Specialties

  • Conditions We Treat

  • Treatment for a Range of Neurological Conditions

    At Littleton Adventist Hospital our team of expert neurologists and neurosurgeons offer patients expertise in the treatment of a wide range of neurological conditions including:

  • ALS (Amyotrophic Lateral Sclerosis) is a disease of the nerve cells in the brain and spinal cord that control voluntary muscle movement.

    The upper and lower motor neurons are affected progressively. The specialists at Littleton Adventist Hospital conduct tests and exams to patients experiencing ALS including:

    • ALS testing and treatments in ColoradoA physical exam
    • Blood tests
    • Breathing tests
    • Cervical Spine CT
    • Electromoyography
    • Genetic Testing
    • Head CT or MRI
    • Nerve Conduction Studies
    • Spinal Tap

    Our team provides treatment options such as medicines and therapy, and offers various forms of nutritional advice to help with intake and swallowing.

    A primary brain tumor is a group, or mass, of abnormal cells that begins in the brain. They can start in brain cells, in the membrane surrounding the brain, or in brain nerves or glands. The tumor may act directly within the brain to destroy brain cells, or it can cause damage through inflammation, which can increase pressure within the skull.

    Once a brain tumor is identified, it will be classified based on its location, whether the cells are benign (noncancerous) or malignant (cancerous) and what type of brain tissue is affected.

    Brain tumors, benigh or malignant, rarely spread throughout the body. However, most of them can spread through brain tissue. For this reason, doctors tend to focus less on whether or not a brain tumor is benign or malignant, because even benign tumors can destroy and damage healthy brain tissue.

    There are many different types of tumors that can affect adults, but the most common are gliomas and meningiomas.

    Gliomas are not a type of cancer, but a term for a group of tumors that start in glial cells. A number of tumors can be considered gliomas, including glioblastoma, astrocytomas, oligodendeogliomas and ependymomas. Approximately three out of 10 of all brain tumors are gliomas.

    Meningiomas start in the meninges, the tissues that surround the outer part of the brain and spinal cord. Approximately one of every three brain and spinal cord tumors is a meningioma - they're the most common brain tumors in adults.

    Causes

    Very little is currently known about the causes of brain tumors, and the risk factors are diverse. Certain hereditary conditions may increase the risk of brain tumors, including:

    • Neurofibromatosis
    • Von Hippel-Lindau syndrome
    • Li-Fraumeni syndrome
    • Turcot syndrome


    In addition, previous radiation therapy to the brain (often used to treat brain cancers) will incrase the risk for additional tumors for up to 30 years after treatment. Lymphomas that begin in the brain in people with a weakened immune system are sometimes linked to the Epstein-Barr virus.

    Just as important perhaps are the factors that have NOT been proven to cause brain tumors, including: exposure to radiation via power lines or in the workplace, head injuries, hormone replacement therapy and smoking. In addition, recent studies have shown NO increased risk of brain tumors from cell phone or cordless phone use.

    Symptoms

    Each brain tumor behaves differently - some cause symptoms slowly over time, some cause sudden damage and quick onset of symptoms once they reach a large size. Generally, symptoms vary based on the size of a tumor, how far it has spread and whether or not it's accompanied by any swelling.

    Symptoms vary from individual to individual, but may include:

    • Changes in mental function or personality
    • Physical weakness, particularly in one area of the body
    • Seizures
    • Headaches
    • Balance problems
    • Changes in alertness, hearing, taste, smell or touch
    • Clumsiness
    • Confusion
    • Difficulty swallowing, reading or writing
    • Dizziness
    • Eye problems, including a drooping eyelid
    • Hand tremor
    • Lack of bladder or bowel control
    • Loss of coordination and balance and trouble walking
    • Muscular weakness, numbess or tingling, particularly on one side of the body
    • Difficulty speaking or understanding others


    Headaches related to a brain tumor often are:

    • Worse in the morning, clearing up after a few hours
    • Common while sleeping
    • Accompanied by numbness, weakness, confusion, vomiting or double vision
    • Made worse with physical activity, coughing or change in position

    Diagnostic Testing

    If a brain tumor is suspected, any of the following tests may be performed to check for a tumor and perhaps identify its location:

    • CT scan (cranial computed tomography) uses x-rays to create pictures of the head, including the skull and brain.
    • EEG (electroencephalogram) is a test to detect problems in the electrical activity of the brain.
    • Biopsy is a test of tissues removed from the tumor during surgery.
    • Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord to look for cancerous cells.
    • An MRI scan (magnetic resonance imaging) of the head uses powerful magnets and radio waves to create pictures of the brain and surrounding nerve tissues.

