Neurological Diseases and Conditions
The Mount Sinai Department of Neurology treats a full range of neurological disorders, from the first signs of multiple sclerosis to the advanced stages of Parkinson’s disease. Our department houses a renowned group of specialized centers that combine personalized treatment plans and cutting-edge research into the best possible care for patients struggling with a variety of neurological conditions.
The Mount Sinai Hospital is highly experienced in the diagnosis and care of patients with neuromuscular disease. Neuromuscular diseases are disorders affecting the peripheral nervous system, which consists of nerves, muscles, and the synapses in between, and regulates activities from raising your arm to sensing the heat of a stove. Neuromuscular diseases include the following:
- Neuropathy, the most common disorder of the peripheral nervous system, is characterized by symptoms such as weakness, numbness, and changes in skin color or texture.
- Amyotrophic lateral sclerosis (also called ALS or Lou Gehrig’s Disease) is a progressive motor neuron disease involving the painless deterioration of muscle function. Symptoms include muscle weakness and atrophy, and possibly difficulty with swallowing and speaking.
- Myopathy is a muscle disorder causing weakness that is usually most severe in the upper arms and thighs. Causes may include infection and injury.
- Muscular dystrophy is a group of progressive muscle disorders caused by genetic defects. Symptoms may start with weakening of the muscles closest to the trunk, muscle enlargement, and clumsiness, and progress to severe muscle deterioration and muscle contraction..
- Myasthenia gravis is an autoimmune disorder that blocks the signals from the nerves to the muscles, rendering the muscle unable to move.
Mount Sinai’s Robert and John M. Bendheim Parkinson and Movement Disorders Center treats a range of movement conditions, which are characterized by abnormal motions that can be too slow (hypokinetic) or excessive (hyperkinetic). Common movement disorders include the following:
- Parkinson’s disease is a neurodegenerative disorder characterized by symptoms such as tremors, slowed movements, and rigidity in the arms and legs. It is generally a slowly progressing disorder that can lead to slurred speech and difficulty swallowing.
- Dystonia is a painful condition causing muscles to twist, shake, or contract into abnormal postures.
- Huntington’s disease is an inherited condition causing the progressive degeneration of nerve cells in the brain, resulting in abnormal body movements and mental impairment.
- Benign essential tremor is a disorder usually characterized by shaking in the hands, and in some cases the head and arms.
- Tourette syndrome is a tic disorder characterized by rapid, involuntary movements and sounds that occur repeatedly. Motor tics can range from eye blinking to jumping, and vocal tics can range from throat clearing to saying socially inappropriate words.
- Cerebral palsy is a chronic condition that impairs control of movement. Symptoms of this disorder, which is not considered progressive, typically appear when a child is aged three or less, and include lateness walking, trouble with fine motor activities, weak or tight muscles, and speech problems.
- Spasticity is the involuntary, continuous contraction of muscles following damage to the spinal cord or brain. The muscle contractions of the condition interfere with functions such as walking and speech.
Mount Sinai’s Corinne Goldsmith Dickinson Center for Multiple Sclerosis provides a multidisciplinary approach to diagnosing, managing, and researching multiple sclerosis. An autoimmune disorder, multiple sclerosis is a disease in which the immune system attacks the central nervous system, damaging the covering (called myelin) of certain nerves in the body. The disorder usually strikes adults between the ages of 18 and 40, causing a range of disabilities, from mobility problems to cognitive defects. Symptoms—which include vision problems, muscle weakness in the extremities, numbness, bladder problems, and certain cognitive impairments—can be mild or severe, and can occur in relapsing episodes (lasting days or weeks) or become chronic.
The term NeuroAIDS refers to any neurological condition—such as dementia, neuropathy, brain infections, and disorders of the spinal cord—that occurs as a result of HIV infection. Depending on which part of the nervous system is affected, symptoms could include headache, dizziness, memory loss, numbness, pain, vision problems, and difficulty walking. Mount Sinai’s NeuroAIDS Program specializes in diagnosing and treating the full range of HIV-related neurological disorders.
The Mount Sinai Epilepsy Center offers inpatient and outpatient monitoring, evaluation, and medication management for patients with epilepsy, which is a neurological disorder that causes repeated seizures. There are many types of seizures, ranging from the often-dramatized tonic clonic seizures (which involve falling and rhythmic body jerks) to absence seizures (which involve a short period of unresponsive staring).
