REM Sleep Behavior Disorder

Posted on April 10, 2026 by Patrick Hercules

Rapid eye movement (REM) sleep behavior disorder occurs when a person unknowingly, physically acts out their vivid, often bad dreams with vocal sounds and sudden, often violent arm and leg movements during REM sleep.

People don’t normally move during REM sleep, which is a normal stage of sleep that occurs many times during the night.

About 20% of a person’s sleep is REM sleep, the usual time when dreaming occurs, primarily during the second half of the night.

REM sleep behavior disorder may be linked to neurological conditions, such as:

Lewy body dementia
Parkinson’s disease
Multiple system atrophy

The onset of REM sleep behavior disorder can be gradual or sudden, and it can worsen over time. Episodes of the disorder occur occasionally or several times a night.

Symptoms of REM sleep behavior disorder include:

Movements, such as kicking, punching, arm flailing, or jumping from bed, in response to action-filled or violent dreams, such as being chased or fighting off an attack
Noises, such as talking, laughing, shouting, emotional outcries, or even cursing
Being able to recall the dream if awoken during the episode

Usually, the nerve pathways in the brain that prevent muscles from moving are active during normal REM sleep, which results in temporary paralysis of the body. However, in REM sleep behavior disorder, the nerve pathways no longer work, causing a person to physically act out their dreams.

There are several risk factors associated with the development of REM sleep behavior disorder, including:

Having a certain type of neurodegenerative disorder
Taking certain medications
Having narcolepsy
Being male and over 50 years old

Additionally, recent evidence indicates there may also be several specific environmental or personal risk factors for REM sleep behavior disorder, including:

Occupational pesticide exposure
Farming
Smoking
A previous head injury

REM sleep behavior disorder can cause various complications, including:

Injury to yourself or your sleeping partner
Distress to your sleeping partner or other people living in your home
Social isolation for fear that others may become aware of your sleep disruption

To diagnose REM sleep behavior disorder, a healthcare provider reviews your medical history and symptoms. The evaluation can include:

Physical and neurological exam
Nocturnal sleep study
Talking with your sleeping partner

A healthcare provider uses the symptom criteria in the International Classification of Sleep Disorders, Third Edition (ICSD-3). The criteria include:

You have repeated times of arousal during sleep where you talk, make noises, or perform complex motor behaviors, such as punching, kicking, or running movements, that often relate to the content of your dreams
You recall dreams associated with these movements or sounds
If you awaken during an episode, you are alert and not confused or disoriented
A sleep study shows you have an increase in muscle activity during REM sleep
Your sleep disturbance is not caused by another disturbance, a mental health disorder, medication, or substance abuse

REM sleep behavior disorder can be the first indication of the development of a neurodegenerative disease, such as Parkinson’s disease, multiple system atrophy, or dementia with Lewy bodies.

Treatment for REM sleep behavior disorder may include physical safeguards and medications.

Physical safeguards make it safer for you and your bed partner.

Medications such as melatonin and clonazepam can be prescribed to help treat REM sleep behavior disorder.

If you are experiencing any symptoms of REM sleep behavior disorder, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

IBS Awareness Month

Posted on April 2, 2026 by Patrick Hercules

April is observed as IBS Awareness Month, a month dedicated to raising awareness about irritable bowel syndrome (IBS), a common disorder that affects the large intestine.

Researchers are unclear of what exactly causes IBS, but they categorize it as a neurogastrointestinal (GI) disorder. Neurogastrointestinal disorders, also known as gut-brain interaction, involve problems with how the gut and brain coordinate to help the digestive system work. This communication challenge between the brain and gut can cause:

Dysmotility

Visceral hypersensitivity

Other potential causes of IBS may include:

Gut bacteria

Severe infections

Food intolerance

Childhood stress

IBS affects approximately 15% of the U.S. population, causing abdominal pain and changes to the frequency of your bowel movements. Other symptoms of IBS include:

Diarrhea, constipation, or alternating between the two

Feeling like you are unable to empty your bowels after pooping

Cramps

Excess gas and bloating

Mucus in stool that makes it look whitish

If a person has IBS, they may notice when certain things trigger symptoms. A trigger doesn’t cause IBS itself, but it can cause or worsen symptoms to flare up. Common IBS triggers include:

