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focal points

stroke

Acute and chronic circulatory disorders of the brain and spinal cord can lead to a variety of symptoms such as paralysis, visual disorders, speech disorders and sensory disorders. An acute stroke is an emergency and must be treated immediately in the hospital. After a stroke, further neurological care is usually necessary. In patients with so-called precursors of stroke (TIA), further investigations must be carried out to prevent the risk of a subsequent stroke. In the case of constriction of the arteries supplying the brain (e.g. carotid stenosis), regular checks are carried out in our practice using state-of-the-art ultrasound procedures in order to prevent a stroke, but also to prevent unnecessary interventions on the blood vessels.


 

Additional information:

https://www.schlaganfall-hilfe.de/de/start

Stroke prevention

Primary prevention of stroke is extremely important. In our practice, in addition to a detailed discussion of personal lifestyle, we carry out check-ups using an ultrasound-based examination of the blood vessels supplying the brain (Doppler/Duplex carotid artery (ECD)

Doppler/Duplex Artery of the Brain (TCD)) and one

Evaluation of blood values to estimate risk factors.

Unfortunately, this is a self-pay service. The liquidation takes place on the basis of the official fee schedule for doctors (GOÄ).

multiple sclerosis

Multiple sclerosis is a disease of the central nervous system, i.e. the brain and spinal cord. Inflammation of the myelin sheaths of the nerve fibers of the central nervous system leads to a functional disorder and tissue damage, which can be accompanied by a variety of symptoms such as visual disturbances, paralysis and sensory disturbances. The disease usually occurs between the ages of 20 and 40. It usually occurs in spurts and progresses slowly. The cause of this disease has not yet been fully clarified. A disorder of the immune system in the sense of a so-called autoimmune disease is suspected. In recent years in particular, the therapeutic options have improved tremendously.

Our practice looks after patients right from the first suspected diagnosis and offers all the necessary examinations and therapies in the practice. Admission to hospital is only necessary in rare cases. In addition to medical expertise, the practice team also has an experienced, qualified MS nurse who can offer help in all questions relating to MS. Depending on the medical requirements, we enable timely initial appointments for consultation for new patients.


 

Additional information:

https://www.dmsg.de/

https://www.kompetenznetz-multiplesklerose.de/

 

epilepsy

Epilepsy is a chronic disease that originates in the brain and can occur at any age. In all epilepsies, epileptic seizures occur from time to time without any identifiable cause. These are caused by sudden, short-term functional disorders of the brain. 5% of all people experience an epileptic seizure at some point in their lives. In most cases, however, they do not have epilepsy, but what is known as an occasional seizure. 

Diagnosis is based on radiological imaging (CCT, cMRT) and an encephalographic examination of the brain (EEG). A large number of modern medications are available for the treatment of epilepsy. It is also important to get advice on the consequences of the seizures with regard to work and fitness to drive.

 

Additional information:

https://www.epilepsie-vereinigung.de

Parkinson's syndrome and other movement disorders

Parkinson's syndromes are among the most common diseases of the central nervous system. The risk increases with age. The cardinal symptoms of Parkinson's disease are: akinesia, rigidity and tremor. The patient's postural instability, which only occurs later in the course, is mentioned as a typical fourth symptom.

We offer the necessary neurological examinations including a detailed consultation in our practice. This includes in particular a detailed anamnesis, neurological examination, laboratory tests and the planning, coordination and evaluation of additional tests.

Once Parkinson's disease has been diagnosed, it requires intensive and comprehensive care like hardly any other disease. We take the necessary time for this.


 

Additional information:

https://www.parkinson-gesellschaft.de

https://www.parkinson-vereinigung.de/

https://www.jupa-rlp.de

https://www.parkinsonfonds.de

https://www.movementdisorders.org

migraines/headaches

The medical history that the patient reports to the doctor (anamnesis) allows a headache diagnosis to be made in most cases. It is important to find out how long headache attacks last and what accompanying symptoms they are associated with. By keeping a headache diary, those affected can provide the doctor with valuable information over time at the first contact, when the diagnosis should be made.

The anamnesis is supplemented by a physical examination, during which the doctor carries out a neurological examination. In primary headache disorders, it is usually unremarkable. If abnormal findings are made, additional examinations (cMRT, duplex, EEG) may have to be carried out. In some cases, an examination of the spinal fluid (liquor) is necessary. Drug treatment or non-drug measures can then be initiated.

