Functional Neurology and Childhood Neurodevelopmental Disorders

Functional Neurology and Childhood Neurodevelopmental Disorders

More than one in seven children suffer from developmental disorders today. But this doesn’t mean change isn’t possible. The brain is enormously malleable, or plastic, and with the right input on a consistent basis using functional neurology, we often can improve brain function.

Common childhood brain development disorders today include:

  • Attention deficit disorder (ADD)
  • Attention deficit/hyperactivity disorder (ADHD)
  • Asperger’s syndrome
  • Autism
  • Developmental coordination disorder (DCD)
  • Nonverbal learning disability (NLD)
  • Obsessive-compulsive disorder (OCD)
  • Oppositional defiant disorder (ODD)
  • Pervasive developmental disorder (PDD)
  • Tourette’s syndrome
  • Chronic allergies, asthma, eczema, digestive disorders

How brain development disorders arise

These disorders can arise for a variety of reasons, such as:

  • Environmental toxins interfere with normal brain development.
  • A viral or bacterial infection interferes with brain development.
  • The child has an autoimmune reaction against neurological tissue that prevents normal brain development and function. This can be passed on in utero from the mother or develop in early life due to an environmental, viral, bacterial, or dietary trigger.

Poor brain development unfolds in a variety of ways. For instance, important milestones in brain development, such as crawling, may be  skipped. The brain is a highly complex network of multiple pathways. Proper formation of this network of pathways depends in part on the child going through each milestone of development.

When the brain fails to develop correctly, one hemisphere grows more slowly than the other, giving rise to various disorders that are either left-brain dominant or right-brain dominant. This is why we see kids who are intellectually advanced (left brain) yet socially and emotionally delayed (right brain). As this imbalance progresses, the brain finds it increasingly difficult to network between the hemispheres, causing poor function.

Also, infections and autoimmune attacks against areas of the brain sabotage proper development and hinder function in those pathways. For instance, the basal ganglia, which helps regulate involuntary motor movements, is a common site of viral and autoimmune attack. This can cause disorders such as PANDAS, OCD, Tourette syndrome, and tics.

Start with metabolic health of the brain

Functional neurology also includes addressing the metabolic health of the brain. If the brain is struggling with inflammation, iron deficiency, blood sugar imbalances, or chronic poor health from a bad diet, it will not respond as well to rehabilitation. Additionally, children’s brains require ample healthy fatty acids — EPA and DHA.

Metabolic issues to look out for with brain development disorders include:

  • Inflammatory foods (sugars and junk foods) and food intolerances
  • Chemical sensitivities
  • Chronic infections — bacterial, fungal, or viral
  • Digestive issues and leaky gut
  • Autoimmune disease (when the immune system attacks and destroys tissue in the body, which can include the brain)

Functional neurology brain exercises for brain development disorders

Fortunately, functional neurology can address brain development disorders.

The types of brain rehabilitation a child needs depends on patient history and a functional neurology examination, which assesses brain function, areas of under and over development, and areas that are over stimulated or under stimulated. The functional neurologist can then tailor exercises to the brain environment and adjust them over time as function improves.

Many families report swift and significant shifts in behavior, mood, sociability, learning, and other brain-based signs.

Ask my office how functional neurology can help if your child has a brain based developmental disorder.

Brain Fog, Alzheimer’s, and Homocysteine

Brain Fog, Alzheimer’s, and Homocysteine

Brain Fog and associated signs and symptoms such as decreased mental clarity, decreased mental performance, increased occurence of loss of keys, and increased occurence of forgeting names with faces should not be shrugged off as old age.  This may be an early sign of neurodegeneration that could progress to Parkinson’s or Alzheimer’s.

How can we know our risk?  Are there lab markers that we can use to give us an indication of where we are on the spectrum of neurodegeneration?  

Yes, there are.  In today’s show we will dive into a couple and discuss what to do about it if your levels of these biomarkers are unhealthy.

5 Causes of Brain Fog

5 Causes of Brain Fog

Brain fog is a common symptom suffered by many people each day.  In this episode, we will dive into 5 common causes of brain fog.  These causes may show up individually or in combination.  How many are contributing to your brain fog?

Is Your Anxiety Due to Poor Balance?

Is Your Anxiety Due to Poor Balance?