Headaches and Pain Disorders of the Skull, Brain, and Face
Head pain can range from the dull ache of a tension headache to the extreme pain of trigeminal neuralgia. The Mount Sinai Center for Headache and Pain Medicine provides individually tailored treatments for chronic and acute headaches and other painful disorders of the brain, skull, and face.
- Headaches include tension headaches (a dull, steady pain in areas such as the neck or forehead), cluster headaches (a stabbing or explosive pain on one side of the head), and migraines (severe pain accompanied by symptoms such as sensitivity to light and nausea).
- Hemifacial spasm is a neuromuscular disorder causing involuntary and frequent contractions in the muscles on one side of the face. Symptoms may include twitching of the eyelids, forced closure of the eye, spasms of the lower face, and the pulling of the mouth to one side.
- Trigeminal neuralgia (TGN) is a condition causing shocks of extreme pain in the lips, eyes, nose, scalp, forehead, and jaw, lasting up to two minutes. Episodes could persist for days or months, and could be triggered by contact with the cheek through actions like shaving or tooth brushing.
- Occipital neuralgia is a form of chronic headache that involves a throbbing or piercing pain in areas such as the back of the head and upper neck, usually occurring on one side. Symptoms could also include sensitivity to light and scalp tenderness.
- Temporomandibular joint disorder (TMJ) is a painful condition of the joints attaching the lower jaw to the skull. Pain could be accompanied by symptoms such as clicking or grating sounds when moving the jaw, a sensation of the jaw catching, and difficulty opening the mouth fully.
Stroke and Cerebrovascular Disorders
The Mount Sinai Stroke Center specializes in the treatment and rehabilitation of patients who have suffered a stroke. A stroke occurs when the flow of blood to the brain is compromised by either a clot or injury blocking a vessel (called ischemic stroke) or the breakage of a vessel allowing blood to leak into the brain (called hemorrhagic stroke). Related conditions include the following.
- Transient ischemic attack (also called TIA or “mini stroke”) results from a temporary blockage of blood to the brain, causing short-term brain dysfunction lasting no more than 24 hours. A serious condition, TIA is a warning sign for potential stroke and shares many of its symptoms.
- Traumatic brain injury (TBI) occurs when a head trauma damages the brain. Symptoms can be mild (even imperceptible at first) and include headache, confusion, visual disturbances, and nausea. Signs of severe TBI include loss of consciousness exceeding six hours, convulsions, dilation of the pupils, and dizziness.
- Brain aneurysm is a protruding sac on a weakened section of an artery, which has the potential to rupture and leak blood into vital brain structures. Symptoms could include a sudden “thunderclap” headache, neck stiffness, intolerance to light, nausea, seizures, and loss of consciousness.
Neurological tumors are benign or malignant growths occurring anywhere throughout the nervous system, and include diseases such as the following.
- Pituitary adenoma is a benign tumor on the pituitary gland, which secretes a number of hormones including those that regulate growth. These tumors can cause symptoms including vision problems, growth problems, and hormonal disruptions.
- Acoustic neuroma is a slow-growing tumor on the eighth cranial nerve, which runs from the brainstem to the ear and is involved in hearing and equilibrium. Symptoms could begin with gradual hearing loss and ringing in the ear, then progress to balance problems and facial numbness.
- Meningioma is a slowly-developing brain tumor in the meninges, which are the membranes protecting the brain and spinal cord. Symptoms may include nausea, weakness, and hearing or vision loss.
- Brain tumors fall into two main categories: Primary brain cancer begins in the brain and can be either benign or malignant; secondary brain cancer has spread to the brain from another part of the body and is always malignant.
- Neurofibromatosis (NF) is a genetic disease causing tumors to form on nerves in any part of the body. There are two types: NF1symptoms include brown spots on the skin, deformed bones, and mild intellectual impairment. NF2 symptoms include ringing in the ears, poor balance, and pain in the face.
Alzheimer’s Disease and Other Dementias
The most common form of dementia, Alzheimer’s is a progressive disease that destroys brain cells, eventually interfering with the most basic mental and physical functions. It progresses through three stages (early, intermediate, and severe), during which symptoms intensify from mild memory lapses to a complete dependence on others for care. Mount Sinai’s Center for Alzheimer’s Disease (housed within the Friedman Brain Institute) specializes in the diagnosis and treatment of this disorder at all stages.