly tired. Knowing your triggers can help you avoid or reduce your symptoms.

Questions to ask your doctor

Is blepharospasm genetic?
Can blepharospasm be a sign of a brain tumor?
Can eye strain cause blepharospasm?
Which medicines cause blepharospasm?

Resources
U.S. National Library of Medicine, Eyelid Twitch

Michael J. Olek, DO
Associate Professor of Neurology
Touro University Nevada
School of Osteopathic Medicine
874 American Pacific Drive
Suite 100
Henderson, NV 89014
Telephone: 702-777-1810
FAX: 702-777-1799
Email: Michael.Olek@tun.touro.edu

An MRI can only show the anatomy of the nerve or if it is being compressed. An EMG/NCS also called electromyography/nerve conduction test will be able to evaluate the conduction of the nerves.

Michael J. Olek, DO

Pain is a very complex issue. There is no way to evaluate your specific pain unless a physician does a complete history and physical and from there does some testing.


Back pain often develops without a cause that your doctor can identify with a test or an imaging study. Conditions commonly linked to back pain include:

Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. If you're in poor physical condition, constant strain on your back can cause painful muscle spasms.
Bulging or ruptured disks. Disks act as cushions between the bones (vertebrae) in your spine. The soft material inside a disk can bulge or rupture and press on a nerve. However, you can have a bulging or ruptured disk without back pain. Disk disease is often found incidentally when you have spine X-rays for some other reason.
Arthritis. Osteoarthritis can affect the lower back. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
Skeletal irregularities. A condition in which your spine curves to the side (scoliosis) also can lead to back pain, but generally not until middle age.
Osteoporosis. Your spine's vertebrae can develop compression fractures if your bones become porous and brittle



Michael J. Olek, DO
Associate Professor of Neurology
Touro University Nevada
School of Osteopathic Medicine
874 American Pacific Drive
Suite 100
Henderson, NV 89014
Telephone: 702-777-1810
FAX: 702-777-1799
Email: Michael.Olek@tun.touro.edu

Asymptomatic aortic aneurysms usually require surgery if they are > 5.5 cm.

Michael J. Olek, DO

Sorry about such a long answer, but it is a complex question.


Neuroscientists have known for many years that the brains of men and women are not identical. Men’s brains tend to be more lateralized—that is, the two hemispheres operate more independently during specific mental tasks like speaking or navigating around one’s environment. For the same kinds of tasks, females tend to use both their cerebral hemispheres more equally. Another difference is size: males of all ages tend to have slightly larger brains, on average, than females, even after correcting for differences in body size.

Electrical measurements reveal differences in boys’ and girls’ brain function from the moment of birth. By three months of age, boys’ and girls’ brains respond differently to the sound of human speech. Because they appear so early in life, such differences are presumably a product of sex-related genes or hormones. We do know that testosterone levels rise in male fetuses as early as seven weeks of gestation, and that testosterone affects the growth and survival of neurons in many parts of the brain. Female sex hormones may also play a role in shaping brain development, but their function is currently not well understood.

Sex differences in the brain are reflected in the somewhat different developmental timetables of girls and boys. By most measures of sensory and cognitive development, girls are slightly more advanced: vision, hearing, memory, smell, and touch are all more acute in female than male infants. Girl babies also tend to be somewhat more socially attuned—responding more readily to human voices or faces, or crying more vigorously in response to another infant’s cry—and they generally lead boys in the emergence of fine motor and language skills.


Boys eventually catch up in many of these areas. By age three, they tend to out-perform girls in one cognitive area: visual-spatial integration, which is involved in navigation, assembling jigsaw puzzles, and certain types of hand-eye coordination. Males of all ages tend to perform better than females on tasks like mental rotation (imagining how a particular object would look if it were turned ninety degrees) while females of all ages tend to perform better than males at certain verbal tasks and at identifying emotional expression in another person’s face. (It is important to emphasize that these findings describe only the average differences between boys and girls. In fact, the range of abilities within either gender is much greater than the difference between the “average girl” and the “average boy.” In other words, there are plenty of boys with excellent verbal skills, and girls with excellent visual-spatial ability. While it can be helpful for parents and teachers to understand the different tendencies of the two sexes, we should not expect all children to conform to these norms.)