The cerebellum (the area at the back of the brain) is best known for its role in balance and coordination. However, the cerebellum does more than that — when it starts to malfunction, the results can be not only worsened balance, but also anxiety, insomnia, and hyper sensitivity.

The cerebellum is a primary integrator of information for the brain. Our body has hundreds of thousands of receptors that detect motion, vision, and where and how our body and joints are positioned at all times. These receptors constantly relay information to the brain so that we can move and function properly in our environment.

This information requires organizing before heading to the rest of the brain. The cerebellum condenses the information and “gates” it, meaning it releases it in manageable amounts to the brain’s cortex, the outer covering with its characteristic folds.

The cortex, which is responsible for higher-order functions of thought and action, decides if you need to carry out a specific action or thought in response to the information, such as turn left, answer a question, run from danger, make a decision, etc. The cortex then sends its information back to the cerebellum to help carry out actions.

When things go wrong with the cerebellum

The cerebellum is a common site of dysfunction. It can degenerate, meaning neurons die. The cerebellum is very susceptible to sensitivity to gluten and other foods, environmental toxins, autoimmunity, and oxidative stress. It also can degenerate with age — why older people notoriously have bad balance. Children born with brain developmental disorders often have poor cerebellar function.

Poor cerebellar function is observed in various ways, such as poor balance, lack of coordination, or a tremor as you go to pick something up or bring a glass to your mouth (known as termination tremors).

Stand with your feet together, your arms at your side, and then close your eyes. If you sway more frequently to one side, that may indicate the side with more cerebellar dysfunction — it takes it longer to respond to falling on that side of your body.

Other tests your doctor may use to observe cerebellum function are coordination tests such as: finger to nose, walking heel to toe in a straight line, performing complex alternating movements, and ocular tracking (the eyes give insight into function).

Poor cerebellar function can also cause dizziness, disorientation, and nausea in cars, on boats, or when seeing things move swiftly, such as in a movie. Basically, the cerebellum is not able to respond appropriately to input from the environment.

Cerebellum function and anxiety and insomnia

As the cerebellum loses function it begins to falter at its job of gating information delivered to the cortex. As a result, excess information slips through.

This means the cortex and areas in the brainstem receive more information than they can adequately manage. Much of the role of the frontal cortex is to act as a brake pedal on the brainstem, preventing the brainstem from spinning out of control. Our brainstem governs myriad functions, such as emotions, heart function, blood pressure, and digestion.

This poorly gated sensory overload can cause many symptoms:

  • Anxiety
  • Sensitivity to light and sound
  • Startle easily
  • Insomnia due to racing mind
  • Irritable
  • Trouble staying asleep
  • Highly emotionally sensitive
  • Fearful
  • Heart racing/palpitations
  • Blood Pressure changes
  • Digestive Issues

Many factors work against us when it comes to healthy brain function that prevents an overactive brain and anxiety. They include a culture that cherishes overworking, inflammatory diets, unstable blood sugar, too much screen time, stressful lives, and not enough sleep.

Ask my office for information on how to dampen brain activity and help relieve anxiety and insomnia.

Beating Acid Reflux Naturally

Beating Acid Reflux Naturally

Do you suffer from acid reflux, indigestion, slow gut transit time, or feeling like there’s a brick in your stomach after eating? Or perhaps you’re on a restricted diet for a chronic health condition but still react to an ever shrinking list of foods. If so, you need to work on restoring digestion.

Many factors affect digestion, including aging, poor brain function that affects gut function, poor diet, and more. Often the problem isn’t the food itself, but a hyper sensitive immune system reacting to food proteins that are not broken down properly. Thankfully, you can improve your symptoms greatly with proper supplementation.

Breakdown of food proteins is key for good digestion

For good digestion, you need sufficient hydrochloric acid (HCl) and digestive enzyme activity in the gut. These both serve the important function of breaking down food proteins, which prevents the immune system from targeting them and causing symptoms.

HCl is naturally present in the stomach and is vital for digestion of proteins. Low HCl symptoms include:

  • Not feeling well after eating meat
  • Feeling like meat sits in your stomach too long
  • Feeling like you ate a brick
  • Acid reflux
  • Constipation

It may sound contrary that low stomach acid can cause acid reflux. In fact, many people with acid reflux-like symptoms are mistakenly prescribed acid-blockers intended to cut stomach acid, when in fact it’s low stomach acid causing the problem — the low stomach acid results in undigested food becoming rancid and moving back up the esophagus to cause the pain and burning sensation. What these people need is additional HCl to improve digestion.

