HealthNews A Silent Threat r Movement Disorders • • Moving Toward a Solution . 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."