Functional Neurology
According to existing data, more than 1.5 million people experience a traumatic brain injury (TBI) each year in the United States. Mild traumatic brain injuries consist of the majority. It is absolutely vital to have proper nutrition during your recovery.
Frequently Asked Questions
FUNCTIONAL NEUROLOGY
Functional neurologists work with neurological disorders without the use of drugs or surgery. They are trained to assess and intervene in all manner of neurological conditions.
Our training consists of postdoctoral education in diagnosis and management of neurological disorders that requires several years to complete. This training generally takes place at extension facilities throughout the country, including chiropractic schools, medical schools, university campuses, and others.
A number of different educational institutions train functional neurologists.
The largest and longest serving of these is the Carrick Institute for Graduate Studies. The Carrick institute has trained functional neurologists throughout North America, Europe, Asia, and Australia for four decades.
The majority of functional neurology practitioners are chiropractors, however many different types of healthcare providers are represented within the functional neurology profession. Medical doctors, Doctors of Osteopathy, and Naturopathic Physicians have completed functional neurology training and also received fellowships in functional neurology.
Upon completion of functional neurology training, students become eligible to sit for board examinations that certify them as functional neurologists. Certification is provided through two primary organizations, the American Chiropractic Neurology Board, and the American College of Functional Neurology. The ACNB is itself accredited by the National Commission for Certifying Agencies, the same organization that certifies all medical specialty boards.
Absolutely not.
Our care is not intended to be an alternative to treatment by a medical neurologist. Our services are complementary to medical care. We work closely with numerous medical providers, including neurologists, neurosurgeons, physiatrists, internists, and primary care providers. In many circumstances, we require you to be under medical care in order for us to take your case.
No.
We cannot cure neurological diseases, or change the ultimate outcome for someone with a degenerative condition. We treat people, not their diseases. Our care is not designed to fix incurable conditions. Rather, our care is designed to improve function in the parts of the nervous system that still work in order to promote the best possible quality of life for our patients.
When you develop a neurodegenerative disorder such as Parkinson’s disease, Alzheimer’s disease, or multiple sclerosis, some nerve cells are unfortunately lost, and some pathways in the nervous system are irreparably damaged. There is nothing we can do to change that. However, when you have such a condition, we can often find ways to influence the remaining working parts of the nervous system to make them work better.
We strive to take the pathways that still are healthy and precisely stimulate and exercise them, in order to make them more efficient, increase their endurance, and improve your ability to function in the world.
We use a number of different technologies for this.
To name a few, we start with Computerized Platform Posturography. We put you through a series of balance tests in different types of surfaces, with and without vision, and with a series of different head positions. This allows us to see how well you can stabilize yourself against gravity. It also shows us how your brain uses different types of sensory information to localize itself in space, and how it uses that information in various combinations. It lets us see how well your sensory systems work, and determine how well or poorly the different information they provide matches with each other.
We use VideoNystagmography to assess the function of all of your important visual reflexes. You wear a set of infrared goggles that precisely track your eye position as you follow a series of targets on a screen. This gives us information about a number of important brain regions and circuits, and how well they work together in different situations. The regions we evaluate are not only important for vision, but are involved in a host of cognitive and emotional processes. When they are struggling, not only do we see the difficulty with vision but difficulty with all the mental and emotional functions they also are necessary to perform.
We use Vestibular Head Impulse Testing to determine how well the complicated structures in your inner ear are working. You wear another set of goggles that contain an infrared camera and an accelerometer, and we move your head in a number of directions to see how your eyes react. This lets us see how well your vestibulo-ocular reflexes work, which are critical to your recovery and often overlooked. They let you know how your head is moving and how fast. They also help you create your brain’s unconscious concept of where it is located in space.
If they are providing the wrong information, the brain does not know where it is accurately when the head moves. This causes it to fire the wrong stabilizing muscles at the wrong time, leading to chronic musculoskeletal problems.
We combine all of this information with your examination findings to create a rehabilitation program that is entirely unique to your brain.
Our therapy starts with various types of stimuli, including electrical modalities, laser and light therapies, auditory and visual inputs, and tactile and proprioceptive therapies. We use these to stimulate the deficient parts of your brain and build endurance in your fragile systems. We then use a series of exercises that activate the deficient parts for precise tasks and in very specific orders.
We start with fundamental brain reflexes and functions and build up to more complicated tasks as your brain’s endurance improves.We create exercises that integrate the various regions that are struggling and train them to work together again.
We then create types of exercises that allow us to simulate the contexts in the world where you struggle the most and help you rebuild your function in real-world contexts.
We will always use the most recent advances in technology, that have passed rigorous trials in clinical and data based research, to allocate the best possible outcomes to your well being.
Our process starts with a comprehensive history. To properly understand the complexities of your case, we need to uncover all of the factors and events in your past that brought you to this point.
We follow this with an extremely thorough and detailed neurological examination. Our examination is similar to a medical neurological examination but differs in a number of important respects. A traditional medical neurological examination is primarily designed to reveal disease processes and severe neurological dysfunction, as seen with tumors, strokes, nerve injuries, and other pathological conditions.