Periods

Certain foods

Stress

Researchers categorize IBS based on how a person’s stool looks on the days when they’re having flare ups. Most people with IBS may experience days when they have normal bowel movements and days when they experience abnormal ones. The bowel movements on abnormal days define the type of IBS they have. The types of IBS include:

IBS with constipation (IBS-C)- most of the stool is hard and lumpy

IBS with diarrhea (IBS-D)- most of the stool is loose and watery

IBS with mixed bowel habits (IBS-M)- stool is both hard and lumpy and loose and watery

Post-infectious IBS- generally occurs after an infection in the intestines, and stool is either similar to IBS-D or IBS-M, with a smaller number of cases presenting stool as IBS-C

To diagnose IBS, a healthcare provider will get a full medical history by asking about your symptoms. Depending on your symptoms, they may need other tests to confirm a diagnosis. These tests include:

Lab tests

Imaging tests

No specific therapy works for everyone who has IBS. However, most people with IBS can find a treatment plan that works best for them. Typical treatment options for IBS include:

Modifying your diet

Exercising regularly and trying relaxation techniques

Therapy

Medications

No matter what form of IBS you are experiencing, working with a gastroenterologist can help you manage your symptoms effectively. You can schedule an appointment with a gastroenterologist at Jamaica Hospital Medical Center’s Ambulatory Care Center by calling (718) 206-7001.

World Epilepsy Awareness Day (Purple Day)

Posted on March 26, 2026 by Patrick Hercules

World Epilepsy Awareness Day, or Purple Day, is observed on March 26th, a global initiative to raise awareness of epilepsy and support the millions of people living with it worldwide.

Approximately 65 million people are living with epilepsy across the world, and one in 26 people in the U.S. will be diagnosed with epilepsy during their lifetime.

Epilepsy is a brain condition that causes recurring seizures. Most people who suffer from epilepsy generally have the same type of seizure each time, and symptoms are usually similar from episode to episode. The symptoms of seizures can vary depending on the type of seizure, and because epilepsy is caused by certain activity in the brain, seizures can affect any brain process. Seizure symptoms may include:

Short-term confusion.

A staring spell.

Stiff muscles.

Jerking movements of the arms and legs.

Loss of consciousness.

Psychological symptoms such as fear, anxiety, or déjà vu.

Sometimes people with epilepsy may have changes in their behavior and may also experience psychosis.

Seizures can be categorized as either focal or generalized, based on where in the brain the brain activity that causes the seizure originates.

Focal seizures are the result of brain activity in just one area of the brain. Focal seizures can fall into two categories: focal seizures with preserved consciousness or focal seizures with impaired consciousness.

Types of focal seizures include:

Temporal lobe seizures

Frontal lobe seizures

Occipital lobe seizures

Focal seizures may have warning signs called auras in the moments before a seizure begins. Auras might include a feeling in the stomach, emotions such as fear, or the feeling of déjà vu. They can also be a taste, a smell, or a visual, such as a steady or flashing light, a color, or a shape. Some people may even experience dizziness and loss of balance, or hallucinations.

Generalized seizures are seizures that involve all areas of the brain. Types of generalized seizures include:

Absence seizures

Tonic seizures

Atonic seizures

Clonic seizures

Myoclonic seizures

Tonic-clonic seizures

There is no identifiable cause of epilepsy in about half of the people with the condition. In the other half, the condition may be traced to various factors, including:

Family history of epilepsy

Head trauma

Brain tumors

Infections, such as meningitis, HIV, viral encephalitis, and some parasitic infections

Abnormal blood vessel formation or bleeding in the brain

Alzheimer’s disease

Strokes, heart attacks, and other conditions that deprive the brain of oxygen

Brain inflammation or swelling

Alcoholism or alcohol withdrawal

Injury before birth

Developmental conditions

Seizures can be caused by environmental triggers. These seizure triggers don’t cause epilepsy, but they may trigger seizures in people who suffer from epilepsy. Most people with epilepsy don’t have reliable triggers that always cause seizures. However, there are often factors that make it easier to have a seizure, including:

