Services

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Stroke / Vascular Disorders

Stroke
A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. Without oxygen, brain cells start to die after a few minutes. Sudden bleeding in the brain also can cause a stroke if it damages brain cells. A stroke is a serious medical condition that requires emergency care. A stroke can cause lasting brain damage, long-term disability, or even death. If you think you or someone else is having a stroke, call 911 right away.

What Are the Symptoms of a Stroke?

  • Sudden weakness or numbness in the face, arm, or leg on one side of the body.
  • Abrupt loss of vision, strength, coordination, sensation, speech, or the ability to understand speech. These symptoms may become worse over time.
  • Sudden dimness of vision, especially in one eye.
  • Sudden loss of balance, possibly accompanied by vomiting, nausea, fever, hiccups, or trouble with swallowing.
  • Sudden and severe headache with no other cause followed rapidly by loss of consciousness.
  • Brief loss of consciousness.
  • Unexplained dizziness or sudden falls.

Vascular Disorder
Vascular disorder includes any condition that affects the circulatory system. As the heart beats, it pumps blood through a system of blood vessels called the circulatory system. The vessels are elastic tubes that carry blood to every part of the body. Arteries carry blood away from the heart while veins return it. Vascular disease ranges from diseases of your arteries, veins, and lymph vessels to blood disorders that affect circulation.

If you have recently experienced a stroke or suffer from a vascular disorder and would like to speak to a doctor about treatment, make an appointment by calling (818) 937-9944.


Migraines / Headache Disorders

A migraine headache can cause intense throbbing or a pulsing sensation in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can cause significant pain for hours to days and be so severe that all you can think about is finding a dark, quiet place to lie down. Some migraines are preceded or accompanied by sensory warning symptoms (aura), such as flashes of light, blind spots, or tingling in your arm or leg. Medications can help reduce the frequency and severity of migraines.

Migraine headaches are often undiagnosed and untreated. If you regularly experience signs and symptoms of migraine attacks, keep a record of your attacks and how you treated them.

If you suffer from migraines or other headache disorders and would like to speak to a doctor about treatment, make an appointment by calling (818) 937-9944.


Memory Loss / Dementia

The word “dementia” is an umbrella term used to describe a set of symptoms, including impairment in memory, reasoning, judgment, language and other thinking skills. Dementia begins gradually in most cases, worsens over time and significantly impairs a person’s abilities in work, social interactions and relationships. Often, memory loss is one of the first or more-recognizable signs of dementia.

What Are the Symptoms of Dementia?

  • Asking the same questions repeatedly
  • Forgetting common words when speaking
  • Mixing words up — saying “bed” instead of “table,” for example
  • Taking longer to complete familiar tasks, such as following a recipe
  • Misplacing items in inappropriate places, such as putting a wallet in a kitchen drawer
  • Getting lost while walking or driving around a familiar neighborhood
  • Undergoing sudden changes in mood or behavior for no apparent reason
  • Becoming less able to follow directions

Diseases that cause progressive damage to the brain and consequently result in dementia include:

  • Alzheimer’s disease, the most common cause of dementia
  • Vascular dementia (multi-infarct dementia)
  • Frontotemporal dementia
  • Lewy body dementia

People with dementia may have problems with short-term memory, keeping track of a purse or wallet, paying bills, planning and preparing meals, remembering appointments or traveling out of the neighborhood.

If you suffer from dementia and would like to speak to a doctor about treatment, make an appointment by calling (818) 937-9944.


Multiple Sclerosis

Multiple sclerosis (MS) is a disease of the central nervous system (CNS). The CNS consists of the brain, optic nerves and spinal cord. With MS, areas of the CNS become inflamed, damaging the protective covering (known as “myelin”) that surrounds and insulates the nerves (known as “axons”). In addition to the myelin, over time, the axons and nerve cells (neurons) within the CNS may also become damaged.

The damage to the protective covering and also to the nerves disrupts the smooth flow of nerve impulses. As a result, messages from the brain and spinal cord going to other parts of the body may be delayed and have trouble reaching their destination.

What Are the Symptoms of MS?

  • balance
  • bladder dysfunction
  • bowel problems
  • cognitive changes
  • depression
  • dizziness/vertigo
  • fatigue
  • mobility and walking issues
  • numbness
  • pain
  • pseudobulbar Affect (PBA)
  • sleep issues
  • speech difficulties
  • spasticity (stiffness)
  • swallowing disorders
  • tremor
  • visual disorders
  • weakness

While MS has the potential to cause several different symptoms, the specific symptoms each person experiences vary greatly. Medications are available to treat many MS symptoms. These may include over-the-counter drugs as well as prescribed medications. Diet and exercise may also be helpful with managing certain symptoms. All treatments or changes in diet or exercise should only be done under the guidance of a qualified physician.