Genes and hormones set the ball rolling, but they do not fully account for sex differences in children’s brains. Experience also plays a fundamental role. Consider, for example, the “typical” boy, with his more advanced spatial skills; he may well prefer activities like climbing or pushing trucks around—all of which further hone his visual-spatial skills. The “typical” girl, by contrast, may gravitate more toward games with dolls and siblings, which further reinforce her verbal and social skills. It is not hard to see how initial strengths are magnified—thanks to the remarkable plasticity of young children’s brains—into significant differences, even before boys and girls begin preschool.

But this remarkable plasticity also provides parents and other caregivers with a wonderful opportunity to compensate for the different tendencies of boys and girls. For example, it is known that greater verbal interaction can improve young children’s language skills. So the “typical boy” may especially benefit from a caregiver who engages him in lots of conversation and word play. On the other hand, the “typical girl” may benefit more from a caregiver who engages her in a jigsaw puzzle or building a block tower—activities that encourage her visual-spatial integration. The point is not to discourage children from sex-typical play (since pushing trucks or playing with dolls are great activities for any young child), but to supplement those activities with experiences that encourage the development of many competences

Michael J. Olek, DO

A good neurologist taking a good history and performing a detailed examination along with blood tests, spinal fluid analysis and MRI can diagnose multiple sclerosis within a year.

Pain, weakness and sensory changes are common with pinched nerves. A neurologist can do a EMG/NCS (Electromyography/Nerve Conduction Study) to evaluate the problem.

Michael J. Olek, DO

When your primary care physician cannot control migraines to your satisfaction, I would then see a neurologist.

Diet, exercise, avoiding tobacco and alcohol, and keeping up with current news at alz.org.

Asperger syndrome (AS) is a developmental disorder. It is an autism spectrum disorder (ASD), one of a distinct group of neurological conditions characterized by a greater or lesser degree of impairment in language and communication skills, as well as repetitive or restrictive patterns of thought and behavior. Other ASDs include: classic autism, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS). Unlike children with autism, children with AS retain their early language skills.

The most distinguishing symptom of AS is a child’s obsessive interest in a single object or topic to the exclusion of any other. Children with AS want to know everything about their topic of interest and their conversations with others will be about little else. Their expertise, high level of vocabulary, and formal speech patterns make them seem like little professors. Other characteristics of AS include repetitive routines or rituals; peculiarities in speech and language; socially and emotionally inappropriate behavior and the inability to interact successfully with peers; problems with non-verbal communication; and clumsy and uncoordinated motor movements.

Children with AS are isolated because of their poor social skills and narrow interests. They may approach other people, but make normal conversation impossible by inappropriate or eccentric behavior, or by wanting only to talk about their singular interest. Children with AS usually have a history of developmental delays in motor skills such as pedaling a bike, catching a ball, or climbing outdoor play equipment. They are often awkward and poorly coordinated with a walk that can appear either stilted or bouncy.

Below is the link to the NIH Information Page:
https://www.ninds.nih.gov/Disorders/All-Disorders/Asperger-Syndrome-Information-Page


Michael J. Olek, DO

At the recent Alzheimer Association’s International Conference in the U.K, researchers revealed that following either a heart-healthy Mediterranean diet or its close cousin, the MIND diet (see details below), can reduce future cognitive impairment by 35 percent.

They do, but it is usually in the later stages. The best website for information is the Alzheimer Association at alz.org.

Strokes vary widely in scope from very minor, such as mild numbness or weakness, to major such as severe weakness on one side of the body which makes the patient unable to walk. Recovery depends on the severity of the stroke as well as how quickly any clot busting techniques were given. Recovery can vary anywhere from no recovery to full recovery. Patients are usually sent to a rehabilitation facility after the stroke. As a general rule I tell patients that most stroke patients will recover in 3 to 4 months, but some patients may take 1 to 2 years to reach their maximal recovery. More information can be found at the American Stroke Association website.

As long as there is no ferrous metal hardware associated with your spinal fusion, then an MRI would be okay, but it is always safer to ask your surgeon.

Michael J. Olek, DO