Many people with poor digestion also have poor pancreatic enzyme output. Similar to stomach acid, these enzymes are critical to break apart food proteins so the immune system doesn’t react to them, causing inflammation.

Supplement with HCl and digestive enzymes for healthy digestion

Supplementing with HCl (use code: lifeatoptimal) and digestive enzymes can go a long way toward improving your digestion by supporting breakdown of food proteins as well as relieving symptoms.

Follow this advice when supplementing with HCl and digestive enzymes:

  • HCl: Supplement with HCl when you eat meats to help break down the proteins better. This will not only improve your digestion but also bring you relief from uncomfortable symptoms. Take HCl with the last bite of the meal.
  • Digestive Enzymes: Take these with all meals; include pepsin, bromelain, and proteases. Look for a high-quality, broad-spectrum digestive enzyme supplement with a minimum of fillers. This is the best one I can find (use code: lifeatoptimal).  Take one capsule with the first bite of each meal.

Oral tolerance and digestive function

It’s particularly important for people with food sensitivities to support food protein breakdown with proper levels of HCl and digestive enzymes. At the root of this is the concept of oral tolerance. Oral tolerance is how well a person’s immune system can tolerate acceptable foods while responding appropriately to bacteria or other harmful compounds.

While there are other factors that affect oral tolerance, it’s important for food proteins to be broken down small enough that the body accepts them and doesn’t mount an immune reaction against them, causing symptoms.

You’ve heard the phrase, “You are what you eat.” When we can’t digest food properly, it means our bodies aren’t getting the fuel to function at their best. If you suffer from symptoms of poor digestion or food sensitivities, contact my office.

Functional Neurology vs. Conventional Neurology

Functional Neurology vs. Conventional Neurology

How does functional neurology differ from conventional neurology? Conventional neurology diagnoses neurological disorders that can be treated with pharmaceutical or surgery. Functional neurology, on the other hand, identifies a broader range of brain disorders and restores function through rehabilitation that either dampens or activates specific regions of the brain.

A good example is migraines. Many people see neurologists for debilitating migraines. However, virtually every person who suffers with chronic migraines has a normal brain scan. As a result, conventional neurology has little too offer beyond pharmaceuticals. In other words, the neurons are there, they just aren’t firing correctly.

The same can be said for other brain disorders. Autism, depression, anxiety, insomnia, chronic fatigue, chronic pain, hyper sensitivity to light and pain, emotional instability, loss of memory, gut problems, childhood developmental disorders, autism, brain injury, memory loss, vertigo, tremors, dystonia, are examples of brain-based disorders functional neurology can help.

An analogy for brain function is a symphony orchestra. Before the performance, the musicians tuning their instruments sounds jarring. However, when the instruments are tuned and the musicians play at the appropriate time, the result is lovely.

Our brain works the same way. Firing and timing that are off in the brain causes symptoms while restoring function through rehabilitation improves neurological harmony.

Functional neurology and underlying causes

Neither drugs nor surgery are appropriate or effective for many brain-based disorders.

For one thing, medications are not selective for one area of the brain, but instead they bathe the entire brain. Depression may be related to dysfunction in just the frontal lobe, but an anti-depressant affects the entire brain and may cause negative side effects.

Another example is a patient with Meniere’s disease, which causes dizziness, ringing ears, and nausea. They may be told they need anti-nausea or anti-vertiginous medication and surgery to sever the nerve in the inner ear. However, Meniere’s is an autoimmune disease caused by the immune system attacking and destroying the inner ear.

Functional neurology looks at not only the underlying causes of an over zealous immune system, but also at the areas of the brain that are responsible for interpreting this information. The combination of these two can provide relief and slow or halt progression of the disease.  

Functional neurology exams and protocols

Functional neurology uses a variety of techniques to assess which areas of the brain are breaking down. An important aspect of the functional neurology exam includes observing your eyes in response to various stimuli; eye function involves almost every part of the brain.

How your eyes respond when tracking fast movements, slow movements, and when you are rotating or balancing delivers specific insights into brain function and what kinds of rehabilitation will work best.

