Training Update for the Bike MS 150 mile ride – Ryan & Noran Clinic

Ryan McCartney takes his training outside for the first time during a winter warm stretch

Ryan McCartney takes his training outside for the first time during a winter warm stretch

Our first update from Ryan McCartney, our very own Noran Clinic Employee who has signed up to complete the Bike MS Challenge this summer and raise some money for a wonderful cause, dear to many of our patients!

MS 150 training (1)Training has officially started! January 31st 2015 was my first outdoor training session to get back to that feeling of biking outside with the wind on my face and cool air in my lungs. While it’s still cold and snowy I’m only putting in an hour or so outdoors to compliment my stationary bike at home or at the gym, keeping a weekly goal of 5 hours per week. As we get closer I will be spending more time outside and bumping up that weekly goal – it’s all about getting a lot of good “seat time.” :)

MS 150 training (3)Team Noran Clinic is still looking for more team members and support donations! If Team Noran Clinic can reach our goal of $1,000 in support we will be given yellow jerseys to wear during the race and will be supporting MS as Golden Gear Club members. The National MS Society makes sure that more than 79 cents out of every dollar raised goes to improve the lives of people living with MS – Help us reach our goal and stand out from the crowd while we raise awareness and support for all those living with MS!

~Ryan McCartney

Check out more information on the MS 150 Event in our first blog post here: Noran Clinic Employee to Represent in the Bike MS

You can also check out the Noran Clinic Team page and support Ryan here: Noran Clinic Bike MS Team Page

You can also start your own team and support those with Multiple Sclerosis, or go cheer them on throughout the course! Be sure to watch for more updates!

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Dr. Vaou Discusses Depression and Parkinson’s Disease on the Mary Hanson Show

Dr. Okeanis Vaou, neurologist at Noran Clinic and fellowship trained in sleep medicine and movement disorders, was interviewed by the Mary Hanson show previously to discuss the non-motor symptoms of Parkinson’s Disease. Mary Hanson and her viewers were interested in hearing more detail about one of these non-motor symptoms in particular: depression in Parkinson’s. Watch the video below of her the interview and learn more about this important, invisible symptom of Parkinson’s Disease with Mary Hanson and Dr. Okeanis Vaou.

You can find the original video posted on Mary Hanson’s YouTube page here: Mary Hanson Interviews Dr. Vaou About Depression and Parkinson’s.

You can also watch the previous interview with Dr. Vaou from 2013 here: Mary Hanson Interviews Dr. Vaou About the Non-Motor Symptoms of Parkinson’s.

To learn more about Dr. Vaou, visit her bio page here.



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Noran Clinic employee to represent in the Bike MS: CH Robinson Challenge 2015!


We are excited to share that our very own Ryan McCartney has signed up to complete the Bike MS C.H. Robinson Challenge in June of this year! This is a fundraiser for Multiple Sclerosis that asks its participants to complete a 150 mile trek from Duluth to the Twin Cities:

“Bike MS: C.H. Robinson MS 150 Ride 2015 is a two-day, fully supported cycling adventure that starts in Duluth and finishes in the Twin Cities. Nearly 4,000 cyclists travel the scenic Willard Munger Trail and celebrate their halfway victory at a festive overnight in Hinckley, Minn. The ride covers approximately 150 miles and is open to cyclists of all levels of expertise.”

Many of you may remember past years when we were a major sponsor of this event. Although we are no longer able to be a title sponsor, we are proud to have employees who are willing to represent us in this great event for a cause that benefits so many of our patients!

For more information, to register to join Ryan’s team in the ride, or to support him in his fundraising efforts, you can visit his team page at:

Please join us in cheering on Ryan as he completes the Bike MS C.H. Robinson Challenge this summer for Noran Clinic!

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Meeting of the Minds Dementia Conference 2015

Meeting of the Minds 2015

We would like to hare information that was sent to us from the Alzheimer’s Association Minnesota-North Dakota Chapter on the upcoming Meeting of the Minds Dementia Conferencein March 2015. Find details here and register soon for early bird rates!

The Meeting of the Minds Dementia Conference is the premier dementia conference for people with Mild Cognitive Impairment (MCI) or early dememntia, families, friends and professionals. The conference is a collaboration between the Alzheimer’s Association Minnesota-North Dakota Chapter and Mayo Clinic, who work together to create a day to engage attendees with speakers and exhibitors and connect them with informational tools.