If you suffer from MS and would like to speak to a doctor, make an appointment by calling (818) 937-9944.


Neuropathy (Nerve Damage)

Neuropathy is the term used to describe a problem with the nerves, usually the ‘peripheral nerves’ as opposed to the ‘central nervous system’ (the brain and spinal cord).

What Are the Symptoms of Neuropathy?

Sensory Neuropathy

  • Tingling and numbness.
  • Pins and needles and hypersensitivity.
  • Increased pain or the loss of ability to feel pain.
  • Loss of ability to detect changes in heat and cold.
  • Loss of coordination and proprioception.
  • Burning, stabbing, lancing, boring or shooting pains – which may be worse at night.
  • Skin, hair or nail changes.
  • Foot and leg ulcers, infection and gangrene.

Motor Neuropathy

  • Muscle weakness – causing unsteadiness and difficulty performing small movements such as buttoning the shirt.
  • Muscle wasting.
  • Muscle twitching and cramps.
  • Muscle paralysis.

Autonomic Neuropathy

  • Dizziness and fainting (because of sudden changes in blood pressure).
  • Racing heart.
  • Reduction in sweating.
  • Inability to tolerate heat.
  • Loss of control over the bladder function leading to incontinence or retention of urine.
  • Bloating, constipation or diarrhea.
  • Difficulties in achieving or maintaining an erection (impotence).

If you suffer from neuropathy and would like to speak to a doctor about possible treatment, make an appointment by calling (818) 937-9944.


Traumatic Brain Injury

Traumatic brain injury (TBI) happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that people must go to the hospital. The worst injuries can lead to permanent brain damage or death. Half of all TBIs are from motor vehicle accidents.

What Are the Symptoms of Traumatic Brain Injury?
Symptoms of a TBI may not appear until days or weeks following the injury. A concussion is one example. It can cause a headache or neck pain, nausea, ringing in the ears, dizziness, insomnia, irritability, and fatigue. People with a moderate or severe TBI may have those, plus other symptoms:

  • A headache that gets worse or does not go away
  • Repeated vomiting or nausea
  • Convulsions or seizures
  • Inability to awaken from sleep
  • Slurred speech
  • Weakness or numbness in the arms and legs
  • Dilated eye pupils

A neurologist can perform an exam and imaging tests to assess TBI. Serious traumatic brain injuries need emergency treatment.

If you suffer from TBI and would like to speak to a doctor about possible treatment, make an appointment by calling (818) 937-9944.


Sleep Disorders

A sleep disorder is a medical disorder of the sleep patterns of a person. Some sleep disorders are serious enough to interfere with normal physical, mental, social and emotional functioning. Disruptions in sleep can be caused by a variety of issues, from teeth grinding (bruxism) to night terrors. When a person suffers from difficulty falling asleep and/or staying asleep with no obvious cause, it is referred to as insomnia.

Some common sleep disorders include sleep apnea (stops in breathing during sleep), narcolepsy and hypersomnia (excessive sleepiness at inappropriate times), cataplexy (sudden and transient loss of muscle tone while awake), and sleeping sickness (disruption of sleep cycle due to infection). Other disorders include sleepwalking, night terrors and bed wetting. Untreated sleep disorders especially obstructive sleep apnea can lead to serious health hazards. Sleep related disorders are usually diagnosed on a polysomnogram or sleep study.

If you suffer from sleep disorders and would like to speak to a doctor about possible treatment, make an appointment by calling (818) 937-9944.


Nerve and Muscle Disorders

Neuromuscular diseases are acquired or inherited (genetic) conditions that affect some part of the neuromuscular system such as:

  • the muscles
  • the peripheral motor nerves (in arms, legs, neck and face)
  • the neuromuscular junction where the nerves and muscles meet
  • the muscle-controlling nerve cells (motor neurons) in the spinal cord

More than a million people in the United States are affected by some form of neuromuscular disease, and about 40 percent of them are under age 18. All neuromuscular diseases are progressive in nature, and all result in muscle weakness and fatigue. Some diseases are present at birth, some manifest in childhood, and others have an adult onset. The disease may be passed down through family genetic lines, and in some cases the affected individual may have an affected sibling, parent or other relative. At other times there is no family history and the disease is the result of a spontaneous genetic mutation, an abnormal immune response or an unknown (idiopathic) cause.

If you suffer from nerve and muscle disorders and would like to speak to a doctor about possible treatment, make an appointment by calling (818) 937-9944.