    Treatments

    Treatment for a brain tumor will be coordinated by a team of specialists, including a neuro-oncologist, a neurosurgeon, an oncologist, a radiation oncologist and other healthcare providers, such as neurologists and social workers. This team approach can provide the best overall outcome and will vary based on the type of tumor.

    Treatment may be focused on curing the tumor, improving brain function, or relieving symptoms.

    Treatment commonly includes surgery - some tumors may be completely removed, while some are deep enough within the brain that they may be debulked instead. Debulking involves moving some of the tissue from the tumor to make it smaller. Brain tumors can be challenging to remove because they can encroach on surrounding brain tissue. In these cases, surgery may be performed to relieve pressure and improve symptoms.

    Other treatments can include radiation therapy and/or chemotherapy, sometimes alone, sometimes in conjunction with surgery.

    One of the more recent innovations in the treatment of brain tumors is non-invasive Gamma Knife radiosurgery. The precision of Gamma Knife radiosurgery leaves surrounding healthy tissues minimally damaged, and results in fewer side effects compared to other types of radiation. Gamma Knife radiosurgery is also considered safer than traditional brain surgery because there is no general anesthesia, long hospital stay or open brain surgery involved.

     

    Dystonia affects approximately 300,000 people in North America, including children and adults.

    A patient suffering from dystonia will experience involuntary muscle contractions, which cause the affected body part to twist. Most often, dystonia alters movement in the head, limbs, trunk or neck and can be reduced or disappear during sleep. The cause of the disorder falls into one of two categories - generalized (inherited) or focal (affecting one body part).

    Tests & treatment for dystonia

    According to the Dystonia Medical Research Foundation, deep brain stimulation (DBS) has been approved for use with this condition for a decade but has only been used with approximately 1,000 patients to date.

    DBS may be considered for patients whose dystonia has not responded to oral medications or botulinum toxin injections, the two most common forms of therapy. Some patients have been reported to have up to 90% improvement.

    Epilepsy is a brain disorder that involves repeated, spontaneous seizures of varying types.


    Seizures can be experienced for many reasons, but with epilepsy, there is no apparent cause and occurs without notice. More than 40 different types of epilepsy have been identified. Our team of specialists are knowledgeable and experienced in utilizing specific equipment and technologies that are used to treat and manage epilepsy.

    Symptoms for patients experiencing epilepsy vary, but may include:

    • Staring spells
    • Violent shaking and loss of alertness
    • Tingling
    • Smelling an odor that isn't actually there
    • Emotional changes

    Epilepsy testing & treatment in Colorado


    Littleton Adventist Hospital offers diagnostics to identify epilepsy including:

    Essential tremor is a neurological disease with the gradual onset of tremors, commonly starting in the hands and can spread to other parts of the body.


    Littleton Adventist Hospital encourages patients to be aware of any potential symptoms of an essential tremor.

    Essential tremor can start at any age, and it is estimated that 14% of people over the age of 65 experience this condition.Symptoms can include
    • Head nodding
    • Shaking or quivering sound to the voice
    • Problems with writing, drawing, drinking from a cup or using tools

    Migraine headache: A throbbing pain, of varying degrees, on one side of the head - lasting for a few hours or even days.

    Migraine headache research has come a long way over the past several years, and there are various new treatment options for both preventative and acute treatments.

    One new development called single-pulse transcranial magnetic stimulation (sTMS) combats migraine pain using magnetic pulses to the back of the head.

    Read more on this experimental treatment in the BBC News.

    Migraine headaches occur for a variety of reasons and can include symptoms such as nausea, vomiting, sensitivity to light or sound and unusual visual disturbances called an aura - sometimes an early sign of a migraine.

    Causes

    While the cause of a migraine is unknown, it is thought that they can be triggered by external factors such as food, weather, stress and other influences. For people affected by this ailment, it is recommended that they try to identify the specific conditions which may contribute to the onset of their headache. By using a journal to record daily habits, patients can identify some possible causes and make lifestyle changes accordingly to help reduce their chances of experiencing future migraine headaches.

    Treatments

    While there is no cure for migraine headaches, there are over-the-counter and prescription medications available to help minimize symptoms. Coupled with healthy lifestyle changes, you may be able to reduce the discomfort and frequency of your headaches. Talk with your doctor to learn what type of medication is best for you.

    Learn more about headaches and migraines.

    More common than once thought, Obsessive Compulsive Disorder (OCD) is an anxiety disorder that affects and disrupts a person's life through unwanted or repeated thoughts, feelings, sensations or behaviors that make them feel driven to do something.