Flashing lights

Alcohol

Illicit drug use

Lack of sleep

Stress

Dehydration

Skipping doses of anti-seizure medicines or taking more than prescribed

Skipped meals

Illness

Epilepsy is diagnosed when a healthcare provider reviews your symptoms and medical history. They may perform several tests to diagnose epilepsy and to detect the cause of seizures. These tests include:

A neurological exam

Blood tests

Genetic testing

A healthcare provider may also request brain-imaging tests and scans that detect brain changes, including:

Electroencephalogram (EEG)

High-density EEG

CT scan

Functional MRI (fMRI)

PET scan

Single-photon emission computerized tomography (SPECT)

Neuropsychological tests

Along with the test results of these brain-imaging tests, a combination of other techniques may be used to help pinpoint where the seizures start in the brain. They include:

Statistical parametric mapping (SPM)

Electrical source imaging (ESI)

Magnetoencephalography (MEG)

Treatment can help people who have been diagnosed with epilepsy have fewer seizures or even completely stop having seizures. These treatments include:

Medicines

Therapies that include devices that stimulate the brain

Surgery

A ketogenic diet

If you are experiencing any symptoms of epilepsy, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

Treatments to Reduce Alzheimer’s Disease

Posted on March 18, 2026 by Patrick Hercules

Alzheimer’s disease is a degenerative brain disease and the most common type of dementia. It causes a slow decline in memory, thinking, and reasoning skills. Age is the biggest risk factor for the disease, followed by sex and family history.

There is currently no cure for Alzheimer’s disease. However, there is progress in Alzheimer’s and dementia research that is creating promising new treatments for those living with the disease.

The U.S. Food and Drug Administration (FDA) has approved medications for Alzheimer’s disease, which fall into two categories:

· Drugs that change disease progression in people living with early Alzheimer’s

· Drugs that temporarily ease some symptoms of Alzheimer’s

Drugs that change disease progression target the underlying biology of the disease process by aiming to slow the decline of memory and thinking, as well as function.

Anti-amyloid treatments work by removing a protein that accumulates into plaques in the brain, called beta-amyloid. Each treatment works differently and targets beta-amyloid at a different stage of plaque formation.

These treatments change the course of the disease significantly for those who are in the early stages by giving them more time to be able to participate in daily activities and live independently.

The two treatment therapies that change disease progression are Donanemab and Lecanemab.

Donanemab is an anti-amyloid antibody intravenous (IV) infusion therapy that is delivered every four weeks to treat early Alzheimer’s disease, which includes people who are living with mild cognitive impairment (MCI) or mild dementia due to Alzheimer’s who have been diagnosed with elevated beta-amyloid in the brain.

Donanemab was the third therapy that demonstrated that removing beta-amyloid from the brain decreases cognitive and functional decline in people living with early Alzheimer’s disease.

Lecanemab was the second therapy to demonstrate that removing beta-amyloid from the brain decreases cognitive and functional decline in people living with early Alzheimer’s disease.

It is important to note that anti-amyloid treatments do have side effects, such as allergic reactions, amyloid-related abnormalities (ARIA), infusion-related reactions, headaches, and falls.

As Alzheimer’s progresses, brain cells die, and the connections among those cells are lost. When this occurs, it causes cognitive and noncognitive symptoms to worsen.

Although these medications don’t stop the damage that Alzheimer’s disease causes to brain cells, they may lessen or stabilize symptoms for a limited time by affecting specific chemicals involved in delivering messages among and between the brain’s nerve cells.