Other exam techniques involve observing your response to balance, coordination, gait, and rotation challenges. The discipline requires a strong understanding of neurological anatomy, physiology, function, and the various pathways and networks in the nervous system.

The functional neurologist uses the data from your exam to create brain rehabilitation exercises that activate sluggish areas of the brain or dampen over active areas.

For instance, a person with anxiety, insomnia, hyper sensitivity to light and sound, and who startles easily may suffer from degeneration of the cerebellum (at the back of the brain) that is causing the midbrain (in the lower center of the brain) to become over active, resulting in PTSD-like symptoms.

Eat Real Food to Beat Chronic Illness

Eat Real Food to Beat Chronic Illness

When you’re starting on a new health journey, knowing what to eat can seem confusing. For starters, there is a ton of conflicting advice out there, with proponents of each diet insisting their diet is the healthiest.

The truth is, the best diet depends on which one works best for you. Factors that depends on include your individual food sensitivities, digestive health , blood sugar handling, autoimmunity, and stress handling.

In functional medicine we follow general guidelines that focus on whole foods, remove foods to which you are intolerant, and stabilization of blood sugar. Beyond that, your history, lab tests, and current condition guides the customization of your diet.

A custom diet plan starts with real food

With customization tips in mind, one basic rule still applies across the board: Eat whole foods.

When you eliminate foods that have been through processing (like breakfast cereal or chips), foods with artificial colorings, additives, and preservatives, and foods laden with industrialized fats and too much sugar, you are already on solid ground nutritionally.

This means stick largely to the produce, meat, and nut sections in the grocery store. Use healthy, natural fats such as coconut oil and olive oil. Avoid vegetable oils, which are unstable and become inflammatory free radicals in your body.

Avoid hydrogenated oil as it has been shown to damage brain cells and raise heart disease risk.

You have to develop new habits to shop for and prep vegetables, cook healthy meats, and wean yourself off sodas, pizza pockets, chips, and other quick-grab items. But you’ll start feeling so much better you won’t mind. In fact, you’ll feel enthusiastic about it.

When eating real food is difficult

Some people favor processed food because they have trouble digesting real foods. This is a red flag that digestion is seriously compromised.

For instance, if your stomach feels heavy after eating meat, as if it just sits there and does not digest, your stomach may be low in hydrochloric acid (HCl). HCl is necessary to digest meats and it’s a common deficiency.  It can lead to insufficient B vitamins too, especially B12.

In functional medicine, a diet that consists primarily of produce is very beneficial. However, the dramatic increase in fiber from eating more fresh fruits and vegetables causes digestive problems in some people.

Factors that make eating produce difficult include an overgrowth of the wrong bacteria, low HCl, insufficient output of pancreatic enzymes, inflammation of the gut lining, and other digestive issues.

These people need to work on restoring gut health and slowly ease into eating more vegetables.

Blood sugar and stress handling

Most Americans eat too many carbohydrates and sugars, which contributes significantly to inflammation and chronic disease. At the same time, not everyone fares well on a very low-carb diet.

People with chronically low blood sugar and adrenal fatigue need to eat smaller meals more frequently to protect their brain health.

Also, some people feel great on a short-term, very low-carb, or ketogenic, diet, while others develop anxiety and insomnia. Finding the right amount of carbohydrates to eat so that you keep blood sugar stable and lower inflammation, yet can function optimally, can take some tweaking. Also, as blood sugar and stress handling improve, you may be able to readjust.

What Type of Tremor Do You Have?

What Type of Tremor Do You Have?

One of the biggest mistakes many people make is assuming a tremor signifies Parkinson’s disease. The truth is many different kinds of tremors exist for different reasons. You can distinguish between them by knowing some basic characteristics.

Understanding the expression of the tremor

Tremors can be grouped into three categories: action tremor, resting tremor, and physiological tremor.

Action tremor happens with movement. These tremors typically stem from a disorder of the cerebellum, the area at the back of the brain involved in movement and coordination. The more calibration the movement requires (such as touching your pinkie finger to your nose with your eyes closed), the easier it is to see this tremor. Drinking alcohol may make this tremor worse.

Resting tremor happens when the hands are totally at rest. These tremors are related to the basal ganglia, and area of the brain involved in regulating movement. Moving the hands will stop the tremor. This is the type of tremor associated with Parkinson’s disease.