In the case of new acute headaches, possibly combined with neurological deficits, fever or epileptic seizures, rapid clarification in the emergency room of a clinic is necessary
 

Further information:
https://www.migraeneliga.de

www.dmkg.de

Congestion syndromes (including carpal tunnel syndrome, ulnar sulcus syndrome)

Bottleneck Syndromes  peripheral nerves  manifest themselves as pain, sometimes associated with increasing sensory disturbances or lack of strength, which are caused by chronic pressure on the affected nerves. Possible causes are injuries, overexertion, metabolic and hormonal disorders or hormonal changes, for example during pregnancy or during pregnancy  dialysis .
The most common bottleneck syndromes are:

  • carpal tunnel syndrome, in which the median nerve is constricted in the wrist area. Typical are (nocturnal) pain and sensory disturbances in the thumb, index and middle finger as well as a reduction in strength and muscle atrophy in the ball of the thumb.

  • the cubital tunnel syndrome or sulcus ulnaris syndrome, in which the ulnar nerve is narrowed in the area of the elbow. The consequences are typically pain and numbness on the outer edge of the hand and on the ring and little finger and weakness in the finger muscles of the affected hand.

In addition to the classic diagnostics with measurement of nerve conduction (neurography) and muscle activity (EMG), we offer an ultrasound examination of the nerves.

Further information:
https://www.dgkn.de

​polyneuropathies

Polyneuropathy is the generic term for certain disorders of the peripheral nervous system that affect multiple nerves. Depending on the respective cause, motor, sensitive (numbness, tingling) or even vegetative nerves can be affected together or as a focal point. The disease can affect the insulating layer of the nerves (myelin) or rather the cell process (axon) itself, it can appear farther away (distal) on the hands and feet or much more rarely also close to the body (proximal), there are symmetrical and asymmetrical ( focal and multifocal) forms; however, several peripheral nerves are always affected (Greek poly "many"). Electroneurography and, in selected cases, electromyography, nerve sonography or a lumbar puncture are diagnostic.

Additional information:
https://www.polyneuro.de
https://dgkn.de
 

Restless Legs Syndrome

Restless Legs Syndrome (RLS) is a circadian sensorimotor disorder characterized by an urge to move that occurs predominantly at rest and can be alleviated by dopamine agonists.
Polyneuropathy, advanced kidney weakness, iron deficiency or the intake of certain medications (e.g. antidepressants) can be the cause. If the symptoms first appear during pregnancy, they usually go away on their own after delivery.
Often no cause for the disease can be found. Hereditary factors play a role in more than half of those affected. Then several people in a family are affected.
Various medications can be used.

For more information: 
https://www.restless-legs.org

dementia syndromes

Dementia is a persistent or progressive impairment of memory, thinking or other brain functions. The reason for this can be different. There are different forms of dementia such as Alzheimer's disease and vascular dementia.
We carry out extensive neurological examinations, neuropsychological tests and laboratory tests. If necessary, an examination of the liquor is also carried out. Image morphological diagnostics (cMRI) are planned and evaluated.
We are also happy to advise relatives.

Additional information:
https://www.deutsche-alzheimer.de

Back pain/herniated discs

The term lumbago or lumbalgia describes a sudden, shooting pain in the lower back area, which is often accompanied by immobility when bent over and severe pain when standing upright. The pain usually occurs with severe tension and cramps.
Lumboischialgia refers to back pain that originates in the lumbar spine and radiates into the legs.
Conservative treatment is sufficient in most cases. The rare serious diseases (e.g. herniated disc, inflammation or a tumor) should be diagnosed quickly.
We will be happy to advise you on all questions relating to drug/non-drug therapies and also ask for a second opinion before any planned surgery or intervention.

For more information: 
https://www.patienten-information.de/patientenleitlinien/kreuzschmerz/kapitel-1

Neuromuscular Diseases

In addition to neuropathies and myopathies, neuromuscular diseases include motor neuron diseases (eg amyotrophic lateral sclerosis) and myasthenic syndromes.
In myasthenia gravis there is general muscle weakness, swallowing, speaking or chewing difficulties as well as double vision and drooping of the eyelids.
In the case of motor neuron diseases, progressive muscle weakness and muscle atrophy are typical, often combined with muscle twitching or muscle stiffness.
We carry out a detailed clinical and neurophysiological assessment and accompany you therapeutically.