    Treatments for OCD in Littleton, ColoradoWhile there are many theories about the cause of OCD, none have been confirmed.

    Some reports have linked OCD to brain injuries and infections, but further research is needed. There are many types of obsessions and compulsions an individual with OCD may experience. The person usually recognizes that their behavior is excessive or unreasonable.

    Symptoms of OCD are obsessions and compulsions that:

    • Are not due to medical illness or drug use.
    • Cause major distress or interfere with everyday life.

    Parkinson's disease is a slow-progressing neurodegenerative brain disorder that leads to tremors or shaking, difficulty walking and compromised movement and coordination.


    Causes

    Parkinson's disease generally develops in older adults, after the age of 50, and it's the most common nervous system disorder of the elderly.

    Parkinson's disease is the slow destruction of the nerve cells in the brain that make dopamine. Without enough dopamine, nerve cells in the affected areas of the brain can't properly send messages, leading to loss of muscular function. This nerve cell damage gradually worsens over time, up to 20 years.

    Scientists do not yet understand what causes these brain cells to waste away. In some cases, Parkinson's disease appears to be hereditary.

    Symptoms

    Generally, symptoms are quite mild at first, often a slight tremor or a feeling that one foot or leg is stiff. Parkinson's disease symptoms can affect one side of the body or both, and may include:

    • Movement-related problems, such as:
      • Slow movements
      • Difficulty starting or continuing movement
      • Loss of small or fine hand movemvents (handwriting may become small and hard to read)
    • Slow blinking
    • Constipation
    • Drooling or difficulty swallowing
    • Difficulty balancing or walking
    • Lack of facial expressions
    • Muscular aches and pains
    • Stiff muscles
    • Shaking (tremors)
      • Often when arms and legs are resting or held out
      • Stops with movement
      • May appear in the head, lips, tongue and feet
      • Can be worse when tired, excited or stressed
    • Slowed speech and monotone voice
    • Stooped posture


    Other symptoms include:

    • Confusion
    • Depression
    • Dementia
    • Anxiety
    • Memory loss

    Diagnostic Testing

    Healthcare providers generally diagnose Parkinson's disease based on medical history and the symptoms they observe during a physical examination. However, Parkinson's can be difficult to identify, particularly in its early stages and in the elderly. Identification becomes more clear as symptoms progress over time. Doctors may also request brain scans or other laboratory tests in order to rule out other diseases.

    During the examination, healthcare providers are looking for:

    • Shaking
    • Difficulty starting or finishing movements
    • Jerky or stiff movements
    • Muscular weakness or atrophy
    • Heart rate changes

    Treatments

    Currently there is no known cure for Parkinson's disease, so treatment focuses on controlling and minimizing symptoms. Because each person's disease progresses differently, with a unique set of symptoms, there is no single "best" treatment for Parkinson's. Treatment generally includes some combination of medication and surgical therapy.

    Medications for Parkinson's generally work by elevating levels of dopamine in the brain to improve muscular function. As medication wears off, symptoms can worsen or return. Because many medications for Parkinson's cause severe side effects, it's important to be monitored regularly by a healthcare provider.

    Patients are usually given two medications: levodopa combined with carbidopa. Carbidopa delays the conversion of levodopa into dopamine until it reaches the brain. Nerve cells can then use levodopa to make dopamine. Levodopa is usually helpful for most people with Parkinson's, but not all symptoms respond well to drug treatment.

    Deep brain stimulation (DBS) is an effective surgical treatment for patients with Parkinson's disease. During DBS, electrodes are implanted deep into the brain to rebalance timing circuits that have been negatively impacted by Parkinson's.

    DBS can result in reduced tremor and stiffness, improved facial expression and significantly less need for medication. DBS has been used in more than 80,000 Parkinson's patients since 1995, and it has been proven to be more effective than treatment with medication alone.

    In addition, patients with Parkinson's disease can benefit from an array of healthy lifestyle changes including:

    • Good nutrition
    • Exercise based on changing energy levels
    • Regular periods of rest
    • Stress avoidance
    • Therapy, including physical therapy, speech therapy and occupational therapy
    • Assistive devices, including special utensils, wheelchairs, bed lifts and wall bars

    Asleep Deep Brain Stimulation for Parkinson's Disease

    Watch Dr. David VanSickle explain awake and asleep DBS.


    Making the Most of Every Moment

    Denver-based actress Lucy Roucis doesn't let Parkinson's disease alter her positive outlook on life.