The medications that are prescribed to treat symptoms related to memory and thinking include:

Cholinesterase inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment, and other thought processes. These medications prevent the breakdown of a chemical messenger important for memory and learning, called acetylcholine. Cholinesterase inhibitors support communication between nerve cells. The most prescribed cholinesterase inhibitors include:

· Benzgalantamine treats mild-to-moderate dementia due to Alzheimer’s disease

· Donepezil treats mild-to-severe dementia due to Alzheimer’s disease

· Galantamine treats mild-to-moderate dementia due to Alzheimer’s disease

· Rivastigmine treats mild-to-moderate dementia due to Alzheimer’s disease as well as mild-to-moderate dementia due to Parkinson’s disease

Possible side effects for these medications include:

· Headache

· Dizziness

· Diarrhea

· Increased frequency of bowel movements

· Nausea

· Vomiting

· Loss of appetite

Glutamate regulators are medications prescribed to improve memory, attention, reasoning, language, and the ability to perform simple tasks. This medication regulates the activity of glutamate, a different chemical messenger that helps the brain process information.

Memantine is a glutamate regulator that treats moderate-to-severe Alzheimer’s disease. It can cause side effects that include headaches, constipation, confusion, and dizziness.

A cholinesterase inhibitor combined with a glutamate regulator, such as donepezil and memantine, treats moderate-to-severe Alzheimer’s disease. Possible side effects can include nausea, vomiting, loss of appetite, confusion, dizziness, increased frequency of bowel movements, and constipation.

Alzheimer’s disease doesn’t just impact memory and thinking. It also impacts a person’s quality of life by affecting a variety of behavioral and psychological symptoms that come with dementia, such as agitation, hallucinations and delusions, and sleep disturbances. Some medications focus on treating these non-cognitive symptoms for a time; however, it is important to try non-drug strategies to manage behaviors before adding medications.

The FDA has approved only one drug to manage symptoms of insomnia that has been tested in people who are living with dementia, and one that treats agitation.

Orexin receptor antagonists are prescribed to address symptoms of insomnia and inhibit the activity of a type of neurotransmitter involved in the sleep-wake cycle called orexin.

Suvorexant treats insomnia and has been shown in clinical trials to be effective for people who are living with mild to moderate Alzheimer’s disease. Possible side effects can include a risk of impaired alertness and motor function, worsening depression or suicidal thinking, complex sleep behaviors, sleep paralysis, and compromised respiratory function.

Atypical antipsychotics are a group of antipsychotic drugs that target the serotonin and dopamine chemical pathways in the brain. These drugs are mainly used to treat schizophrenia and bipolar disorder, as well as add-on therapies for major depressive disorder. The FDA requires that all atypical antipsychotics carry a safety warning that the medication has been associated with an increased risk of death in older patients who are experiencing dementia related psychosis.

Many atypical antipsychotic medications are used “off-label” to treat dementia-related behaviors, and there is only one FDA-approved atypical antipsychotic to treat agitation associated with dementia due to Alzheimer’s disease. It is important to try non-drug strategies to help manage non-cognitive symptoms such as agitation before adding any medications.

Brexpiprazole treats agitation associated with dementia due to Alzheimer’s disease. Possible side effects may include weight gain, sleepiness, common cold symptoms, dizziness, and restlessness.

If you or a loved one is experiencing any symptoms of Alzheimer’s disease or would like to learn more about treatment options, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

Muscle Spasms

Posted on March 6, 2026 by Patrick Hercules

Muscle spasms or muscle cramps are painful contractions and tightening of the muscles. Muscle spasms occur when the muscles involuntarily and forcibly contract and cannot relax.

Muscle spasms are normal and very common, and can involve part of, or all of, a muscle or several muscles in a group. These spasms can occur anywhere in the body. The most common types of muscle spasms include:

Back spasms

Leg cramps and charley horses

Neck spasms

Arm spasms

Abdomen spasms

Ribcage spasms

Chest spasms

Muscle spasms can occur in anyone at any time, including while walking, sitting, exercising, or sleeping. Some individuals are more susceptible to muscle spasms than others and experience them regularly with any type of exertion. People most likely to get muscle spasms include:

Athletes

Pregnant women

Infants

People who are obese

People over the age of 65

Most of the time, muscle spasms aren’t something to worry about. However, muscle cramps can indicate an underlying neurological condition that affects the brain. Involuntary muscle movements resulting from a neurological condition are called dystonia.