Additional information:
https://www.dgm.org

Verkehrsmedizinische Begutachtung

Wir führen eine verkehrsmedizinische Begutachtung nach der Fahreignungsverordnung (FeV) durch. Eine solche Untersuchung wird von der Fahrerlaubnisbehörde veranlasst. Auch empfehlen manchmal medizinische Einrichtungen (z.B. Rehakliniken) die Durchführung eines entsprechenden Gutachtens z.B. nach einem Schlaganfall oder einer anderen akuten Erkrankung. Relevante Erkrankungen aus dem neurologischen Bereich sind beispielsweise Epilepsie, Demenz, Parkinson-Erkrankung, Schwindel, Folgezustände nach Schlaganfall sowie Erkrankungen mit Hirn-, Rückenmarks- oder Nervenschädigungen. Das Gutachten hat der Führerscheinbewerber bzw. -inhaber auf eigene Kosten beizubringen.

Botulinum gegen Mimikfalten

Fältchen rund um Augen, Mund oder auf der Stirn verleihen unserem Gesicht Ausdruck und Lebendigkeit. Gleichzeitig können sie uns müde, zornig oder erschöpft wirken lassen. Für die temporäre Glättung dieser Mimikfalten hat sich Botulinumtoxin – bekannt unter dem Markennamen Botox® – als effektive Methode bewährt. Dieses aus Bakterien gewonnene Protein blockiert die Übertragung von Nervenimpulsen an die Muskeln. In präziser Dosierung schwächt es gezielt Muskelkontraktionen, was zu einer deutlichen Glättung der Falten führt.

Seit den 1980er-Jahren ist Botulinum in Deutschland als Arzneimittel gegen Muskelkrämpfe und Verspannungen zugelassen. Ab den 1990er-Jahren findet es auch in der ästhetischen Medizin Anwendung – insbesondere zur Behandlung von Falten. Ziel einer Botox-Behandlung ist es, die Gesichtsmuskulatur zu entspannen und so eine glatte, jugendlichere Ausstrahlung zu erzielen.

Für wen eignet sich die Behandlung?

Durch die enge Verbindung der Gesichtsmuskulatur mit der Haut entstehen bei Muskelanspannung sichtbare Falten. Mit der Zeit prägen sich diese auch im entspannten Zustand ein. Solche Falten, sogenannte Mimikfalten, lassen sich mit Botulinumtoxin effektiv behandeln. Besonders häufig werden Stirnfalten, die Zornesfalte, Krähenfüße, hängende Mundwinkel sowie Falten an Hals und Dekolleté korrigiert.

Ablauf der Behandlung

Mit einer extrem feinen Nadel wird Botulinum gezielt in den gewünschten Bereich injiziert. Die eingesetzten Mengen sind minimal und individuell an die Haut und das angestrebte Ergebnis angepasst. Der Eingriff ist nahezu schmerzfrei und verursacht höchstens ein leichtes Pieksen. Auf Wunsch kann eine lokale Betäubung angewendet werden, um den Einstich noch angenehmer zu gestalten.

Dauer der Sitzung

Eine Behandlung dauert nur wenige Minuten. Die Wirkung tritt nach etwa drei bis sieben Tagen ein und hält in der Regel vier bis sechs Monate an.

Gibt es Ausfallzeiten?

Nein, Ausfallzeiten sind nicht zu erwarten. In seltenen Fällen können an den Einstichstellen vorübergehende Rötungen oder kleine Blutergüsse auftreten. Leichte Kopfschmerzen innerhalb der ersten 24 Stunden nach der Behandlung sind ebenfalls selten, aber möglich.

Was ist nach der Behandlung zu beachten?

Nach der Injektion sollte der behandelte Bereich nicht massiert werden. Zudem sollte am Behandlungstag auf Sport und Saunagänge verzichtet werden, um die bestmöglichen Ergebnisse zu gewährleisten.

Lassen Sie sich beraten
Gerne informieren wir Sie ausführlich über die Möglichkeiten einer Botulinumtoxin-Behandlung. Sprechen Sie uns einfach an – wir sind für Sie da!

Preis für Faltenbehandlung ab 250 Euro
Für Terminvereinbarungen erreichen Sie uns unter:
Telefon: 8342038 / 8342039 oder
E-Mail: a.abraham@neurolge-berlin.com

Stethoskop

© 2022 Practice for Neurology Dr. Alexei Abraham

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