Physiological tremor results from a metabolic issue affecting muscle contractions, such as too much coffee, low blood sugar, too much thyroid hormones, or certain medications. The key feature of this tremor is that it happens both at rest and in action.

Types of tremors

Those are the three primary ways tremors express themselves. Beyond that, we can identify different tremors based on what causes them.

Essential tremor is the most common tremor and is caused by a hereditary disorder of the cerebellum. You know you’re a candidate for this tremor if drinking alcohol makes it better and other family members have it. It may also occur in the head and the voice.

Orthostatic tremor occurs in the legs when a person stands up but goes away upon walking. It is related to misfiring in the autonomic nervous system, which governs unconscious bodily functions.

Dystonic tremors occur with dystonia, a disorder in which muscles contract involuntarily.

Parkinsonian tremor is a pill-rolling rest tremor and re-emergence tremor (i.e., it occurs after the arms have been held out a few moments).

Cerebellar tremors occur when the cerebellum cannot correctly calibrate muscle movements during movement, such as bringing a glass to your mouth. Vertigo and nausea may be other complaints.

A Holmes tremor is also known as wing-beating, midbrain, or rubral tremor. It is associated with strokes that impact the midbrain, as well as copper toxicity.

Palatal tremor is a rare disorder that causes rhythmic tremor of the soft palate.

Neuropathic tremor stems from neuropathy, more often an acute autoimmune neuropathy.

Neurotoxic and drug-induced tremors, are, like they sound, induced by toxins and medications.

Psychogenic tremors are a psychiatric disorder in which the individual creates the tremor.

Functional neurology and tremors

In functional neurology, we can often lessen the severity of tremors by identifying the area of the brain causing them and then using brain rehabilitation techniques to address dysfunction in those areas. We also work with you to reduce inflammation, ensure proper brain nutrition, and improve overall metabolic health so that your brain has the best chance at improvement.

Why Lab Testing is Important in Functional Medicine

Why Lab Testing is Important in Functional Medicine

Lab testing is foundational to functional medicine, and for good reason. It can show you what is causing your symptoms, if you are headed toward a disease (even if you don’t have symptoms), track the progress of your protocol, and motivate you to stick with your protocol. 

Lab testing includes many different tests. Some examples of testing used in functional medicine include:

Food sensitivity testing. If a you eat food regularly causes inflammation, this contributes to chronic health disorders.  

Gut testing. Gut problems contribute to chronic health issues. Tests can screen for leaky gut, gut function, parasites, bacterial overgrowth, and autoimmune reactions.

Blood chemistry panel. This is an excellent starting point in functional medicine testing and includes the use of functional medicine ranges (versus lab ranges). Blood testing screens for some diseases and can catch a trend toward a disease while there’s still time to reverse it.

Chemical and metal sensitivity testing. As with foods, an immune reaction to metals and/or chemicals can trigger chronic inflammatory health disorders.

Adrenal testing. Adrenal testing reveals the relationship between your health and stress handling. The most important test is the second one because it shows if your protocol is working. If not, you need to dig deeper.

Hormone testing. Hormone imbalances profoundly affect health. Testing screens for excesses, deficiencies, feedback loops, and how well you metabolize hormones.

DNA genetic testing. Genetic testing delivers insight into disease risk and genetic metabolic variations that affect health. An example is the MTHFR variance.

These are just a few examples of the types of testing used in functional medicine. What type of testing you need depends on your symptoms and health history. 

Why lab testing is important in functional medicine

Functional medicine is based on peer-reviewed science and finds the root cause of your symptoms. There are a variety of factors that can lead to depression, fatigue, chronic pain, poor function, and other chronic health disorders.

Functional lab testing shows a trend toward disease

In conventional medicine, doctors use labs to screen for disease. Once a condition has become a disease, such as diabetes or autoimmune disease, the damage is significant.

Functional medicine uses lab testing to catch a health trend that is on the way to disease but that can still be slowed, halted, or reversed. For instance, lab markers that show elevated blood sugar, inflammation, and poor liver function allow you to easily reverse the march towards diabetes.

Another example is autoimmunity. A significant amount of tissue must be destroyed before conventional medicine can diagnose autoimmune disease. However, by testing for antibodies against tissue, the autoimmune progression can be slowed or stopped in its early stages.

