Grove Neurology: Andrew Lerman, MD

Migraines are a common neurological condition affecting 39 million people in the United States. Though the frequency and severity of migraines vary, sufferers can have severe throbbing pain that lasts a few hours or a few days. At Gables Neurology in Miami, Florida, Andrew Lerman, MD has personally suffered from migraines from a very young age. He and the team devote themselves to helping their patients find ways to treat and prevent migraines. For relief from your migraines at a practice that takes a personalized approach to care, call Gables Neurology, or request an appointment online today. Migraines Q & A What are migraines? Migraines are a type of recurring headache. The severity of the head pain varies but may cause severe throbbing pain or a pulsing sensation, usually on one side of the head. Dr. Lerman has a personal history of migraines, suffering from these chronic headaches from a young age. He understands what you’re going through and is motivated to help you find a treatment that provides lasting relief. Dr. Lerman takes a comprehensive approach to treating migraines and offers in-patient management for chronic migraines, recurrent and severe headaches that impact day-to-day life, and tension-type headaches (TTH). His treatments aim to help you live a normal life without pain. What are the symptoms of migraines? Migraine symptoms typically occur in four stages. However, not everyone with migraines goes through all of the stages. Prodrome The prodrome stage begins about 24 hours before the headache. Symptoms may include food cravings, mood changes, or uncontrollable yawning. Aura The aura stage causes temporary nervous system disturbances such as visual changes, weakness, or pins and needles sensation. You may experience the aura stage before or during your headache. Headache Migraine headaches cause a throbbing sensation in one area of your head that may last for hours or days. Postdrome During the postdrome stage, which follows the headache, you may feel drained and exhausted. How are migraines treated? Dr. Lerman and the team take a personalized and comprehensive approach to the treatment of migraines. They offer many innovative therapies to help you get long-lasting relief from your chronic head pain. Treatment options at Gables Neurology include: Medication Dr. Lerman and the team work with you to find the correct medication to prevent and relieve your pain and symptoms. Preventive medications act before the onset of migraines, while acute medications stop migraines after they start. In-house Botox® A powerful prophylactic, Botox chemodenervation prevents headaches and migraines with quick injections every 12 weeks. Occipital nerve block (ONB) ONB is a steroid injection that reduces pain and symptoms. Lifestyle counseling Lifestyle counseling is part of a migraine treatment plan at Gables Neurology and includes identifying and avoiding migraine triggers. Sleep evaluation The team evaluates your sleep habits, which may play a role in the frequency, duration, and severity of your migraine symptoms. Call Gables Neurology, or click the website booking tool to schedule your migraine consultation today.

Parkinson’s disease is a progressive neurological disorder that affects movement. At Gables Neurology in Miami, Florida, Andrew Lerman, MD, and the team take a proactive approach to the treatment of Parkinson’s disease. They utilize the newest and most effective medications to slow down the progression of the disease. They also work with Neurosurgery to offer cutting edge medical devices such as Deep Brain Stimulation. For comprehensive care from a compassionate team, call the office or use the online booking tool to schedule a consultation today. Parkinsons Q & A What is Parkinson’s disease? Parkinson’s disease is a neurological disorder that affects nerve cells in the brain. Over time, the disease kills these nerve cells, affecting movement, causing shaking, stiffness, and difficulty walking. Dr. Lerman is an experienced and devoted neurologist who’s always looking for the best treatment for his patients with Parkinson’s disease. He invests time in learning about new therapies and getting his patients access to the most cutting-edge treatments. What causes Parkinson’s disease? Parkinson’s disease occurs from damage or death of the nerve cells in the brain that control motor movement. These nerve cells produce the chemical messenger dopamine. Damage or death to these nerve cells affects dopamine production, leading to abnormal brain activity. Researchers are trying to understand what causes these nerve cells to die but theorize it may be from genetic and environmental factors. What are the symptoms of Parkinson’s disease? Symptoms of Parkinson’s disease vary and develop gradually. Some of the most common and distinct symptoms include: Trembling in the hands, legs, arms, jaw, or head Stiffness in the trunk or