Saturday, March 14, 2015

8:30 a.m.-4:30 p.m.


Saint Paul RiverCentre

175 West Kellogg Boulevard

Saint Paul, MN 55102

Learn More

Sponsor and Exhibitor Info

2015 registrationGeneral Conference registration will open on January 5, 2015 at 9 a.m. Individual registrations will not be accepted prior to that date. Registration fees are as follows:

Families/Friends/Students and People with MCI or Early Dementia 

Early Bird (1/5/15 – 2/6/15)

$80 online ($90 via phone)

Standard (2/7/15 – 3/9/15)

$100 online ($110 via phone)

Family Scholarships will be available beginning January 5, 2015. 

Call 952.857.0548 for more information.


Early Bird (1/5/25 – 2/6/15)

$140 online ($150 via phone)

Standard (2/7/25 – 3/9/15)

$160 online ($170 via phone)

Group Discount for Professionals

When 5 or more professionals register from the same company/organization, a discount of $20 is applied to each registration. To take advantage of this discount, professionals must register and pay together by selecting “add another person” during the registration process. The person registering the group will need to have all session selections prior to starting the registration process. The group discount is automatically applied during the check-out process.

2015 keynote speaker

Michael W. Weiner, M.D.

Professor of Radiology, Medicine, Psychiatry, and Neurology, UCSF, SFVAMC Center for Imaging of  Neurodegenerative Diseases  

Dr. Weiner has been doing research for over 45 years and is the Principal Investigator of the Alzheimer’s Disease Neuroimaging Initiative (ADNI), a 10-year national longitudinal study of over 1,500 subjects which is aimed at validating biomarkers for Alzheimer’s disease.

He has also launched the which is an internet based registry with the overall goal of accelerating development of effective treatments for brain diseases. This website registry recruits, screens, and longitudinally monitors brain function on thousands of subjects all over the USA. Dr. Weiner’s overall research goal is to participate in the development of effective treatments and methods for early detection of Alzheimer’s disease and other brain disorders.

Dr. John Zeisel, Ph.D.

President and co-founder of the I’m Still Here Foundation 

and Hearthstone Alzheimer Care, Ltd.

Dr. Zeisel received his Ph.D. in Sociology from Columbia University, was a Loeb Fellow at the Harvard School of Design, and has taught at the University of Minnesota, Harvard and Yale Universities, and in Montreal at McGill and the University of Quebec at Montreal.

He is Scientific Advisor to the Salford Institute for Dementia in the UK and is a member of the Comité Pedagogique de l’enseignement at Paris VI, the Pierre & Marie Curie University in Paris. Dr. Zeisel is the author of I’m Still Here: A Breakthrough Approach to Understanding Someone Living with Alzheimer’s.



For more information about the Meeting of the Minds Dementia Conference 2014, contact

Deborah Richman, Director of Education & Outreach:

By phone: 952.857.0551

By email:

ALZAssociation contact graphic


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Myasthenia Gravis – a Q&A with Adam Todd MD


Adam Todd MD is a Board Certified Neurologist with Noran Neurological Clinic.  As a certified electromyographer, he additionally performs EMGS for both his own patients and for other providers’ patients when ordered.  He has special interests in neuromuscular disorders, epilepsy, and stroke. In this Question and Answer session, Dr. Todd answers some common questions about Myasthenia Gravis.




Myasthenia Gravis

Question: What is myasthenia gravis?

Answer: Myasthenia gravis is an autoimmune disorder affecting the neuromuscular junction. As the name suggests, the neuromuscular junction is link between nerve and muscle. This link is established through chemical transmission. To move your muscles, a specific chemical neurotransmitter by the name of acetylcholine is secreted by the nerve. Acetylcholine clings to receptors on the muscle cell, stimulating them and resulting in muscle contraction. In myasthenia gravis, an antibody, a protein made by our own immune system blocks the receptors, effectively disconnecting the nerve from the muscle. This leads to weakness.


Question: What are the symptoms?

Answer: Premature fatigue, weakness, droopy eyelids and double vision are common presentations. Symptoms can be severe enough to cause weakness in muscles associated with breathing and swallowing. These symptoms are potentially life-threatening and require immediate medical attention.


Question: How is it diagnosed?

