HealthNews

A Silent
Threat

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Movement Disorders

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Moving Toward a Solution

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0 noring never killed
°anyone. But if the
snore is followed by an
abrupt silence, then a se-
rious problem needs at-
tention. The silence
signals a drop in oxygen
that increases the risk of
strokes, heart attacks
and high blood pressure.
The New England
Journal of Medicine re-
cently reported that eight
to 12 percent of middle-
aged men suffer from
sleep apnea, a health-de-
priving and life-threat-
ening sleeping disorder.
A definitive diagnosis
can be made during an
overnight stay at Sinai's
Sleep Apnea Center, di-
rected by Bradley
Rowens, M.D., and Oscar
Bigman, M.D. Once the
condition is confirmed,
Dr. Pichurko says, "It
must be treated." Most of-
ten, a mechanical device
can do the trick while
congenital problems can
be treated surgically.
The successfully treat-
ed patient welcomes the
payoffs: More alertness,
and new per-
sonality
restoration.

Peter A. LeWitt, M.D., directs the Sinai Clinical Neuroscience Center and treats patients with movement dis-
orders such as Alzheimer's and Parkinson's diseases.

hat do Parkinson's
disease, Alzheimer's dis-
ease, Tourette syndrome,
dystonia and tremors all
have in common?
They are all movement
disorders caused by neu-
rological impairment. And
they are all the special in-
terest of the Clinical Neu-

roscience Center at Sinai
Hospital, the largest and
busiest movement disor-
der center in Michigan.
Directed by Peter A. Le-
Witt, M.D., the Center's
patients benefit from an
active clinical research ef-
fort, making the latest in
innovative drugs available

as soon as possible.
There are only 50 to 75
movement disorder spe-
cialists in the entire coun-
try, and two of them — Dr.
LeWitt and Dr. Richard
M. Trosch — are at Sinai.
Dr. LeWitt completed a
residency at Stanford, and
Dr. Trosch completed a
residency at Yale. The aca-
demic commitments of
these fellowship-trained
neurologists have attract-
ed research grants from
the National Institutes of
Health.
For example, five new
drugs are under study at
Sinai to treat Alzheimer's.
And some improvement in
memory or alertness has
been noted in one out of
five of these otherwise
hopeless cases.
Dr. LeWitt stresses the
importance of early diag-
nosis. In his lab, in fact,
there is an effort to dis-
cover "markers" or chem-
ical clues in patient tissues
that would permit diag-
nosis before any symp-
toms occur. "By the time
someone is displaying the
disease," he explains, "fifty
percent of the reserve
nerve cells are already
lost. Our goal is early in-
tervention, before there is
any deterioration."
The Sinai team has also
published research on its
search for Parkinson's dis-
ease markers. This disor-
der is characterized by
slowed movements and oc

casional shaking and bal-
ance problems. "Sinai has
the most expertise of any
center in Michigan for
managing Parkinson's dis-
ease," Dr. LeWitt says. "It
is a highly specialized ser-
vice. Cases that are diffi-
cult to diagnose and treat
are referred to us by neu-
rologists from around the
state."
Sinai is testing six
Parkinson's drugs now,
one of which appears to
slow the progression of the
disease. Sinai is also a
leader in testing the
promising drug, Botox, for
alleviating the disabling
spasms of dystonia.
But science is only one
focus for the Clinical Neu-
roscience Center, which
recently opened a new fa-
cility in West Bloomfield.
Speaking of the very de-
bilitating disorders, Dr.
LeWitt says, "We seek to
establish more involve-
ment with the patient; not
just a diagnosis. We get to
know the family and offer
whatever supportive re-
sources we can, including,
if necessary, nursing home
or home care referrals."
"We are making sure
people feel they're not
alone and they can still
live a quality existence."

Sinai Neurologists Offer Treatment of
Headaches and Neuromuscular Diseases

6PEC IAL ADVERTI EM I

R

emember the last
time you had a
headache? Remem-
ber the throbbing pain, the
strain on your eyes and
the inability to concen-
trate? Sinai neurologists
have been treating
headache patients from all
over Michigan and have
met great success in treat-
ing these individuals'
problems and alleviating
their pain.
"In the past, headaches
have been described as
tension, stress-related or

migraine," says Sinai's
Chief of Neurology
William Leuchter, M.D.
"However, we now know
they may be attributed to
a neuro-chemical disorder
which may be treated with
prescription drug thera-
py."
Sinai's team approach
to headache treatment of-
fers patients the expertise
of a diverse staff. "Our
treatment team includes
neuro-psychologists and
anesthesiologists who help
patients manage pain. We

use sophisticated inves-
tigative tools to determine
the cause of the patient's
headache and, therefore,
an appropriate treatment
plan. We invest the nec-
essary time and resources
to reach a firm diagnosis
and proceed with proper
treatment," says Dr.
Leuchter. "Most impor-
tantly, our strategy in-
cludes the personal
involvement of the neu-
rologist.
"Our multi-disciplinary
approach and the direct

e‘sinal

involvement of a neurolo-
gist give Sinai a distinct
advantage in headache
treatment in southeastern
Michigan," says Dr.
Leuchter.
A new avenue of Sinai's
neurology section is the
treatment of neuromus-
cular disease which is led
by renowned neurologist
Danny Watson, M.D., who
recently joined the Sinai
medical staff. Peripheral
neuromuscular diseases
include neuritis and myas-
thenia gravis, an auto-

immune disorder in which
the facial muscles weaken
causing drooping eyelids,
hesitant speech and diffi-
culty swallowing.
According to Dr.
Leuchter the treatment of
neuromuscular disorders
is a growing clinical pro-
gram at Sinai. "Under Dr.
Watson's direction, we're
developing new treatment
of these diseases," he says.
"We're very optimistic
about expanding this area
of expertise in southeast-
ern Michigan."