Muscle spasms range from mild to severe. Mild muscle spasms feel like the muscle is jumping around on its own and can be seen twitching. Severe muscle spasms feel like the entire muscle stiffens into a tight ball. If the cramping is painful, it may cause lingering discomfort in that area for a couple of days.

If muscle spasms result from a neurological condition, they may cause symptoms such as:

Paralysis

Muscle pain

Muscle weakness

Coordination issues

Numbness

Difficulty sleeping

Vision issues

Experts aren’t sure why some people get muscle spasms more than others. However, possible causes can include:

Dehydration

Muscle fatigue

Exercising in extreme heat, which causes heat cramps

Not enough stretching

Electrolyte imbalance

Stress

Too much high-intensity exercise

A healthcare provider can diagnose muscle spasm by reviewing a person’s health history and medications, as well as asking questions that include:

How bad is the pain?

How long do the cramps last?

When do muscle spasms usually happen?

What do the muscle spasms feel like?

When did the muscle spasms start?

There is no pill or injection used to treat and relieve muscle spasms. However, some things can be done to try and stop muscle cramps, including:

Massage the affected areas with your hands or a massage roller

Stretch the affected area

Stand up and walk around

Apply heat or ice

Take over-the-counter (OTC) pain relievers such as ibuprofen or acetaminophen

Muscle spasms can happen at any time, and because they are so predictable, they can be difficult to prevent. Unfortunately, there are risk factors that can’t be avoided, such as your age. However, there are things you can do to reduce your risk, including:

Stretching your muscles regularly

Performing flexibility exercises

Drinking a lot of water

Wearing shoes that fit properly

Avoiding exercising in extreme heat

Working toward better overall fitness

Staying at a weight that is healthy for you

Avoiding medications that may cause muscle spasms as a side effect

Stretching your muscles before going to sleep

Using pillows to keep your toes pointed upward if you sleep on your back or letting your feet hang over the end of the bed if you sleep on your chest, to prevent leg cramps

If you are experiencing muscle spasms, you can schedule an appointment at Jamaica Hospital Medical Center’s Ambulatory Care Center. Please call (718) 206-7001.

What to Do Next After Receiving a Dementia Diagnosis

Posted on January 28, 2026 by Patrick Hercules

Receiving a dementia diagnosis can be devastating. Whether it is you are a loved one, several questions are raised after the diagnosis, namely “What do I do next?”

After receiving a dementia diagnosis, it is important to be as proactive as possible. There are several steps you can take to help you or a loved one plan for the future, as well as help everyone involved feel that they are informed, supported, and less alone. Steps include:

Learn about and understand the specific dementia diagnosis, as it helps guide healthcare decisions, treatment options, and expectations for the future.

Dementia is not a specific disease, but an overall term that describes a group of symptoms such as memory loss and the loss of other mental abilities severe enough to interfere with daily life. Dementia is caused by physical changes in the brain.

Different types of dementia include:
Lewy Body Dementia and Parkinson’s Disease
Creutzfeldt-Jakob Disease
Down Syndrome and Alzheimer’s Disease
Frontotemporal Dementia
Huntington’s Disease
Korsakoff Syndrome

There are many signs and symptoms of dementia. They include:

- Memory loss that disrupts daily life
- Challenges in planning or solving problems
- Difficulty completing familiar tasks
- Confusion with time and place
- Trouble understanding visual images and spatial relationships
- New problems with words in speaking or writing
- Misplacing things and losing the ability to retrace steps
- Decreased or poor judgment
- Withdrawal from work or social activities
- Changes in mood and personality
Communicate with you or your loved one’s healthcare providers to discuss what can be expected and how to best manage symptoms.
Plan for the future by consulting with various financial and legal experts to discuss advance care directives, such as a living will and durable power of attorney, as they outline any wishes for future medical treatment and designate someone to make decisions on your or your loved one’s behalf if/when you are unable to. A financial adviser can help you or your loved one organize and manage any expenses that may relate to long-term care
Communicate with family members and caregivers openly about your or your loved one’s diagnosis, any care preferences, and plans so that everyone is on the same page.
Maintain any and all social connections and participate in activities that encourage cognitive function. Maintaining a support network is important, as dealing with dementia can make you or a loved one feel isolated.
Ask your or your loved one’s healthcare provider about which treatments are available and recommended based on one’s specific dementia diagnosis, and ask about eligibility for clinical trials.
Start any of the recommended treatments or medications that may help manage dementia symptoms. Be sure to schedule regular appointments with your healthcare providers so they can monitor the condition and adjust care as needed. Monitor your symptoms and keep your healthcare providers up to date with them so they can offer any interventions that can help with any new symptoms that present themselves.
Remove any household hazards that may lead to falls or injuries. According to the Alzheimer’s Association, adults ages 65 and older living with dementia are at a 45.5% risk of getting injured or dying from falls, compared to 30.9% of people in the same age group who don’t have dementia. It is important to note that falls are the leading cause of death for that age group.