These processes create ablative pathology, which means pools of dead nerve cells. If a reflex is tested during the examination, and it appears to work reasonably well, it is generally considered to be normal and free from ablative pathology.
We assess the same types of pathology in our examination, but we also look deeper to assess for varying levels of neurological function. By looking beyond whether or not a reflex works, but also at how well it works, when it fatigues, and what happens when it fails, we gain much more and deeper information regarding your neurological function.
A standard neurology exam may tap the patellar tendon with a reflex hammer, see that the knee moves, grade the reflex, and move on. We do the same thing, but also look at how long it takes to work, the intensity of the response, and how long it takes for the response to fatigue and fail.
This gives us far more information, and when correlated with other reflexes, it allows us to map out a functional picture of how your well your nervous system works, what happens when it is under stress, and what happens when it fatigues and fails. This provides us with more of what we need to create your unique NeuroRestoration Program.
Our programs take great care to ensure that you exercise your fragile pathways at a rate that does not promote neurological fatigue.
By keeping your program within a rate that does not promote failure, you build endurance quicker and recover faster. We believe that if you feel worse during or after a therapy, the therapy is either wrong, provided at the wrong intensity, or with the wrong duration.
Our programs account for all of those factors to make sure that you only take steps forward with no steps back. We also provide you with a thorough evaluation of your metabolic function as a fundamental part of our program. We assess all of the systems that can contribute to impaired neurological function. We start with a series of unique assessment tools that allow us to see how well your various physiological systems are functioning.
This gives us insight into blood sugar, oxygenation, hormones, inflammation, digestion, and many other systems that can directly or indirectly influence how well your brain is working. We perform laboratory assessment when necessary, and develop strategies to promote improved function in all of these systems using the best of functional medicine interventions. And when problems we identify are better managed by other providers, we confer with your primary care or provide referrals to other providers to ensure that your metabolic condition cannot interfere with your neurological recovery.
By evaluating and managing you on all of these different levels, we can help you get better faster, with less effort, and fewer symptoms along the way.
In a traumatic brain injury, most of the common symptoms such as headache, dizziness, and brain fog involve the brain being unable to determine where it is in space. The brain needs to be able to make sense of the environment and localize itself within it in order to be able to adapt to the world properly.
This requires accurate visual information from the eyes to localize the world, accurate vestibular information from the inner ear to let you know where your head is in relation to gravity and how your head is moving, and accurate proprioceptive feedback from muscles and joints, to let the brain know where the body parts are and what they are doing. These systems need to provide the correct information to the brain and be able to work together for you to make sense of your environment and function well within it.
The pathways that provide this information are almost always impaired to some degree during brain injuries. These pathways come from almost all areas of the brain, and send long, thin fibers to areas of the brainstem where they integrate and work together.This makes them very susceptible to twisting, shearing forces that can damage the sensitive fiber tracts.
More importantly, these pathways lose the ability to integrate and work together. When they do not, the consequence is a mismatch between sensory pathways in certain conditions, leading to a failure to adapt to the world in all situations.
There are many forms of therapy that have traditionally been employed to treat these conditions. All are useful and effective in many cases, but none are completely effective on their own.
Physical therapy and chiropractic can be helpful to address structural issues that create pain. Vestibular therapy can be helpful to address balance difficulties and dizziness. Vision therapy can be helpful to address problems with double vision and visual focus.
But none of these individual types of therapy can fully address the impairment of integration that prevents all of these systems from effectively working together. If a structural issue such as ongoing neck pain is created by a neurological reflex that the brain is using to compensate for an impaired visual reflex, the neck pain will often continue to return regardless of how many times it is addressed with exercises, therapy modalities, massage, and adjustments.
Similarly, if a visual reflex is impaired because an inner ear pathway that moves the eyes is damaged, vision therapy will be incompletely effective. And if dizziness and balance issues exist because the eyes and inner ear are not working well together, rehabilitation of these systems independently will often fail to completely resolve the patient’s symptoms. This is why we created our NeuroRestoration Program. We stand at the intersection between neurology, physical therapy, vision therapy, vestibular therapy, and physical medicine.
We are uniquely equipped to not only evaluate how well visual, vestibular, proprioceptive, and cognitive systems are working, but also to determine how well these systems are working together. Using our comprehensive systems of cutting-edge diagnostics, we can develop programs unique to your own brain and condition to make these systems work well and in harmony with each other once again.
Functional Neurology encompasses a very thorough neurological examination, which is not different to anyone else trained in neurology. The nervous system is the same. It’s not specific for a chiropractic neurologist, a medical neurologist or a dentist. The eye works only in certain ways [for example]. Our examinations are in-depth – more in-depth than some disciplines, perhaps less in-depth than others. They are very specific to the brain, central and peripheral nervous system in regard to environmental activations whether they be light, heat, cold, taste, smell, movement, or different sensations. We examine and quantify them so certainly our discipline is one of evidence base,”