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Q - My husband had a post radiation stroke in March of 2007 (he had a pre-cancerous tumour removed from his right frontal lobe in March 2004, followed by a 6 week course of radiation). The stroke happened in the tiny arteries in the center of his brain, and has left him with a right sided weakness, speech difficulties, incontinence, impulsiveness and cognitive difficulties. He was 45 years old when the stroke happened, he is now 47. After many attempts at rehab, he has now learned to walk for the third time - he walks independently with a quad cane and a spotter, but he still has some issues with movement of his right foot/ankle/leg. He had regained just about full usage of his right arm (fine motor being the remaining issue, and certain positions reaching from right to left), but with delays in funding, he has lost most of that movement again. He is impulsive at times; not having a true picture of his abilities, he does not always have a grasp on his situation i.e. will talk of going to work tomorrow, but has not worked since the stroke etc. He is currently living in a rehab (care) facility, and has improved greatly. My concern is the plan is to bring him home eventually, and right now he is not safe to be left at home alone.
My questions are these, do you feel that neurotherapy would be useful for him? Will it help such things as incontinence? Confusion? Cognitive issues? Impulsiveness? How often are the treatments done/necessary? Is the brain mapping QEEG covered under medical or through Blue Cross? Do you know if plans such as Blue Cross cover this type of therapy? And lastly, if funding is an issue, does your company provide some sort of assistance? I have a good job with a good plan, but the majority of my income is sucked up just with day to day expenses and paying for the care home he is currently living in.
Sorry that my question is so long winded, thank you in advance for your information.
A - We treat many clients with stroke and traumatic brain injuries. In general,
clients improve in all of the areas you mention. The extent of the
improvement varies, of course, depending on a number of variables including
area of injury, age of the client, extent of the injury, and time since
injury. Improvements are usually noticed within a few sessions and clients
continue in treatment as long as they see continued progress. Treatments,
including the initial intake, are covered by extended medical plans that
include coverage for registered clinical psychologists. The caps vary widely
among plans so you will have to check the limits of your plan. Fees that are
not covered by your plan are a tax deductible medical expense. Treatments
are usually once per week although when clients come from long distances
they usually come less frequently but have several treatments at each visit. |
Q - Does TBI sometimes erupt as ALS in an adult?
A - The cause of ALS is not well understood. There is some hereditary component
and as such not unlikely that a TBI could contribute to manifestation of ALS
but there is no research evidence for this as far as I know. |
Q - I've just had brain surgery to remove a grade 2 cancerous cyst they found during an MRI scan. I had a scan 7 years ago and they found what they said was a lesion on the brain in exactly the same place as this cyst. I never had any further MRI or CT scans. Should I have been regularly followed up for checkups? I now have epilepsy due to this cyst. Could it had been treated earlier by either drugs or surgery which would have stopped years of headaches and psychiatric problems?
A - It is impossible to determine if more regular assessments would have been
beneficial. I would discuss this with your personal physician to satisfy
yourself about the suitability of your previous treatment. |
Q - My question is about my mother who has reoccurring cysts and tumors-venous ones. She has had 4 surgeries and this last one 2 years ago was more serious as she waited too long to let her neurologist know she was having problems again. She had to have many surgeries and later gamma ray and physical therapy after awhile. Although she has never seemed to recover from the last one yet, she would get dizziness before and surgeries would help that go away, this time it hasn't gone away, making life difficult for her. Her neurologist says she could come to Seattle at Harborview (where her neurologist is-who does the surgeries-well many of them)for this treatment., which I do not know what it is...she says something about hanging in a box. Could you tell me what this is and tell me about a site where I could read up on it. Thank you again for your time.
A - There are many causes of vertigo and a number of very effective treatments.
You should contact the neurologist for information on the specific treatment
that is being recommended. Without knowing the details I cannot direct you
to further information but I am sure your neurologist would be happy to
provide the information you require. |
Q - What is the cost per hour or per session for Dr Swingle's treatments . The stroke was caused by a freak accident, namely a blow to the forehead from a tree branch which resulted in the inside lining of the artery in the left side of the neck seperating from the outside lining of the artery causing inside lining to colapse and block blood to the brain.. Patient suffered very little physical damage but lost ability to speak.
Stroke occured eight months ago and patient has been getting speech therapy. Speech improvement is progressing very slowly. Patient is 52 years old, is very healthy and does not receive any medication.
A - After the initial assessment, the treatments vary from $105 to $150 per
session depending on the level of service required. Generally, you can plan
on most sessions at $105 and about 25 percent of the sessions at the higher
rates. |
Q - Steps to get an adult child (27) who refuses to cooperate into a rehabilitation program?