Functional lab testing tracks progress

Although the first test is important for identifying health problems, subsequent testing is also crucial to let you know whether your protocol is working. If there is no improvement, it means you have not hit on the right protocol or discovered all the underlying causes.

Lab testing improves compliance and social support

Seeing the results of a lab test makes it easier to stick with a protocol. It also can encourage a disbelieving spouse, family member, or friend to support you. Many people think gluten sensitivity is just a fad, or that your symptoms aren’t real and you simply complain too much. Your lab results validate your symptoms and can help others be more supportive.

Ask my office about functional lab testing to help you get to the bottom of your chronic health condition, 704-895-2240

Parkinson’s Disease vs. Parkinsonism

Parkinson’s Disease vs. Parkinsonism

Parkinson’s and parkinsonism — symptoms that mimic Parkinson’s — stem from the same areas of the brain. These disorders both cause tremors, stiffness, slowness of movement, however they have different causes and may be helped with different nutritional therapies.

Parkinson’s versus parkinsonism

It’s helpful to know the difference between the two. Parkinson’s is a disease that slowly destroys brain cells (for some people it happens quickly) in an area of the brain that produces the brain chemical dopamine. Symptoms worsen over the years and include resting tremors, stiffness, slowness, not blinking enough, loss of smell, digestive problems, depression, and dementia.

Parkinsonism belongs to a class of disorders called “hypokinetic disorders,” which means diminished muscle function. Symptoms are slow or stiff movements.

Parkinson’s is due to degeneration of the brain’s dopamine area; parkinsonism is caused primarily by abnormal clumping of proteins called alpha-synuclein.

This clumping interferes with communication within the brain and also degenerates tissue.

Nutritional support for Parkinson’s

Because Parkinson’s disease degenerates the area of the brain that produces dopamine, nutritionally (and pharmaceutically) supporting dopamine can significantly help Parkinson’s patients.

Dopamine is an important brain chemical that helps regulate not only feelings of reward and pleasure, but also mood, movements, learning, and motivation. 

Nutritional compounds that support dopamine include L-dopa, pyridoxal-5-phoshate, DL-phenylalanine, beta-phenylalanine, and acetyl-tyrosine.

Nutritional support for parkinsonism

Parkinsonism also involves dopamine, but nutritional support should focus more on preventing or slowing the clumping of alpha-synuclein. In fact, research shows dopamine medications may worsen parkinsonism.

The key is to support the energy factories inside each brain cell, called mitochondria, and to support cell function.

 

Nutritional support for Parkinson’s and parkinsonism

These strategies have been shown in studies to help nutritionally support both Parkinson’s and parkinsonism:

Support healthy gut bacteria and function. Research shows an unhealthy balance of gut bacteria and gut inflammation can cause aggregation of alpha-synuclein, thus increasing the risk of Parkinson’s and parkinsonism.

Consider a ketogenic diet or intermittent fasting. Both these diets have been shown to slow down protein aggregation and promote healthy function of brain cells.

Take flavonoids to protect brain cell mitochondria. Flavonoids are anti-inflammatory plant compounds that have been shown to protect the brain. Turmeric and resveratrol are examples of powerful flavonoids.

Take nutrients to protect mitochondria. Nutritional compounds that have been shown to protect the mitochrondria include CoQ10, carnitine, riboflavin, niacin, alpha-lipoic acid, and magnesium.

Make sure you consume enough essential fatty acids. Essential fatty acids are anti-inflammatory and protective of brain health. Consume enough in the right ratio.

Support methylation. Methylation is a molecular process necessary for healthy brain function and helping prevent brain inflammation and degeneration. Nutritional compounds that support methylation include methyl B12, L-methylfolate (5-MTHF), trimethylglycine, choline, riboflavin, and pyridoxine.

Exercise! Increasing your heart rate through regular aerobic activity has been shown to help manage the progression and symptoms of Parkinson’s and parkinsonism. It’s best to get your heart rate up to higher levels for at least a few minutes every time you exercise.

What not to take. Acetycholine is a brain chemical and a supplement that can be great for the brain but it opposes dopamine. Therefore, in many cases it is recommended not to take acetylcholine supplements or precursors when you have parkinsonism or Parkinson’s disease.

This is a broad and simple overview of some nutritional strategies that can help you manage Parkinson’s or parkinsonism in addition to medical and functional neurological care. Ask my office for more advice, 704-577-9676.

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