legs Slow down in movement Poor balance and coordination Currently, there’s no single test for diagnosing Parkinson’s disease. When you come in with concerns, Dr. Lerman takes a multidisciplinary and multimodal perspective to get an accurate diagnosis. Gables Neurology is a state-of-the-art neurology practice, and Dr. Lerman may request various diagnostic tests, such as a dopamine transporter scan (DaTSCAN), to support his diagnosis. How is Parkinson’s disease treated? Dr. Lerman and the team are comfortable and familiar with all the newest medications and therapies available for Parkinson’s disease. The goal of your treatment plan focuses on improving your quality of life. Treatment may include: Medication To manage symptoms, Dr. Lerman develops a medication regimen that may include conventional pharmacokinetics and alternative therapies. Deep brain stimulation (DBS) DBS is a procedure that alleviates Parkinson’s disease symptoms. Gables Neurology provides DBS through the programs at Baptist Health and the University of Miami Hospital. Lifestyle modification Lifestyle modifications, such as eating a healthy diet and getting regular exercise, help those with Parkinson’s disease experience an improved quality of life. Specialized therapy Gables Neurology offers specialized therapy for their patients with Parkinson’s disease at Baptist Health. Medical cannabis Dr. Lerman is a licensed medical marijuana physician in the state of Florida. Parkinson’s disease is one of the eligible conditions for the use of medical cannabis. He may recommend medical cannabis as an alternative therapy for managing your symptoms and improving your quality of life. Dr. Lerman is vigilant about providing his patients with the best treatments available. Call Gables Neurology, or book an appointment online today. Understanding Deep Brain Stimulation: Your Guide to DBS Therapy Deep Brain Stimulation (DBS) is a revolutionary medical procedure that offers hope and improved quality of life for individuals battling certain neurological conditions. This guide is designed to provide you with a comprehensive overview of DBS, its benefits, eligibility criteria, and answers to common questions you might have about the treatment. What is Deep Brain Stimulation (DBS)? Deep Brain Stimulation is an advanced neurosurgical procedure that involves the implantation of a device, known as a neurostimulator or "brain pacemaker," which sends electrical impulses to specific areas in the brain. These impulses regulate abnormal impulses or affect certain cells and chemicals within the brain. The procedure aims to reduce symptoms of neurological disorders, improving the patient's ability to perform daily activities and enhancing their overall quality of life. Who May Be Eligible for DBS? DBS therapy is not a one-size-fits-all solution. It's typically considered for individuals who: Have Parkinson's disease, essential tremor, dystonia, or other neurological conditions that have not responded well to medication. Experience significant side effects from their current medication regimen. Are in good overall health and can undergo surgery.

Seizures are sudden attacks of abnormal electrical activity in the brain that may cause dramatic symptoms or no symptoms at all. At Gables Neurology in Miami, Florida, Andrew Lerman, MD and his expert team offer novel approaches to seizure treatment. Dr. Lerman is board certified in neurophysiology from NYU - Langone School of Medicine and has years of experience diagnosing and treating seizure disorders and epilepsy. If you have seizures, call Gables Neurology, or request an appointment online today. Seizures Q & A What are seizures? A seizure is an uncontrolled disturbance in the electrical activity within your brain. Seizures can noticeably alter your behavior, movements, emotions, and state of consciousness. Severe seizures can even cause you to fall to the ground and shake violently, while other seizures may be so mild that you’re unaware that they’re happening. If you’ve had two or more seizures, you may have a condition called epilepsy. What are the types of seizures? The two primary categories of seizures include: Focal seizures A focal seizure involves abnormal electrical activity in one part of your brain. If you’re aware that you’re having a seizure, it’s called a focal aware seizure. These seizures can change the way things look, feel, smell, or taste. A focal seizure with impaired awareness involves a change or loss of consciousness. Individuals experiencing this type of seizure may stare off into space and stop responding, or they may engage in repetitive behaviors like walking in circles. Generalized seizures Generalized seizures affect all parts of your brain. There are many types of generalized seizures, including: Absence seizures, which involve staring into space or repetitive eye blinking Atonic seizures, which cause a sudden loss of muscle control Clonic