    Deep brain stimulation for Parkinson'sLittleton Adventist Hospital neurologist Mihaela Alexander, MD and actress Lucy Roucis

    "I was 27 years old, living in Los Angeles, and auditioning for a yogurt commercial, when my right hand wouldn't stop shaking," Roucis says. "I left the audition in tears. Shortly thereafter, I was diagnosed with early-onset Parkinson's disease. It took me six years to believe the diagnosis."

    Parkinson's is a neurodegenerative disease affecting the central nervous system. There is no known cause or cure for the condition, and symptoms can vary from one individual to another. As Roucis attests, "Once it starts, it never goes away."

    In Roucis' most recent role in the film Love and Other Drugs, she is cast as a speaker at a Parkinson's convention who talks about what it is like to live with the disease. The role is memorable because it helps the lead character, Maggie, who is living with early-onset Parkinson's, rethink her outlook.

    "Outlook is everything," Roucis says. "I consider myself upbeat and positive - a living, breathing, and trembling example of turning around something adverse and making it work."

    For 21 years, Roucis tried pharmaceutical management of her Parkinson's, but as the disease progressed, the effectiveness of the drugs waned and the side effects increased. In 2008, she made the decision to have deep brain stimulation (DBS) surgery.

    Getting Help
    While her initial DBS surgery was performed out of state, Roucis has chosen neurosurgeon David VanSickle, MD and neurologist Mihaela Alexander, MD - both based out of Littleton Adventist Hospital - to direct her ongoing care.

    During DBS surgery, a lead (also called an electrode) is implanted in the brain and then connected to a neurostimulator (battery pack) implanted under the skin near the collarbone. Impulses from the neurostimulator interfere with and block the electrical signals that are responsible for Parkinson's symptoms.

    Dr. Alexander manages Roucis' DBS frequency settings and medication dosages, and Dr. VanSickle recently performed a surgical procedure to replace her battery pack.

    "Parkinson's patients who have had DBS surgery experience a number of benefits," Dr. VanSickle says. "These include reduced tremors and stiffness, less bradykinesia [slowness of movement], less dyskinesia [tics], improved facial expression, and significantly decreased medication usage."

    For Roucis, the good in her life far outweighs the bad. She is surrounded by supportive family, friends, and "excellent doctors I know I can trust." She continues to enjoy a stage career with PHAMALY (Physically Handicapped Actors & Musical Artists League) in Denver and is also a writer and stand-up comic.

     

    Trigeminal neuralgia affects the trigeminal nerve, normally one of the largest nerves in the head. The trigeminal nerve sends impulses of touch, pain, pressure and temperature to the brain from the face, jaw, gums, forehead and around the eyes.

    Trigeminal neuralgia treatments in ColoradoThe most frequent cause of trigeminal neuralgia is a blood vessel pressing on the nerve near the brain stem. Over time, changes in the blood vessels of the brain can result in a blood vessel sagging and rubbing against the trigeminal nerve root. The constant rubbing with each heartbeat wears away the insulating membrane of the nerve, setting up a “short circuit” that results in facial pain.

    Trigeminal neuralgia causes a sudden, severe, electric shock-like or stabbing pain that lasts several seconds. The pain can be felt on the face and around the lips, eyes, nose, scalp and forehead. Symptoms can occur when a person is brushing their teeth, putting on makeup, touching the face, swallowing or even feeling a slight breeze.

    Brain Tumor: Abnormal and uncontrolled cell division within the brain, cranial nerves, skull or glands. A brain tumor may be cancerous (malignant) or non-cancerous (benign).


    Our multidisciplinary team offers individualized, quality healthcare on both an inpatient and outpatient basis with renowned surgical expertise.

    Our specialists include neurosurgeons, neuro-oncologists, medical oncologists, radiation oncologists and neuropathologists, all of who collaborate to offer the latest diagnostic and therapeutic (surgical and nonsurgical) treatments. This multidisciplinary approach, combined with advanced science and technology, offers patients an increased chance for survival and an improved quality of life.

    Our team can confirm the presence of a brain tumor and/or identify its location with:

    • Cranial CT scan
    • EEG
    • Cranial MRI
    • Biopsy or CT guided examination of tissue removed from the tumor during surgery
    • Examination of the cerebral spinal fluid (CSF)

    Early treatment can prevent additional complications and allow for a positive long-term prognosis. The type of treatment patients receive depends on their diagnosis and overall health.

    All of our patients receive personalized medical assessments to determine the best way to relieve symptoms, improve brain function and eliminate the source of the problem, all while maintaining the highest level of comfort possible.

    Some treatments include physical therapy, occupational therapy, personal safety measures and forms of pain relief. Additionally, counseling and support groups are a positive way our patients manage and discuss the various feelings they may experience.

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