A dementia diagnosis is a difficult time for any family that must experience it. It is important to make sure that you, your loved ones, and any caregivers are prepared for the challenges that may arise on this journey.

If you or a loved one is experiencing any symptoms of dementia, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

Is Obstructive Sleep Apnea Linked to Parkinson’s Disease?

Posted on January 16, 2026 by Patrick Hercules

A new study conducted by Oregon Health and Science University and the Portland Veterans Administration (VA) Health Care System has found that people who have untreated obstructive sleep apnea (OSA) can have an increased risk of eventually developing Parkinson’s disease.

Obstructive sleep apnea is a common sleep disorder that occurs when people repeatedly stop and start breathing while they sleep due to the throat muscles relaxing and blocking their airway.

Parkinson’s disease is a progressive neurodegenerative disorder of the nervous system that worsens over time.

The study analyzed the health records of 13,737,081 U.S. veterans collected by the Department of Veterans Affairs from 1999 to 2022. The average age of the participants in the study was 60.5 years, with 9.8% being women.

1,552,505 participants of the study had obstructive sleep apnea. Six years after their original OSA diagnosis, there were 1.6 cases of Parkinson’s disease for every 1,000 individuals with obstructive sleep apnea, compared to those without it.

What’s more, the study shows that because OSA causes repeated airflow blockages during sleep, it leads to low oxygen levels and briefly interrupted blood flow to the brain and blood vessels. It can also lead to ischemia-reperfusion, which occurs when blood flow is restored after a period of reduced blood supply, leading to cells becoming damaged instead of healing. When this occurs, it causes fragmented sleep and triggers the autonomic centers in the brain, making neurons and blood vessels vulnerable. Similarly, Parkinson’s disease causes neurons to slowly break down and die, affecting neurological function.

People who are suffering from OSA can improve their sleep quality with early treatment using common treatments for sleep apnea, such as a continuous positive airway pressure (CPAP) mask or the new Inspire device. Unlike the CPAP mask, the Inspire device works inside the body with a patient’s natural breathing process, using mild stimulation to open the airway during sleep, allowing oxygen to flow naturally. The patient uses a small handheld remote to turn Inspire on before bed and off when they wake up. could help lower their risk of developing Parkinson’s disease.

If you would like to get tested for sleep apnea, you can make an appointment at Jamaica Hospital Medical Center’s Sleep Center by calling 718-206-5916.

To learn more about CPAP or Inspire at Jamaica Hospital Medical Center, please visit Jamaicahospital.org or call 718-206-7110 to make an appointment with an ENT doctor.

If you would like to learn more about Parkinson’s disease, you can schedule an appointment with a neurologist at Jamaica Hospital Medical Center’s Ambulatory Care Center. Please call (718) 206-7001.

How to Care for a Loved One Who Has Dementia

Posted on October 23, 2025 by Patrick Hercules

Caring for a loved one with dementia comes with many emotional and physical challenges. Whether you are providing round-the-clock care at home, or visiting them at a homecare facility a couple or few times a week, understanding how to better care for a loved one with the condition can have a transformative effect on your relationship with them.

Dementia is a general term that represents a group of diseases and illnesses that cause the loss of cognitive functioning to the point that it interferes with a person’s daily life and activities.

