Michigan Head & Spine Institute, Author at Michigan Head & Spine Institute Blog - Page 6 of 8

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Patients arrive at Michigan Head & Spine Institute with many different conditions and injuries.  We hear from our patients that learning about conditions other than what you might be experiencing often helps family members or friends. So this month the MHSI Health Education Series will discuss trigeminal neuralgia.

Robert Johnson, M.D., MHSI neurosurgeon explains, “Pressure or damage to the trigeminal nerve can cause malfunction of the nerve which leads to the pain in the face known as trigeminal neuralgia.” Trigeminal neuralgia usually affects more women than men, and those over 50 years of age. Doctors may use medications, and sometimes surgery to relieve the pain and release the pressure on the nerve.

Some Possible Causes:

  • Contact between a normal blood vessel and an artery/vein
  • Aging
  • Multiple Sclerosis or other movement disorders
  • Brain lesion
  • Stroke or facial trauma
  • Abnormal position of blood vessel related to the nerve

Symptoms of Trigeminal Neuralgia

There are many symptoms of trigeminal neuralgia which could include one of these patterns:

  • Extremely painful, sharp electric-like spasms that may last a few seconds to a few minutes.
  • Spontaneous attacks of pain while doing regular daily activities such as talking, brushing your teeth, or chewing.
  • Pain that is triggered by sounds, wind or touch.
  • Pain that affects one side of the face, rarely does it affect both sides of the face.
  • Constant aching or burning pain.
  • Pain is usually in the areas that are supplied by the trigeminal nerve: cheek, jaw, teeth, gums, or lips. Pain in the eyes and forehead are less common.
  • Attacks become more frequent and increase in intensity.
  • Pain, for an unknown reason, isn’t usually felt while sleeping. Knowing this may help physicians pinpoint if it could be a migraine or toothache rather than trigeminal neuralgia.
  • In atypical trigeminal neuralgia, a severe migraine in addition to the sharp electric like spasms may be present.

Treatment for Trigeminal Neuralgia

Medication, which may include muscle relaxers, anti-seizure drugs, and antidepressants to target the inflamed nerve, may be prescribed to those diagnosed with trigeminal neuralgia. In some cases, surgery may be needed to relieve the pressure that is causing the nerve disruption. These surgical options may include:

  • Microvascular decompression – relocating or removing a blood vessel that is in contact with the trigeminal nerve. This is done with a small incision behind the ear on the side of your pain
  • Tumor Removal
  • Gamma Knife Radiosurgery
  • Glycerol injection – the sterile glycerol damages the trigeminal nerve and blocks pain signals
  • Balloon compression

Robert Johnson, M.D. and Jeffrey Jacob, M.D. are MHSI neurosurgeons who specialize in treating trigeminal neuralgia.  If you identified these symptoms as those you may be experiencing, please call MHSI for an appointment, 248-784-3667.


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The two main blood vessels in the neck that supply blood to the brain are called the carotid arteries. When these arteries narrow, blood flow to the brain is reduced. This is called carotid artery stenosis. The gradual buildup of fatty substances and cholesterol deposits is called plaque.  Plaque occurs as we age, engage in unhealthy lifestyles and don’t manage risk factors, like high cholesterol.

Often, there are often no symptoms until a stroke occurs. So it is important to seek regular physical exams. If your doctor hears an abnormal sound in these arteries a carotid duplex or Doppler ultrasound may be required to examine the blood flow and look for plaque or blood clots.

Medication may be prescribed if less than 50% of the artery is blocked. If more than a 70% blockage is present a carotid endarterectomy or a carotid angioplasty / stenting procedure can improve blood flow to the brain.  Both procedures are usually conducted by a neurosurgeon. In the carotid endarterectomy, an incision is made in the neck and the plaque and diseased portions of the artery are removed to increase blood flow to the brain.

If you find yourself in an emergency situation, like having a stroke that requires a carotid endarterectomy or angioplasty, or your doctor says you need one of these procedures ask for an MHSI neurosurgeon. To schedule an appointment, call 248-784-3667 or online at MHSI.us


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Dr. Holly Gilmer joined her past patients and their families and answered questions about Chiari during the Conquer Chiari Walk Across American on September 17, 2016 at Stoney Creek Metropark. The Conquer Chiari Walk Across America is a series of local awareness and fundraising walks held the same day. The walk is about three miles.

Dr. Gilmer and patients
Dr. Gilmer and patients

Dr. Gilmer was thrilled to be the guest speaker for the Michigan Chiari-Conquer Chiari Walk, and has been for the last few years. Money raised goes to fund Chiari research, education and awareness programs. For more information about future walks and events, check out the Conquer Chiari Walk Across America website

To learn what Chiari Malformation is and how it’s treated, click here.


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Congratulations to MHSI’s doctors named ‘Top Docs’ in the October 2016 issue of HOUR Detroit.  Each year the publishers of HOUR Detroit provide area doctors an opportunity to select the doctors they consider to be ‘Top Docs’. The doctors receiving the greatest number of nominations from their peers are then listed in the magazine as being the best among their colleagues.

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For Neurological surgery, Doctors Fernando Diaz, and Richard Fessler were named, and for Pediatric-Neurosurgery is Holly Gilmer, M.D.

‘Top Docs’ is an honor and shares what their patients already know.


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Dr. Veyna
Dr. Veyna

Everyday, the neurosurgeons at Michigan Head & Spine Institute see patients who arrive with head injuries at area hospital Emergency Departments. For Dr. Richard Veyna, it may have all been in a day’s work, but for 13-year-old Drew Pelkowski and his parents it was a life-changing event when Drew was involved in a golf cart accident.

