Sergio Azzolino, DC, DACNB

Functional Neurology

DATE AIRED: June 9, 2017

Episode Description

Functional Neurology looks at the underlying functioning of the nervous system. While allopathic neurology can diagnose gross pathology such as a stroke or traumatic brain injury: functional neurology can pinpoint functioning of specific parts of the brain. Such studies include studies with the eyes (saccades (rapid movements from point to point), pupil reflexes) and other neurological assessments. Brain imbalances can be identified long before the pathology points to a specific diagnosis. Once brain imbalances are identified, individualized treatment plans can be prepared to reverse the damages. Periodic assessments can track the improved status of the brain in response to treatment. The causes of such brain imbalances can be many such as toxins, an infectious process such as Lyme disease, metabolic disorders such as blood sugar irregularities and hormone imbalances. It is important to seek and treat the underlying cause as well.

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FUNCTIONAL APPROACH

  • Looking at the underlying causes of conditions that will lead to pathology (such as a stroke or a tumour)
  • This could manifest as changes in balance, movement, dizziness etc.
  • Jeffrey Bland is the father of functional medicine
  • Ted Carrick is the father of functional neurology started in 1983

FUNCTIONAL NEUROLOGY

  • Includes an in depth neurological examination
  • Looking at the functioning of brain: is it functioning too high or too little
  • Identify what is working correctly and not working correctly
  • Individual treatment stimulating the brain areas that  under-functioning

FUNCTIONAL NEUROLOGIST

  • Rather than using pharmaceutical or surgical approaches, the functional neurologist focuses on rehabilitation
  • Look at underlying causes such as toxins and infections
  • While the underlying cause is addressed, they focus on brain rehabilitation
  • Treatment is individualized for the patient. No two treatments are alike
  • Can to over come it.precisely pinpoint the under-functioning parts of the brain and then rehabilitate.
  • Can test power and strength and reaction time.
  • Need to reinforce/ stimulate the part of the brain that is under-functioning (under firing).  Reinforcing the part of the brain that is working too much may cause further damage
  • This will result in mitochondrial stimulation and increased plasticity in appropriate areas
  • With these tests, practitioners will know if they are targeting the proper area of the brain by looking at the brain functioning.

STANDARD ESTSMEDICAL / NEUROLOGICAL TESTS

MRI looks at structure, stroke, blood vessels

SPECT and PET scans

  • Assesses glucose metabolism in brain Metabolism of muscle does not tell about strength and power of muscles

FUNCTIONAL NEUROLOGY TESTS

  • These will assess the functioning in different parts of the brain

Ocular Motor Functions (eye movement)

  • Represented by different parts of brain
  • See changes in reactions early on before manifest full blown illness
  • Objective measurement of how various parts of brain are working
  • Can assess the parts of the brain that are weak and need stimulation.

Smooth Pursuits   trace image on a screen

Saccades  -Move eyes rapidly in different directions

Video Nystagmography

  • The use of infrared cameras with goggles for testing inner ear and central motor function
  • May determine if an inner ear condition may be causing a balance or dizziness problem
  • Vestibular by spinning with head in different positions

Latency  Tests

FUNCTIONAL NEUROLOGY EVALUATION

  • Boston heart test
  • Pathogen tests (Labcore or Quest)

The sensitivity of these labs is sufficient to identify

chlamydia pneumonia, mycoplasma pneumonia, Epstein Barr Virus,  herpes virus 6 affects the brain)

Toxoplasmosis gondii and parasites

  • Test for Lyme Disease

For testing for Lyme disease, a specialty lab is needed

(Western Blot)