Cognitive changes they may experience include:

Memory loss, usually noticed by someone else
Problems communicating or finding words
Trouble with visual and spatial abilities, such as getting lost while driving
Problems with reasoning or problem-solving
Trouble performing complex tasks
Trouble with planning and organizing
Poor coordination and control of movements
Confusion and disorientation

Some people with dementia can’t control their emotions, and they may also have psychological changes, such as:

Personality changes
Depression
Anxiety
Agitation
Inappropriate behavior
Hallucinations

Dementia is caused by damage to your brain, affecting its nerve cells and destroying the brain’s ability to communicate with its various areas. Dementia can also result from blocked blood flow to the brain, depriving it of oxygen and nutrients. Without oxygen and nutrients, brain tissue dies.

Progressive dementias get worse over time. Types of dementias that worsen and aren’t reversible include:

Alzheimer’s disease (the most common cause of dementia)
Vascular dementia
Lewy body dementia
Frontotemporal dementia
Mixed dementia

As your loved one may be experiencing changes in thinking, remembering, and reasoning in ways that affect their daily life and activities, they will need more help with simple, everyday tasks. Here are some ways you can care for a loved one to ensure they are provided with compassionate and effective support:

Establish a consistent daily routine that offers a sense of security for your loved one. Schedule their meals, medications, and activities at the same times each day. This can help reduce confusion and anxiety and make the caregiving process smoother.
Communicate clearly and calmly with your loved one. This can be achieved by doing the following:
- Using simple words and short sentences
- Maintaining eye contact and speaking slowly
- Being patient and giving them time to process and respond
Making your loved one’s environment dementia-friendly to ensure the home is safe and easy to navigate. You can do this by:
- Removing tripping hazards
- Labeling drawers and rooms with words and pictures
- Using night lights to reduce nighttime disorientation
Encourage their independence and dignity by allowing them to do as much as they can on their own, breaking tasks into manageable steps, and offering gentle guidance when needed
Avoid arguing and correcting a misstatement or memory error. Use validation therapy by acknowledging their feelings and redirecting the conversation gently, as this can reduce their agitation
Engage in meaningful activities that stimulate the mind and body, which can boost their mood and cognitive function. These activities can include:
- Listening to music
- Looking at old photos
- Simple puzzles and crafts
Watch for signs of discomfort as individuals with dementia may not always clearly express their pain or discomfort. Watch for non-verbal cues, such as restlessness, facial expressions, or changes in behavior
Take care of yourself. As a caregiver of a loved one with dementia, burnout is common. Prioritize your own health by taking breaks, seeking emotional support, and joining caregiver support groups
Plan for your loved one’s future by making early decisions about legal documents, long-term care options, and financial planning
Use assistive technology and tools such as reminder clocks, GPS trackers, and medication dispensers

If your loved one is experiencing any of these dementia symptoms, you can schedule an appointment with a neurologist at Jamaica Hospital Medical Center’s Ambulatory Care Center by calling (718) 206-7001. If they are experiencing an emergency, call 911.

ALS

Posted on October 1, 2025 by Patrick Hercules

Amyotrophic lateral sclerosis, commonly referred to as ALS, is a neurological disorder that affects nerve cells in the brain and spinal cord. ALS causes loss of muscle control.

ALS is often called Lou Gehrig’s disease after the baseball player who was diagnosed with it. There is no exact known cause of the disease. However, a small number of cases, about 10%, are inherited. For the other cases, there isn’t a known cause.

The symptoms of ALS can vary from person to person. Symptoms depend on which nerve cells are affected. ALS typically begins with muscle weakness that gradually worsens over time. Symptoms might include:

Trouble walking or doing usual daily activities
Tripping and falling
Weakness in the legs, feet, or ankles
Hand weakness or clumsiness
Weakness associated with muscle cramps and twitching in the arms, shoulders, and tongue
Untimely crying, laughing, or yawning
Thinking or behavioral changes

ALS often starts in the hands, feet, arms, or legs, with muscle twitching and weakness in an arm or leg. It then spreads to other parts of the body, causing muscles to get weaker as more nerve cells die. The disease eventually affects control of the muscles needed to move, speak, chew, eat, swallow, and breathe. Unfortunately, there is no cure for this fatal disease.