See the entire story on WXYZ-TV as told by Drew’s parents at Beaumont Hospital in Royal Oak.

A GO FUND ME account has been set up to help the Pelkowski’s with medical expenses.


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It’s a pleasure to announce Karl Freydl, D.O.freydl web, has joined the MHSI team of physiatrists. Dr. Freydl specializes in physical medicine treatment of neck and back pain, epidural steroid and platelet rich plasma injections, spine and disc disease, sciatica, neuropathy, joint pain, and spinal cord and peripheral nerve stimulation. He is a board-certified interventional physiatrist, and completed his residency at the Mayo Clinic in Physical Medicine and Rehabilitation.

Dr. Freydl is accepting new patients at the Meadowbrook – Novi Location.

To schedule an appointment with Dr. Freydl, please call (248) 784-3667, or visit www.MHSI.us to request an appointment online.


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Updated January 2017:  Please note, that all procedures and visits are at the Meadowbrook Medical Center.

We are pleased to announce that beginning August 1, Michigan Head & Spine Institute is relocating its Novi physician offices only.

If you see your doctor in Novi for a regular office visit, starting on Monday, Aug. 1, you will now be seen at the Meadowbrook Medical Center instead of the Keystone Medical Center. However, if you are scheduled for a procedure in Novi, you should come to the Keystone Medical Center.

Meadowbrook Medical Center – Novi (Regular Office Visit ONLY)
25500 Meadowbrook Road (at W. 11 Mile Rd.)
Suite 250
Novi, MI 48375

Keystone Medical Center – Novi (Procedures ONLY)
46325 W. 12 Mile Road
Suite 150 ~ Please note the NEW suite number
Novi, MI 48377

To make an appointment at the new Meadowbrook office, please call 248-784-3667, these numbers have not changed. You can also request an appointment on our website.


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It’s a pleasure to announce the addition of two highly respected physicians to MHSI’s medical staff. A big welcome to: Fredrick S. Junn, M.D., and Tejpaul S. Pannu, M.D. Their current office will become MHSI’s newest location at: 18181 Oakwood Boulevard, Suite 403, Dearborn, MI 48124. 

Current patients of Dr. Junn and Dr. Pannu will continue to be seen in the same Dearborn office. To schedule an appointment, patients should make note of the new phone number, 313-438-5560.

Fredrick S. Junn, M.D., is a board certified neurosurgeon specializing in movement disorders, general neurosurgery, complex spine disorders, and peripheral nerve injuries.

Tejpaul S. Pannu, M.D., is also a board certified neurosurgeon specializing in complex spinal surgery, brain tumors, Trigeminal Neuralgia, and aneurysm surgery. 

To schedule an appointment with Dr. Junn or Dr. Pannu, please call 313-438-5560.  Or, visit www.MHSI.us to request an appointment online.

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The statistics from the Centers for Disease Control (CDC) are staggering. In the United States, 78 people die every day from an opioid overdose and 1.9 million people have a substance abuse disorder involving prescribed pain relievers, like oxycodone, hydrocodone, and methadone. In fact, since 1999, the number of deaths related to overdose of a prescribed opioid quadrupled.

What was once prescribed strictly for pain related to surgery, an injury, or the physical suffering that accompanies cancer has now become more commonly used for chronic aches and pain.

A doctor's responsibility

A study by the Johns Hopkins Center for Drug Safety and Effectiveness found that half of all pain visits in 2000 were treated with a medication and roughly 11 percent of those prescriptions were for an opioid pain reliever. In 2010, while half were still being treated with medication, the number using opioids rose to 20 percent.

CNN recently produced a special on the topic of opioid abuse, calling it an epidemic and issued a call to action among doctors. They cite the CDC’s recommendation against doctors prescribing opioids for most chronic pain situations, or at least the lowest effective dosage, with the shortest amount of time which is usually a few days.

At the root of the problem are the drugs themselves. Opioids are highly addictive and the body has a tendency to become tolerant, leading the patient to need more and more of the drug in order to manage pain. The patient feels physically dependent and, even if they attempt to cut back on usage, the symptoms of withdrawal can be felt. According to CNN’s Sanjay Gupta, M.D., “80% of new heroin users start by using pain pills, which contain the same type of base ingredients.”

Patients seeing a physician for help managing pain often think that certain kinds of medications are the solution, but for all the reasons stated above, many providers are rightly discouraging the use of opioids for managing things like back pain, arthritis, and other chronic conditions.

What other options are available? Nerve blocks, specialty devices, like TENS units, non-narcotic medications, exercise, dietary changes, behavioral therapy. All should be explored to find relief from chronic pain. In some instances, the use of opioid pain relievers may be warranted but should be managed safely. Patients in search of safe and effective relief have options and, with the assistance of a conscientious physician, will find a non-addictive solution.

Share this article with those who may be using pain medications.


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Andrew R. Xavier, M.D., MHSI’s interventional neurologist, was quoted in an Oakland Press article on May 27, 2016. The story features a Lake Orion restaurateur who received live saving stoke care at St. Joseph Mercy-Oakland, where Dr. Xavier also is the chief of interventional neurology. In discussing the urgency of stroke care he said, “Our stroke response is integrated with EMS so that once they call it in, we were able to free up the CT machine, surgical room and other medical equipment we needed.”  Read the full article.