  • Mold Toxins Tests
  • Very few labs look at
  • Search environment
  • Not all molds are toxic
  • Exposure does not mean illness
  • Some genetically don’t clear toxins well and may become ill with mold exposure well
  • Look in urine for mold
  • Swab nose to see if mold
  • Toxin Profiles
  • Look at genes predisposition get idea how to react to toxins in environment
  • There are labs that will test for Glyphosate, and 172 different environmental pollutants
  • Toxic Metal Tests
  • Serum gives 3 -4 months exposure won’t pick up other locations
  • 24 hour urine collection how much dumping
  • Then a provoke six hour urine test where DMSA,  DMPS or EDTA (which chelate/ provokes  the heavy metals so they are excreted)
  • Before the provocation urine test can be administered, have to check if detoxification channels are working adequately (drainage).   For example, if a gutter is cluttered, it won’t drain.
  • IV glutathione can help detoxification channels so the patient can eliminate the heavy metals from the provocation test.
  • Many can do this at home

EXAMPLE OF TREATMENT MODALITIES

  • Focuses on underlying conditions rather than symptoms
  • balance platforms put targets tailored for specific parts of the brain
  • force body movement with proprioceptive input giving also  vestibular input (in inner ears)  patterns to reach
  • may put artificial electrical stimulation to stimulate nerve from areas of body with certain frequencies that stimulate brain
  • visual motor integration screens for eye hand coordination
  • Glasses
    • different flashing colors different affect different parts of the brain
    • red stimulates the left brain
    • higher positioning of lights stimulate the temporal lobe
    • lower positioned lights stimulate the parietal lobe

EXAMPLE OF CONDITIONS TREATED

Professional Athletes

  • to maximize their function as a second change in reaction time can make the difference between a gold metal or not placing
  • They might look perfect on the outside although their brain might

Traumatic Brain Injury

  • is insult to brain
  • Impulsivity may occur
  • Giving medications will slow down all reactions.
  • A better approach is to help rewire the brain and stimulate the inhibitory pathways.
  • The condition is not being treated but the brain function is directed through specific exercises
  • Eye movements following a concussion is common
  • Pre concussion screening would be useful
  • Treatment may focus on
    • balance, coordination
    • dynamic visual stability
    • reaction time

Pain

  • Anxiety and pain have plasticity in wrong areas i.e., dealing with awareness, recognition sensitivity of pain, and the sensitivity of nerves
  • For pain activate parts brain that inhibit pain and inhibit the limbic system

Depression as a Brain disease

  • Specific weakness frontal lobes with a variety integrative patterns from cerebellum to frontal lobes
  • Stimulating these areas can help with depression

Neurodegeneration

  • Usually due to a combination of vents.
  • For example, a car accident that damages the neck results in decreased proprioceptive input to the brain which results in changes in balance, posture, coordination
  • These things are cumulative with cumulative insults  decrease brain function
  • Another path towards neurodegeneration: Working with computers can lead to changes in posture rounded shoulders. This leads to a decrease in stability, postural control eventually leading to a decrease in control of the sympathetic nervous system and motor function decline

Parkinson’s Disease

  • Movement requires hand- eye coordination to move in different patterns as well as the ability to shift weight before falling.
  • Individual programs will help shift posture and movement which will recruit smooth muscles and improve smooth movement

Balance Difficulties

  • Balance is not only a matter of the inner ear.
  • Vestibular deficits balance and coordination are off
  • Changes in occulomotor patterns (which are not just a product of the eyes)
  • For cases where:
  • Eyes do not move as quickly
  • Eyes are not as accurate
  • There is a delay in reaction time
  • Treatment
  • Can speed up eye movements and increase accuracy
  • Use a balance platform while moving hands to targets
  • This improves balance

PTSD

  • Brain wiring is changed from abuse
  • The patient’s limbic system wound up leading to impulsivity which is typically inhibited by the frontal lobes

OTHER

Exercise 

  • most conditions benefit from exercise
  • Majority of stimulation comes from receptors in joints and muscles with input from the eyes and ears

Developmental Stages

  • A child’s brain is a sponge receive input from all systems
  • First the eyes move which starts to wire neurons, and fire into areas of the vestibular system
  • This fires neck muscles so that the neck and then the arms start to move
  • Neurons grow and fire into the back muscles
  • Neurons continue to grow so the child sits up and then stands
  • As the child ambulates, he gets fine motor control, a lowered heart rate, improved digestion function, and gains bladder control