Alzheimer’s Disease – Understanding the Diagnosis

 In Alzheimer's Disease

Alzheimer's Disease Diagnosis: Correct or Incorrect?

We see a lot of people in our practice who have been told they may have Alzheimer’s disease. or they do have Alzheimer’s disease. You have to step back and see how that diagnosis was made. Sometimes they go to their provider who does a simple memory test called a Mini-Mental State Examination or the St. Louis University Mental Status Examination. The patient receives a couple of basic blood tests and maybe they’re sent for some brain imaging like an MRI or a CAT scan of the brain. The provider looks at these tests, and when the blood tests and the MRI look normal, and the Mini-Mental Status Examination is in the abnormal range, they’re told that they have Alzheimer’s disease. But the reality is that there are much more sophisticated ways of making the diagnosis. Unfortunately, unless we use those sophisticated approaches, you’re going to have a lot of people told they have this condition when in fact they don’t.

So what do we do at Sharlin Health and Neurology?

First of all, you come in and you do your usual office paper work, and you have an appointment with me. We spend a good amount time together taking a detailed history, going through a comprehensive neurological examination, including a more detailed, but still fairly brief, memory test called the Montreal Cognitive Assessment. This is still more or less of a screening tool, but it’s definitely more sensitive to Alzheimer’s disease as a diagnosis than the Mini-Mental Status Examination. We either perform blood work or we review blood work to make sure that all the necessary blood work has been done, and it is necessary to have imaging.

MRI: NeuroQuant Technology

Now, there is brand new software for the MRI that is called NeuroQuant software. The reason this is very interesting and important is that NeuroQuant software actually measures the volume of the region of the brain affected in Alzheimer’s disease. We can compare that brain, the brain volume of our patient to normal brain volume and determine if there’s been significant shrinkage, or what we call atrophy, in that brain region. That gives us much more specific information than a standard MRI without volume measurements. But that’s just the first step. We can use other tools like PET imaging or we routinely perform spinal fluid examinations using what are called biomarkers which are specific to this condition, something called Abeta42 and tau protein. These proteins measured in the spinal fluid can tell us, with a very high degree of certainty, whether the diagnosis is correct or not.

Need a Second Opinion?

At Sharlin Neurology, I feel, that I can bring the diagnosis to a much more sophisticated level. I have the tools to address the problem. We need to anchor in the problem, we need to make sure we have the right diagnosis, so we apply the right treatment to the right diagnosis. If you have questions or are in need of a second opinion I am here for you. We currently are accepting self-referrals. As the Ozark’s only private neurology practice I am able to see patients within 14 days. Click below to schedule today.

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Protect Against Coronavirus: Doing our Part to Help you

In these difficult times we want to share with you some brief bullet-points about Sharlin Health and Neurology and COVID-19:
  • First and foremost, we want you to know that the safety and well-being of each and every one of you is number one importance to us. If you have a chronic lung condition or another health reason that would make you susceptible to the more severe effects of the coronavirus, we want you to stay at home.
  • Sharlin Health and Neurology is considered an “essential” business because we provide critically needed care to those with neurological disease in our community. Despite the threat of the coronavirus conditions like Alzheimer’s, Parkinson’s disease, seizures, migraine, MS, and other neurological diseases do not go away. We are a privately-owned neurology practice here to serve our community.
  • We follow all CDC guidelines for protection against the dissemination of coronavirus. There have not been any known cases of coronavirus in our office, among staff and those customers who have entered our door. 
  • We have six available exam rooms in our clinic and every effort will be made to prevent patients from having to stay in our waiting room. We can move you quickly from the reception desk to a private exam room, and have the doctor meet you there.
  • If you are sequestered at home, it may be possible to visit with you by telemedicine. We have the capability of using a telemedicine portal though the smart phone or computer that is HIPAA compliant and allows us to see you and speak with you. Alternatively, we can speak by telephone. Please ask our receptionist.
  • If you do come to our clinic for a doctor visit or a need a test please do not touch any surfaces you can avoid touching, and come by yourself or – if you do need to have someone with you – have them bring you to the door and we will help you from that point. If they wait in their vehicle, we can call them when you are finished.
  • If you have had contact with a person with known or suspected COVID-19, have had contact with a person coughing or with fever in the past 14 days, or you yourself have a fever, cough, or runny nose in the past 14 days, please let us know and we will either reschedule you or schedule you a telemedicine visit. 

If you think you may have been exposed to COVID-19 please reach out to your nearest medical center. We will not be testing patients at Sharlin Health and Neurology. 

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