Seizure Disorders

A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain. Seizures occur when a person’s body shakes rapidly and uncontrollably. During seizures, the person’s muscles contract and relax repeatedly. There are many different types of seizures. Some have mild symptoms without shaking.

What Are the Symptoms of a Seizure Disorder?

  • Brief blackout followed by a period of confusion (the person cannot remember for a short time)
  • Changes in behavior such as picking at one’s clothing
  • Drooling or frothing at the mouth
  • Eye movements
  • Grunting and snorting
  • Loss of bladder or bowel control
  • Mood changes such as sudden anger, unexplainable fear, panic, joy, or laughter
  • Shaking of the entire body
  • Sudden falling
  • Tasting a bitter or metallic flavor
  • Teeth clenching
  • Temporary stop in breathing
  • Uncontrollable muscle spasms with twitching and jerking limbs. Symptoms may stop after a few seconds or minutes, or last longer. The person may have warning symptoms before the attack, such as fear or anxiety, nausea, vertigo (feeling as if you are spinning or moving), and visual symptoms (such as flashing bright lights, spots, or wavy lines before the eyes)

If you suffer from seizure disorders and would like to speak to a doctor about possible treatment, make an appointment by calling (818) 937-9944.


Electromyography (EMG)

Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons). Motor neurons transmit electrical signals that cause muscles to contract. An EMG translates these signals into graphs, sounds or numerical values that a specialist, such as Dr. Harutunian interprets. An EMG uses tiny devices called electrodes to transmit or detect electrical signals.

During a needle EMG, a needle electrode inserted directly into a muscle records the electrical activity in that muscle. EMG results can reveal nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission. An EMG is conducted if you have signs or symptoms that may indicate a nerve or muscle disorder.

What Are the Symptoms Requiring an EMG?

  • Tingling
  • Numbness
  • Muscle weakness
  • Muscle pain or cramping
  • Certain types of limb pain

EMG results are often necessary to help diagnose or rule out a number of conditions such as:

  • Muscle disorders, such as muscular dystrophy or polymyositis
  • Diseases affecting the connection between the nerve and the muscle, such as myasthenia gravis
  • Disorders of nerves outside the spinal cord (peripheral nerves), such as carpal tunnel syndrome or peripheral neuropathies
  • Disorders that affect the motor neurons in the brain or spinal cord, such as amyotrophic lateral sclerosis or polio
  • Disorders that affect the nerve root, such as a herniated disk in the spine

In addition to his training as a Neurologist, Dr. Harutunian is also fellowship trained at the Keck Hospital of USC and board certified specifically in electrodiagnostic medicine, which includes EMG studies. If you suffer from any of the symptoms described above and would like to speak to a doctor to see if an EMG will help with the diagnosis of your symptoms, make an appointment by calling (818) 937-9944.


Nerve Conduction Study

A nerve conduction study (NCS) is a measurement of the speed of conduction of an electrical impulse through a nerve. NCS can determine nerve damage and destruction. During the test, the nerve is stimulated, usually with surface electrode patches attached to the skin. Two electrodes are placed on the skin over the nerve. One electrode stimulates the nerve with a very mild electrical impulse and the other electrode records it. The resulting electrical activity is recorded by another electrode. This is repeated for each nerve being tested. The nerve conduction velocity (speed) is then calculated by measuring the distance between electrodes and the time it takes for electrical impulses to travel between electrodes.

A related procedure that may be performed is electromyography (EMG) (see description in section above). An EMG measures the electrical activity in muscles and is often performed at the same time as NCS. Both procedures help to detect the presence, location, and extent of diseases that damage the nerves and muscles.

In addition to his training as a Neurologist, Dr. Harutunian is also fellowship trained at the Keck Hospital of USC and board certified specifically in electrodiagnostic medicine, which includes EMG and NCS studies. If you would like to speak to a doctor to see if a nerve conduction study will help with the diagnosis of your symptoms, make an appointment by calling (818) 937-9944.


Electroencephalography (EEG)

An EEG is a test that detects electrical activity in your brain using small, flat metal discs (electrodes) attached to your scalp. Your brain cells communicate via electrical impulses and are active all the time, even when you are asleep. This activity shows up as wavy lines on an EEG recording. An EEG is one of the main diagnostic tests for epilepsy. An EEG may also play a role in diagnosing other brain disorders.

In addition to his training as a Neurologist, Dr. Harutunian is also fellowship trained at the Keck Hospital of USC and board certified specifically in electrodiagnostic medicine, which includes EEG studies for the diagnosis of epilepsy and other central nervous system disorders. If you would like to speak to a doctor to see if a nerve conduction study will help with the diagnosis of your symptoms, make an appointment by calling (818) 937-9944.