In and out of hospitals ever since she fell off a race horse and smashed her helmeted head on pavement/cement in May 2005.
It is evident there is permanent brain damage that has led to behavioral problems getting her into more serious trouble as the years go by.
How do I get all her medical files so I can have a more complete package to present to the next doctor & lawyer that there may be some progress in treating her for what really ails her?
Thank you
A - We routinely have parents, children and spouses ask this question. One of
the common effects of head injury is agonistic, uncooperative and/or
socially inappropriate behavior. Getting these head injured individuals to
cooperate and receive treatment is very challenging for family members.
There is no standard method for persuading these individuals to at least
explore the possibility for beneficial treatment. We have had family members
try all manner of methods to get the person to an initial evaluation
session. Some have been successful in convincing the head injured person to
"explore" the options just as they would explore any other situation such as
finding a good auto mechanic. Others have simply "insisted" that the person
gather information (i.e., come for an evaluation), that saying "no" to
something they have limited information about is not intelligent behavior.
And just About every other method between these previous two. It is
important to keep in mind that with frontal lobe injury the person's
judgement is seriously impaired and their behavior may be completely
illogical. We have had instances in which the person agreed to come and then
would not leave the waiting room to have the assessment. With persistence of
family members, however, we are often successful in eventually getting the
injured person to have the assessment that in turn becomes persuasive
evidence for the head injured person to pursue treatment. Getting the
medical records, on the other hand, only requires signed consent and then
the files are forwarded either to the patient directly or to the
professional (lawyer, physician, psychologist) designated by the patient.
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Q - I've heard that closed brain injuries are more easily treated than open brain injuries. I wonder whether neurotherapy could help in correcting the symptoms of penetrating injuries such as memory loss or executive difficulties.
A - Yes, in general closed head injuries are far more efficiently treated. And
we have considerably more information on the treatment of the closed head
injured client. However, given the effectiveness of neurotherapy in treating
brain injury, it should be considered as adjunct in treatment of the
conditions you describe to facilitate brain recruitment for executive
functions compromised by brain damage. |
Q - My daughter aged six had a severe head injury two months prior to her second birthday.
She had exhibited delayed deveplopment from a young age, and had been diagnosed with mild global developmental delay.
After the head injury she appeared to return to her usual self within two weeks. However she has continued to develop at a delayed rate. She was also formally diagnosed with autism just before she turned five.
She recently had a neuropsych assessment with the report indicating that her symptoms are related to autiam rather than injury. As I understand it, many head injury symptoms are similar to autism. My question is, could the head injury have contribtued or increased the symptoms of autism?
Thanks for your help.
A - As you note from the list of symptoms associated with head injury, autism
like symptoms can be associated such injuries. We also have a number of
cases that would suggest that head injury and other brain injuries
exacerbates ASD conditions. From a neurotherapeutic perspective the origins
of the conditions are largely irrelevant for the treatments are quite
similar. |
Q - My daughter has recently has her second concussion in two years. The most recent one did not receive a "grading" but we have been told to treat it like her previous one - which was a Grade 2 level. Would she benefit from nerotherapy? If so, when should she start?
I also believe she may have undiagnosed mild ADD, due to conversations we have had recently. Are these both treatable with the same 'program' - or are there different therapies for both of these?
A - Yes, your daughter would benefit from neurotherapy for sequela of head
injury. Not too early to start. Depending on the form of ADD that your
daughter has, many of the treatments for the head injury would benefit the
ADD as well. For example, one issue with closed head injury is excessive
slow frequency amplitude, usually in the frontal regions. This excess slow
frequency is also found in many forms of ADD so the treatment may be
identical. Generally, treatments for one condition involving excessive slow
frequency activity benefit other areas with the same problem as well. |
Q - My husband , who had a stroke two years ago, has aphasia as well as seizures. Can you help him with these conditions?
A - There have been significant advances in the neurotherapeutic treatment of
these conditions. We have had considerable success in the treatment of
seizure disorders. As you may know, the treatment of drug resistant epilepsy
was one of the first applications of neurotherapy. Since then, there have
been improvements and refinements in our treatment methods and we treat many
seizure disorders and other non-voluntary movement disorders. The symptoms
of aphasia vary considerable from patient to patient. Some find mild
difficulty in finding words, others cannot speak at all, and others may lack
the capability to understand other's speech. The treatment of these
conditions are guided by data obtained from a full brain quantitative EEG.
This assessment procedure allows neurotherapists to see in detail how the
brain is malfunctioning. Aphasia usually is associated with problems in
brain site to brain site interactions (coherence) that can be corrected or
improved with neurotherapy. Thus, the first step is to obtain a full brain
assessment to determine the exact nature of the disorder. In general,
neurotherapy has been very successful in helping with these conditions. |
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