seizures, which cause repeated, jerking movements Myoclonic seizures, which cause brief twitches in the arms or legs Tonic seizures, which cause muscle stiffening that may make you fall to the ground The most dramatic type of generalized seizure is a tonic-clonic seizure. Previously known as grand mal seizures, this type can cause an abrupt loss of consciousness, body stiffening and shaking, and tongue-biting. How are seizures diagnosed? First, your provider thoroughly reviews your symptoms and medical history and performs a physical and neurological exam. They may order several tests, such as: Blood tests Lumbar puncture Electroencephalogram (EEG) Video Electroencephalogram (EEG) Intracranial electrode monitoring (iEEG or ECoG) Neuroimaging tests CT scan or magnetic resonance imaging (MRI) Functional MRI (fMRI) Positron emission tomography (PET) scan Single-photon emission computerized tomography (SPECT) Wanda testing These tests can help your provider determine the cause of your seizure and develop an individualized treatment plan. How are seizures treated? Seizure treatment may not begin until you’ve had more than one episode or you’ve been diagnosed with epilepsy. Dr. Lerman and the team offer comprehensive seizure care at Gables Neurology. Their goal is to mitigate your symptoms, minimize adverse side effects of anti-seizure medication, and help you experience a better quality of life. Gables Neurology offers the most up-to-date seizure treatments, including: Seizure medications Nutritional therapy Support and education Surgery Medical Cannabis Dr. Lerman applies a conservative, methodical, medical approach to assessing patients for medical cannabis eligibility. All patients who are prescribed medical cannabis must be enrolled in the Florida State Department of Health’s Compassionate Care Act. To learn more about effective seizure management, call Gables Neurology, or book an appointment online today.

About five million adults 65 years of age older in the United States have dementia, a number that may more than double over the next 20 years. At Gables Neurology in Miami, Florida, Andrew Lerman, MD and the team take a comprehensive approach to the treatment of dementia. Dr. Lerman believes researchers are in the midst of a breakthrough in medication treatment that may prevent the cognitive decline that occurs with dementia. To schedule a consultation for you or a loved one, call the office or use the online booking tool today. Dementia Q & A What is dementia? Dementia isn’t a specific disease but a general term that describes changes in a person’s memory, cognition, and social abilities that interferes with their ability to manage their day-to-day life. Dementia is more common in older adults, but it’s not a normal part of the aging process. There are many conditions that cause dementia; however, Alzheimer’s disease is the most common. What are the signs and symptoms of dementia? The signs and symptoms of dementia vary and may depend on the underlying cause. Common symptoms include: Memory loss Difficulty finding the right words Hard time communicating Problems with reasoning or judgment Confusion and disorientation Difficulty handling complex tasks Changes in visual or spatial abilities Personality changes Depression or anxiety Inappropriate behavior Paranoia or hallucinations If you or someone you love is showing signs of dementia, schedule a consultation at Gables Neurology. Some causes of dementia are treatable and reversible, such as nutritional deficiencies, especially when identified early. How is dementia diagnosed? Dr. Lerman and the team conduct comprehensive evaluations when you come in with concerns about dementia. No single test can diagnose dementia or the cause, and the team may conduct a series of tests to get the answers you need. Dr. Lerman reviews your medical and family history, as well as your symptoms. He may talk to family members and caretakers to get a better sense of the history of your symptoms. The team also conducts cognitive and neuropsychological testing to assess memory, orientation, judgment, and thinking. They also run blood work, brain scans, and perform a psychiatric evaluation. How is dementia treated? The team at Gables Neurology approaches dementia with a comprehensive style of care that involves counseling, diet and lifestyle recommendations, and family and caretaker support. The team also has the privilege and opportunity to offer their dementia patients innovative treatments and therapies through their in-office clinical trials. For patients participating in the clinical trials, Dr. Lerman and the team provide close supervision and care. Dr. Lerman believes researchers are in the midst of a breakthrough in medication that may prevent the cognitive decline that occurs with dementia. To schedule a dementia consultation at Gables Neurology for you or your loved one, call the office or book an appointment online today.

