Frequently asked questions about functional neurology
What is a functional neurologist?
Functional neurologists work with neurological disorders without the use of drugs or surgery.
Functional neurologists 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 three 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 become licensed as functional neurologists.
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 certified by the federal government by the National Commission for Certifying Agencies, the same organization that certifies medical specialty boards.
Is functional neurology a replacement for traditional medical care?
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.
Does functional neurology cure neurological diseases?
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.
What is a functional neurology examination?
Our work starts with a detailed health history, followed by a very comprehensive neurological examination. We then perform a series of advanced diagnostics that record and evaluate eye movements, inner ear function, and balance. We utilize the same gold standard technologies found in hospitals, neurology and neurotology clinics, and brain injury treatment centers throughout the world. We use these technologies to see what parts of your nervous system do not work, but more importantly, which ones do. This allows us to determine if there is a realistic chance of improving function through treatment. If so, we prescribe a series of unique exercises and various other forms of stimulus designed to precisely stimulate the specific parts of the nervous system that we may be able to help, and that can hopefully result in a positive change in function.
The types of exercises and stimulus we employ are unique to each patient and generally change several times as we progress through a course of care. These exercises are generally performed for a few minutes several times per day over a period of time ranging from weeks to months. Our frequency of treatment depends on the needs of the patient. In most cases, we see people one to three times per week when we start working with them, and decrease this as they improve. In more challenging cases, we may see them more frequently. When we see people with severe brain injuries or advanced degenerative diseases, often our best hope to make a change involves clustering treatments together into intensive protocols. In such cases, we may treat several times per day over a week or two. We also generally like to work this way for patients who travel longer distances to see us. We usually find intensive protocols are our best opportunity to make the changes we seek.
How soon can I expect to see improvement?
People often experience some degree of immediate improvement in their symptoms after one treatment. In many cases, these changes are immediately felt. In some cases, these changes can be dramatic. It is not uncommon for us to be able to make symptoms improve significantly in real time. Usually these immediate improvements only last for a short period of time, however with more frequent stimulus we can usually create lasting change.
In most of our cases, the changes are smaller but build up over time. Our courses of care usually start by seeing our patients a 1-3 times per week for a few weeks, depending on the severity of the condition, followed by gradually decreasing how often we see then as they improve. Typically treatment lasts for 2-4 months, and we repeat all of the diagnostic tests a few times along the way to evaluate progress and change the exercises and stimulus as needed. When we have reached our maximum level of improvement, our patients may need to continue to perform some of their exercises in order to maintain the gains they have made.
And in some cases, despite our best efforts, we cannot make a change. Unfortunately we cannot guarantee that we can get you better, but we can guarantee that we will do everything we can to help.
Why should every chiropractic patient have a functional neurology exam?
Chiropractic manipulation can profoundly affect the brain. A neurological evaluation allows us to not only safely perform treatment, but indeed to enhance treatment by sending the right kind of stimulation to the brain.
How can functional neurology reduce my risk of Alzheimer’s, Parkinson’s, or other brain diseases?
By recognizing this early before symptoms are obvious, people can take steps to significantly reduce their risk of deteriorating from advanced brain disorders later in life. We can often identify functional changes in gait, balance, and eye movements that can at times be early markers of significant neurodegenerative conditions, and coordinate with other medical providers to ensure proper diagnosis and comprehensive management of your condition. Early intervention may be the best hope for delaying the onset and slowing the progression of these disorders.
These can include Alzheimer’s, Parkinson’s, memory loss, depression, or loss of balance. Good brain health can also help prevent breakdowns in bodily functions that results in poor bladder control, high blood pressure, bad digestion, dry eyes, poor digestion, erectile dysfunction, and more.
What is the functional neurology exam like?
The eyes are a window into brain function, a fact that has been established by scientific studies for decades. For instance we can stimulate your brain using movement (such as turning you around in a chair), visual stimulation (such as moving a striped scarf across your field of vision), sound, or vibration with a tuning fork, and then observe how your brain reacted to this input by observing the movement of your eyes.
We can get a closer look at your reaction to stimuli with the use of special goggles that magnify your eyes on a computer screen. This is called Video Nystagmography.
Other diagnostic tools include looking at your posture, how you walk, how well or quickly you can do certain hand exercises, and whether one side of your face or body droops slightly. These would be signs obvious only to a trained functional neurologist, however they provide powerful insight into how different parts of your brain function.
We also use computer-guided balance exercises in the office for both assessment and rehabilitation.
What are the rehabilitation exercises like?
Brain rehabilitation exercises differ for each person depending on his or her unique needs. Treatments may include chiropractic adjustments, neuromuscular re-education exercises, or stimulation of the auditory, visual, vestibular (balance), or other sensory systems.
Examples of common brain rehab exercises include having someone rotate you in an office chair, specific balance exercises on a wobble board, eye exercises using large or small images, wearing tinted lenses, the use of a tuning fork against a certain part of the body, or even working with an app you can download onto your iPhone or iPad.
The exercises may seem unusual, however they deliver very specific input to select areas in the brain. Brain disorders typically stem from areas of the brain that are underactive or overactive. The exercises help correct these extremes to return function to normal. This in turn may improve or alleviate the symptoms of the condition.