Functional Neurology: What is it?
Functional Neurologists are healthcare practitioners from many different disciplines that are emerging as the authority in the evaluation and intervention for a variety of health conditions with neurological origins. Functional Neurologists are trained to evaluate people is a systems-oriented fashion. This is a departure from the traditional healthcare practice that utilizes a disease-based focus. Embracing a more patient-centered approach to healthcare, shifts the attention away from focusing on isolated symptoms and allows the practitioner to spend time, understand the full history, look at genetic and lifestyle factors as well as the mechanisms or accumulation of injuries over a person's lifetime. When a more robust clinical picture is developed, signs and symptoms begin to correlate and can guide a more effective treatment strategy that is specified to the needs of the patient. Why is Functional Neurology Necessary? As a society we are seeing a sharp rise in the number of concussions, brain injuries, movement disorders and neurodegenerative diseases like Parkinson's disease, Dementia and Alzheimer's. The dominant system of healthcare is structured around managing acute conditions, diagnosing and treating trauma or illness that is acute and in need of immediate care, such as a stroke or acute infection. For these people rapid administration of medication or surgery can be very effective in solving that problem quickly and saving someone's life. When it comes to more complex injuries or illnesses that become chronic, acute management is not focused on the fundamental methodology and tools to be effective for these people. This often leads to protracted symptoms, frustration, worsening of the condition and ultimately having that person fall through the cracks of the healthcare system, and it happens every day. Functional Neurologists serve an important role in complementing the current system. Working closely with neurologists, neurosurgeons, physiatrists, internists and primary care providers bolsters clinical care team, providing the best environment for optimal recovery. This is especially true for those that have suffered though or survived the acute phase of their injury or illness and now need a treatment designed for the problem at hand. How is Functional Neurology Different? Functional neurology involves a fundamental understanding in how the brain and nervous system can be analyzed, measured and treated based on the ability to perform specific functions. Patients are evaluated through a 3 step process that includes a detailed health history, followed by a comprehensive physical and neurological examination. Then a series of advanced diagnostic procedures may be performed that measure function from the visual, oculomotor, vestibular, cardiovascular and proprioceptive systems. These tests are performed using the same gold standard technologies found in hospitals, neurology clinics, cardiology centers and neurotology clinics across the globe. These technologies form a comprehensive picture of how effective the brain and nervous system are in that exact moment to determine which circuits are not functioning appropriately and more importantly which circuits are functioning well. With this knowledge the functional neurologist can determine if there is a realistic probability of improving brain function through treatment. The primary mode of treatment for the functional neurologist does not rely on surgery or medication. Instead targeted rehabilitation procedures that employ unique combinations of brain exercise and stimuli are designed to precisely interact with specific areas in the brain. The procedures are modified and adapted in real time according to patient response monitoring. Patients are often attended in an outpatient setting where they are evaluated and treated multiple times per day. This type of treatment takes full advantage of the neuroplastic capacity of the brain to rebuild and repair itself. Once patients are comfortable and capable with their rehabilitation strategies that have been developed for them, the exercises are then adapted so the patient can perform them in the comfort of their home and the doctor can monitor them electronically. Functional Neurology Training Functional neurologists undergo rigorous Post-Doctorate training in diagnosis and management that requires several years of course work and clinical fellowship to complete. This training generally occurs at extension facilities around the world through chiropractic, medical, naturopathic, university and other campuses. Training in functional neurology is provided by a number of different educational institutions, originating from the longest serving- the Carrick Institute for Graduate Studies. The Carrick Institute has been the authority in training functional neurologists on 5 continents for over 3 decades and has been built on the work of Professor Frederick Carrick. The work of Professor Frederick Carrick that began nearly 40 years ago has been instrumental in turning concepts in clinical neurology into life-altering solutions for those suffering from brain injury, concussion, movement disorders, vestibular problems and neurodegenerative problems. Functional neurology is safe. Any time a treatment option is considered, it must be weighed against the potential side-effects. When it comes to the brain, this process is even more crucial. Functional neurology uses the processes and pathways that have been refined within the human body for centuries. The neurological rehabilitation that is employed is non-invasive and precise making it very safe for even the most compromised patients. The field of functional neurology has been in development for nearly 40 years even though to many it may seem brand new. These physicians have been trained rigorously to evaluate and intervene in cases where neurological-rehabilitation can have positive outcomes and it is a safe first line therapy. We are learning more each day about what is possible and for many that has meant the ability to heal and recover from significant brain injury or illness Nathan Keiser, DC, DACNB Diplomate of the American Board of Chiropractic Neurology Assistant Professor of Clinical Neurology-Carrick Institute