Multiple sclerosis (MS) is a progressive disease that affects the brain and spinal cord. Though MS may develop at any age, onset most often occurs between ages 20 and 40. At Gables Neurology in Miami, Florida, Andrew Lerman, MD and the team believe one of the most important steps in treating multiple sclerosis is diagnosing it as early as possible. Then, they use the most innovative treatments and therapies to modify the course of the disease and manage symptoms. Call the office or schedule an appointment online today. Multiple Sclerosis Q & A What is multiple sclerosis? Multiple sclerosis (MS) is a disease of the central nervous system, which includes your brain and spinal cord. It occurs when the immune system attacks and destroys the myelin sheath, which is the cover that protects nerve fibers. Without the myelin sheath, you have communication problems between your central nervous system and the rest of your body. It’s not clear why some people develop MS and others don’t, but researchers theorize it may be due to genetic and environmental factors. What are the symptoms of multiple sclerosis? Symptoms of multiple sclerosis vary and may depend on the location of the affected nerve fiber and the course of the disease. Common symptoms include: Double vision Spasticity Electric shock-like sensations Weakness Dizziness and vertigo Tingling or numbness in the hands or feet Urinary incontinence Gait instability Many people with MS experience a relapsing-remitting disease course. They have periods where they develop new or a relapse in symptoms that last days or weeks. These symptoms may eventually lessen or disappear. The disease may then go into a period of remission that lasts months or years. Over time, many people with a relapsing-remitting disease course eventually develop symptoms that progressively worsen over time, with no more periods of remission. Some people with MS have symptoms that start out gradually and worsen over time. No matter your disease course, Dr. Lerman and his team can help. How is multiple sclerosis diagnosed? There’s no single test to diagnose multiple sclerosis. When you come in with symptoms that sound like MS, Dr. Lerman and the team perform a comprehensive evaluation to rule out other conditions that might explain your health issues to diagnose MS. They review your symptoms, as well as your medical and family history. They also conduct a neurological exam, MRI, and blood testing. The team also performs evoked potentials, which record the electrical impulses produced by your nervous system in response to stimuli. Getting an early diagnosis is key for treating multiple sclerosis. How is multiple sclerosis treated? Once you have a diagnosis, the team at Gables Neurology takes a collaborative approach to care with the services offered at the neurology practice. Treatment for multiple sclerosis includes: Oral medications Injectable medications Infusion therapy Physical therapy Plasma exchange The practice offers both focused and expansive treatment options for multiple sclerosis, including alternative therapies such as medical cannabis. For personalized care from a caring and experienced team, call Gables Neurology, or schedule an appointment using the online booking tool today.

Over the past 20 years, there has been a revolution in the technology available to diagnose and treat a variety of neurological disorders. Dedicated to providing the latest advancements in neurology to their patients, the team at Gables Neurology in Miami, Florida, participates in clinical trials. It brings Andrew Lerman, MD and the team immense joy to offer these innovative solutions to their patients and families. To learn more about the clinical trials at Gables Neurology, call the office or request a consultation online today. Clinical Trials Q & A What are clinical trials? Clinical trials are medical studies that involve people. The purpose of the studies is to find new safe and effective ways to prevent, detect, or treat diseases. Dr. Lerman believes the future of neurology is upon him, and he is entering an era where extensive innovations in medicine and therapies are changing the future treatments for his neurology patients. With his constant desire to learn more and do more for his patients, Dr. Lerman is honored to have the privilege and opportunity to offer many of the latest advancements in treatments for neurology patients through clinical research and drug trials. It brings him and the team immense joy to be able to offer these solutions to their patients and families. Who can participate in clinical trials? Dr. Lerman and the team determine who can participate in their clinical trials after a comprehensive evaluation. To get accurate data, clinical trials have set criteria for their participants. The criteria may include age, symptoms, diagnosis, medical history, and previous treatments. To participate in a clinical trial at Gables Neurology, you must meet the set criteria. Gables Neurology is a full-service neurology practice dedicated to providing their patients the best treatments available. If they think you can benefit from the treatment provided in the clinical trial, they do their best to include you. However, in addition to the set criteria, clinical trial participants must strictly adhere to the research guidelines. That may include taking only the medication given through the trial and attending the office visits as scheduled. Failure to fully comply with the clinical trial guidelines may disqualify you from further participation. What can I expect when participating in clinical trials? The specifics of your clinical trial at Gables Neurology may depend on your diagnosis and study. However, you can expect comprehensive evaluations and treatment from the team at Gables Neurology when participating in the clinical trial. Additionally, all of your exams, tests, treatments, therapies, and medication, are at no cost to you. Some clinical trials pay you to participate. The team at Gables Neurology provides the details of the clinical trial at your initial consultation, so you know what to expect. Clinical trials are an opportunity for you and the team at Gables Neurology to use the most advanced treatment options for your neurological condition. Call the office or request an appointment online to learn more about clinical trials.

