JWM Neurology CME Seminar

The neurologists at JWM Neurology are conducting their biennial “Neurology Connection” CME seminar for physicians, nurse practitioners and physician assistants on Saturday, March 8th at the Marten House Hotel and Conference Center in Indianapolis.

Visit our website for a registration brochure with more information including registration details, agenda, speakers and CME credit information.

Welcome Joshua S. Neucks, MD

The physicians at JWM Neurology would like to introduce our new Neurologist, Joshua S. Neucks, MD.

Dr. Neucks received his medical degree from Indiana University School of Medicine in Indianapolis where he also completed his Neurology Residency, serving as Chief Resident. He has two master’s degrees, including a Master of Science in Cellular and Integrative Physiology from IU School of Medicine.

Dr. Neucks sees patients with general neurology problems.

His areas of expertise include:

• Epilepsy and seizures
• EEG and Video EEG
• EMG
• Stroke
• Multiple Sclerosis
• Brain and spinal cord injuries
• Parkinson’s disease and movement disorders
• Neck, back and arm pain
• Headaches
• Alzheimer’s disease
• Botox injections

Central Indiana Neurology Joins JWM Neurology

Central Indiana Neurology (CIN) located in Anderson, Indiana has joined JWM Neurology.

Our collaborative partnership together will enable us to combine and serve a larger geographic area in Central Indiana as well as continue to better serve our patients and referring physicians. Between JWM and CIN, we now have eleven locations including offices in: Indianapolis, Carmel, Mooresville, Franklin, Kokomo, Anderson and Elwood.

JWM welcomes Central Indiana Neurology physicians, Larry Blankenship, MD, Charles Howe, MD, Christopher Rocco, MD, Caroline Stevens, DO and their staff.

Welcome Sara L.P. Schrader, MD

The physicians at JWM Neurology would like to introduce our new Neurologist, Sara L.P. Schrader, MD.

Dr. Schrader received her medical degree from Indiana University School of Medicine in Indianapolis. She completed her Neurology Residency and Clinical Neurophysiology Fellowship at Mayo School of Graduate Medical Education in Phoenix, AZ.

Dr. Schrader is originally from the South Bend area. She recently served as a Major in the United States Air Force as a Staff Neurologist/Neurophysiologist at the San Antonio Military Medical Center in Texas.

Dr. Schrader sees patients with general neurology problems.

Her areas of expertise include:

• Epilepsy and seizures
• EEG and Video EEG
• EMG
• Stroke
• Multiple Sclerosis
• Brain and spinal cord injuries
• Parkinson’s disease and movement disorders
• Neck, back and arm pain
• Headaches
• Alzheimer’s disease

Headaches

Keith R. Ridel, MD
JWM Neurologist

Headaches are a common problem not only for adults but also in children of all ages. Most are mild and self limited; caused by hunger, dehydration or stress. However, many patients go on to develop migraines. In adults, a migraine is a throbbing headache on one side of head, lasting more than four hours, that is severe enough to interfere with activities. It is often associated with nausea, vomiting and sensitivity to light and sound. What parents need to realize is that migraine headaches in children are very different in that they are much more variable in their location, quality, severity and associated symptoms.

The vast majority of headaches in adults and children are benign, meaning they are not caused by anything dangerous. However, your doctor must be mindful of dangerous signs and symptoms that could point to a more serious problem causing headaches. Some of these include headaches that:
• Wake the patient from sleep or are worse in the morning on wakening;
• Progressively worsen in severity and frequency despite treatment;
• Cause vision changes, personality changes and weakness or numbness.

There are many treatment options for headaches that can both prevent and treat headaches when they occur.

JWM Neurology Welcomes Saju Abraham, MD

Neurologist Saju Abraham, MD has joined JWM Neurology.

Dr. Abraham received his medical degree from St. James School of Medicine in Bonaire, Netherland Antilles. He completed his Neurology Residency at the University of Illinois in Chicago and his Epilepsy Fellowship at the University of Michigan in Ann Arbor.

He sees patients with all types of neurological conditions.

His areas of expertise include:

• Epilepsy and seizures


• EEG and Video EEG


• Stroke


• Multiple Sclerosis


• Brain and spinal cord injuries


• Parkinson's disease and movement disorders


• Neck, back and arm pain


• Headaches


• Alzheimer's disease

Tourette Syndrome: What Makes Some Brains Tic?

Keith R. Ridel, MD
JWM Pediatric Neurologist

Tics are a symptom of Tourette Syndrome. Tourette Syndrome is a disorder where a person has at least one vocal and at least two movement tics for more than one year, usually beginning before puberty. Not every person who has tics has Tourette Syndrome. If the tics last less than one year, the diagnosis is Transient Tic Disorder. Persons with other neurologic or psychiatric disorders may also have tics.

Tics are usually brief movements or sounds. They may be simple actions that we all do, such as blinking or humming, done too often. The tic should look or sound the same each time, at least for a while. Usually, in Tourette’s, tics move to different locations over time. Also, tics may become more complex, such as repeating a certain word or tapping a certain way. Young children may not be aware of their tics, but older children and adults often feel a sensation inside, an urge to tic. Holding a tic in may cause stress; letting it out may relieve it.

No one knows for sure what is different about the brain of a person who has Tourette’s. The brain contains 10 billion neurons that communicate with one another in complex ways, controlling thoughts, emotions, movements, and body functions. Studying a living brain to see why it behaves as it does is challenging for neuroscientists, but there are some new clues about why some brains tic.

Information travels to our brain through nerves in our faces, bodies, arms, and legs.

• For example, information that a bug is sitting on my arm must travel from the skin on my arm, up my arm to my spinal cord, then up to my brain.


• Then it must travel to the cortex, the surface of my brain, so I can become conscious of the location of the sensation (left forearm), the meaning of the sensation (a hungry mosquito), and perhaps some emotions associated with the sensation (fear, irritation).


• Then my cortex will form a plan (rotate left arm gently, swat mosquito with right hand) and issue a command to execute the action (rapid movement of flattened right hand onto mosquito on left forearm).

Beneath the brain’s surface are some important structures that communicate within the brain in complex circuits. These areas affect how the information about the mosquito gets to the surface of the brain. These areas also affect how we move in response to sensations. One of these areas that seems to be important in Tourette’s is called the Striatum (rhymes with “I ate ‘em”). The striatum is part of many important brain circuits. Although the striatum looks pretty much the same in people who tic and people who don’t (you can’t diagnose Tourette Syndrome with a brain MRI), there are some new research brain scans that show that areas of the striatum “light up” when someone tics, or tries to hold their tics in. In Tourette’s, it may be that the striatum works differently, in how it regulates sensory information coming in, in how it affects urges to respond to those sensations, or both.

Certain brain chemicals called neurotransmitters (used by neurons to communicate with each other) also appear to be abnormal in the brains of persons with Tourette’s. These include dopamine, which is involved in many movement disorders, and serotonin, which is involved in many mood disorders, such as depression and obsessive compulsive disorder. Currently, these chemical differences are difficult to measure. However, for many persons with Tourette’s, medicines, which block dopamine or increase serotonin can be helpful.

Tourette’s is an area of active research. New studies should increase our knowledge of what makes some people tic. Children with tics are often sent to child neurologists for evaluation and management.