There is generally no pain in the early stages of ALS. Pain is also not common in the later stages. ALS usually doesn’t affect bladder control. And it also doesn’t affect the senses, including the ability to taste, smell, touch, and hear.

There are several risk factors for ALS, including:

Genetics
Age
Sex

Several environmental factors have been associated with an increased risk of ALS. They include:

Smoking
Environmental toxin exposure
Military service

ALS can cause several complications as the disease progresses, including:

Breathing problems
Speaking problems
Eating problems
Dementia

ALS can be hard to diagnose early because it can have similar symptoms to other diseases. Tests that can rule out other conditions or help diagnose the disease can include:

Electromyogram (EMG)
Nerve conduction study
MRI
Blood and urine tests
Spinal tap
Muscle biopsy
Nerve biopsy

Treatments for ALS can’t reverse the damage, but they can slow the progression of symptoms. They can also prevent complications and make you more comfortable and independent.

You may need a team of healthcare providers and doctors trained in many areas to provide your care. This team will work together to prolong your survival and improve your quality of life. They will work to select the right treatment options for you.

The Food and Drug Administration (FDA) has approved two medicines for treating ALS:

Riluzole
Edaravone

There are many forms of therapy and forms of support when ALS affects your ability to breathe, speak, and move. They include:

Breathing care
Physical therapy
Occupational therapy
Speech therapy
Nutritional support
Psychological and social support

If you are experiencing any symptoms of ALS, you can consult with a neurologist at Jamaica Hospital Medical Center. To schedule an appointment, please call (718) 206-7246.

Chronic Traumatic Encephalopathy (CTE)

Posted on August 5, 2025 by Patrick Hercules

Chronic traumatic encephalopathy (CTE) is a degenerative brain condition that happens after repeated head injuries. CTE usually affects athletes who play contact sports or military personnel.

CTE causes neurodegeneration, which means it permanently destroys nerve cells in your brain. Over time, this damage can cause changes in your behavior and mental abilities. It has been associated with second impact syndrome, when a second head injury occurs before symptoms of a previous head injury have fully resolved.

Experts are still trying to understand how repeated head injuries and other factors might contribute to the changes in the brain that result in CTE. Researchers are looking at how the number of head injuries someone experiences and how bad the injuries are may affect the risk of CTE.

There are no specific symptoms that have been linked to CTE, as it shares symptoms with other brain conditions that cause neurodegeneration. It can affect your:

Cognitive function, which can cause:

Memory loss

Trouble solving problems or making plans

Trouble making a choice or judging what you should do next

Mild cognitive impairment

Mood and personality, which can cause:

Anxiety

Depression

Mood swings, especially acting or feeling more aggressive or impulsive

Personality changes

Thoughts of self-harm, suicide, or suicidal behavior

Motor function, which can cause:

Balance issues

Loss of coordination

Tremors, twitches, or other muscle movements you can’t control

There is no way to diagnose CTE in a living person. The only way healthcare providers can confirm CTE is by examining samples of a person’s brain with a microscope during their autopsy.

Even though a healthcare provider may not be able to definitively diagnose CTE while a person is alive, they can still make an educated assumption by building a diagnosis using a few factors, including:

A physical exam

A neurological exam

The symptoms a person is experiencing

A person’s medical history, especially if they have had head injuries

Experiencing CTE symptoms doesn’t automatically mean a person has it. There are a lot of conditions that can cause similar symptoms. A healthcare provider will use tests to help diagnose or rule out these other issues. Tests include:

Blood tests

CT scan

Lumbar puncture

PET scan

There is no treatment for CTE because there is currently no cure for it. Unfortunately, if a person has CTE, their symptoms will continue to get worse. Avoiding head injuries is the only way to lower your risk of developing CTE. Wear the right protective equipment for all activities and sports, especially helmets or protective headwear.

If you are experiencing any symptoms of CTE, you can schedule an appointment with a doctor at Jamaica Hospital Medical Center’s Ambulatory Care Center by calling (718) 206-7001. If you are experiencing an emergency, call 911.