Communication problems between your muscles and nerves affect normal function. Electrodiagnostic medicine is a medical subspecialty that uses innovative techniques to diagnose and treat problems that affect your neurological, neuromuscular, and muscular systems. Gables Neurology in Miami, Florida, is a state-of-the-art neurology practice specializing in electrodiagnostic medicine. Andrew Lerman, MD and the team offers in-home and in-office electroencephalogram (EEG) monitoring to diagnose and treat seizure disorders. For comprehensive care, call the office or schedule a consultation online today. Electrodiagnostic Medicine Q & A What is electrodiagnostic medicine? Electrodiagnostic medicine is a medical subspecialty that uses special tools to diagnose, evaluate, and treat problems that involve the nervous, neuromuscular, or muscular systems. Proper muscle movement depends on electrical signals from your nerves. If your nerves or muscles aren’t working the way they should, it may be a sign that your nerves aren’t sending the right information, or your muscles are misinterpreting the signals. At Gables Neurology, the team uses innovative diagnostic tools to find the source of the problem to get an accurate diagnosis for an effective treatment plan. What are electrodiagnostic medicine tools? The electrodiagnostic medicine tools at Gables Neurology include the electromyogram (EMG) and nerve conduction study (NCS). EMG During an EMG, Dr. Lerman evaluates how well your muscles respond to nerve signals. NCS With the NCS, Dr. Lerman measures the speed and strength of the electrical signal as it travels through the nerve. When coming in for electrodiagnostic medicine at Gables Neurology, the team may perform both an EMG and NCS to confirm or rule out a neurologic, neuromuscular, or muscular condition. Electrodiagnostic medicine testing may take up to an hour and typically requires no downtime afterward. What can electrodiagnostic medicine diagnose? Electrodiagnostic medicine diagnoses many common conditions. The testing also assesses the severity of the nerve or muscle damage to determine the best treatment. Conditions that benefit from electrodiagnostic medicine for a formal diagnosis include: Carpal tunnel syndrome Diabetes neuropathies Brachial plexus injury and neuropathies Chronic inflammatory demyelinating polyneuropathy (CIPD) Myelitis Myelopathy Nerve plexus injury Neuromyelitis optica Trigeminal neuralgia Multiple sclerosis Muscular dystrophy Radiculopathy Neuromuscular disease Spinal cord injury If you have or suspect you have a nerve or muscle condition, Gables Neurology can perform the testing you need to confirm or rule out your suspicions. What is an electroencephalogram (EEG)? An electroencephalogram (EEG) is a test that measures electrical activity in your brain. At Gables Neurology, the team offers prolonged continuous video EEG monitoring both in-home and in-office to diagnose and treat seizure disorders and epilepsy. To learn more about electrodiagnostic medicine at Gables Neurology, and how it may benefit you, call the office or schedule a consultation using the online booking tool today.

Dr. Lerman treats a number of memory disorders. Including Alzheimer’s disease, Attention Deficit Disorder (ADD), progressive supranuclear palsy and various dementia, including Lewy Bodies dementia (LBD). He also provides treatment for children with ADD. Memory Disorders Diagnosis A comprehensive evaluation can identify the factors or conditions leading to memory disorders. Dr. Lerman also evaluates patients for reversible causes of cognitive impairment. Treatment Optimization of medication Lifestyle modification Dietary / nutritional consultation Family support for disorders such as Alzheimer’s disease

With the passing of Amendment 2 by Florida voters on November 8th, 2016, medical cannabis is approved to treat people who have very specific or comparable debilitating diseases. Amendment 2, also known as the Florida Medical Marijuana Legalization Initiative, and the expanded qualifying medical conditions, became effective on January 3, 2017. Medical Cannabis Q & A What is Medical Cannabis? Cannabis is a plant that has recently gained a lot of attention, particularly within the medical community, regarding its potential medicinal benefits in treating various medical conditions. The plant is usually processed into an oil, which serves as a vehicle for ingestion, and there are various formulations depending on the condition being treated or medication’s intended effect. These include high CBD-low THC formulations and high THC formulations. It is now legal for qualifying physicians to prescribe in many states, including Florida, for the treatment of certain indicated medical conditions. Multiple studies have concluded that medical cannabis is an effective treatment for certain medical conditions. For example: A 2007 study appearing in the journal Neurology found that marijuana is highly effective for reducing neuropathic pain resulting from damaged nerves among patients with HIV (pain that traditional opiates, like morphine can’t manage). Led by Orrin Devinsky, MD, director of the NYU Langone Comprehensive Epilepsy Center, a multi-site (11 epilepsy centers), found more than a 50 percent reduction in seizure frequency in some patients using cannabidiol (CBD), a medical marijuana derivative. The study is published in the Lancet Neurology. Another study, conducted at Virginia Commonwealth University, determined that ingredients in marijuana can be crucial in helping to control spontaneous seizures among epileptic patients. These are just three examples of many studies on the benefits of medical cannabis in treating certain conditions and pain. What Conditions are Currently Eligible for Treatment in Florida? Patients in Florida must have specific medical conditions and be certified by a state licensed cannabis doctor in order to be eligible for medical cannabis treatment. Among the conditions approved for eligibility for treatment with medical cannabis are: Epilepsy. Medical cannabis helps to reduce the occurrences of seizures and minimize the symptoms of epilepsy. Cancer. The cannabinoids in medical marijuana are effective for counteracting the side effects, such as nausea, of some cancer treatments. Muscle Spasms. Medical cannabis is used to control muscle spasms and their associated pain. This includes helping people who have muscular dystrophy, multiple sclerosis, and other conditions who are often plagued with muscle spasms as a result of their condition. As well as, Glaucoma HIV/AIDS PTSD Amyotrophic Laterals Sclerosis (ALS) Crohn’s Disease Parkinson’s Disease Multiple Sclerosis Chronic Malignant Pain Other Debilitating Condition of Like, Kind, Or Class Other terminal illnesses previously diagnosed by another physician How is Medical Cannabis Administered? In Florida, it is possible to administer medical cannabis in the form of tincture droplets, pills, drops, and in vaporized forms. It is not recommended or permissible to smoke cannabis for medical treatment in Florida. Are You Eligible to Seek Medical Cannabis Treatment? You must be recommended by a physician licensed to treat you with medical cannabis in order to receive this treatment. Then, only after you have been diagnosed with one of the conditions as set forth by the Florida Medical Marijuana Legalization, Amendment 2, Bill 8A are you eligible to move forward in the process to receive medical cannabis treatment. If you are under 18 years old, you must receive the consent of two physicians. Once all criteria is met, and deemed an appropriate candidate, your physician registers you on the Medical Marjiuana Use Registry, and you or your representative / caregiver are required to apply for a Medical Marijuana Registry Card. Ongoing, your prescribing physician may only write a certification for a 70 - day supply with two refills until the patient is required to see the physician again in person. Telemedicine consultations are not permitted. Physicians may request to follow up with patients at their discretion. Seek Help from a Specialist Experienced in Using Medical Cannabis to Treat Serious Conditions It is essential to work with a licensed medical marijuana physician in the state of Florida who is an experienced specialist, not only, in using medical cannabis for approved neurological disorders and but in treating the underlying condition, understanding potential side effects and drug-drug interactions.