Answer: The diagnosis is based on a combination of clinical, laboratory and neurodiagnostic tests. When the clinical history is suggestive, a blood test is often obtained to look for antibodies specifically associated with myasthenia gravis. Electrodiagnostic testing is sometimes performed which can include nerve conduction studies and, less commonly, single fiber EMG. There is a close association between myasthenia gravis and tumors of the thymus gland. Therefore, a CT scan of the chest is often performed.


Question: How is it treated?

Answer: Myasthenia gravis is treated based on its severity. Milder symptoms may only require symptomatic treatment with an oral medicine called Mestinon (pyridostigmine). When generalized symptoms are present, daily steroids are often administered for a time. When long-term steroid use is anticipated, a steroid-sparing immunomodulating agent is used such as azathioprine, mycophenalate mofetil or cyclosporine . Some people can experience a “myasthenic crisis” which involves severe worsening of symptoms that is potentially life-threatening. This requires hospitalization and close medical monitoring. It is typically treated with either intravenous IVIG or plasmapheresis.


Question: What is the prognosis?  How does it affect a person’s life in the long run?

Answer: In the past, myasthenia gravis had a mortality rate as high 20-30%. With today’s medical knowledge and treatments, the prognosis is much better and most people can expect a normal life span. Some cases can go into remission with return of strength and can be safely taken off medications.


Thank you Dr. Todd for providing us with some great information!

To learn more about Dr. Adam Todd and how he works with his patients, visit his video bio at:

If you have additional questions about myasthenia gravis and would like to schedule an appointment with a neurologist experienced in the management of your condition, please contact Noran Neurological Clinic at 612-879-1500.

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Dr. Burstein Interviewed on Fox 9 News regarding Guillain-Barre Syndrome in a young boy



If you missed the story last month, Dr. Burstein was interviewed for a news story that aired on Fox Channel 9 on November 13th regarding an 8-year old boy who was diagnosed with Guillain-Barre Syndrome, or GBS, shortly after receiving his flu shot last year.

From the KMSP Channel 9 website’s story:


It’s flu season and flu shots have the potential to keep people from getting sick, but in extremely rare cases, some people who get the shot can have a a frightening reaction. That’s exactly what happened to the McGowan family and 8-year-old Mason. They believe their saga started with a flu shot, though doctors will never know for sure.

Minneapolis Dr. Larry Burstein says about 2 out of every 100,000 kids develop Guillain-Barre, what the Mayo Clinic defines as “a rare disorder in which your body’s immune system attacks your nerves.”

…The Center for Disease Control says two thirds of the people who develop Guillain-Barre get it after being sick with a respiratory illness, others get it after the flu or other infections, and then on very rare occasions, after getting a vaccination. It’s most common in older adults. Experts say the benefits of getting a flu shot still outweigh the risks.

To read the full story online, visit Fox Channel 9 here:

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Giving Tuesday!

Giving Tuesday Food Drive 2014


We all know about Thanksgiving, a wonderful time of year to remember and to be thankful for what we have. Then came Black Friday, and then Cyber Monday…now, after giving thanks for what we have ourselves and taking advantage of shopping deals, comes Giving Tuesday. This is the day to give back to others, a day to continue in the spirit of the season and share what we have. For some, this comes in the form of raising money or making a donation to a charity that is dear to us. It may be doing a small deed for a loved one or a stranger. It may be sharing our time in a way that helps someone else. For Noran, we have spent this time of year for the last several collecting food and housegold goods from among our providers and staff and donating them to local food shelves. This year, in honor or Giving Tuesday, we would like to kick off this event on Tuesday, December 2nd and will be collecting for the next two and half weeks. This year, we would also like to welcome donations from anyone who would like to participate in giving along side us! We will provide a donation box in both of our Minneapolis and Blaine lobbies from December 2nd through December 18th, and front desk staff at other locations can take donations at the front desk to be sent in along with our donations at the end of the collection period. If you have an appointment with us during this time frame, or are just conveniently close to one of our locations and would like to particpate, we are happy to accept your food donation along with our own internal donations, and will deliver them all together to local food shelves in December.

However you choose to do so, take advantage of Giving Tuesday and help someone if you can!
To view a printable PDF of the flyer for this event, click here: Giving Tuesday Food Drive 2014

For more information on Giving Tuesday, visit or watch this video from the #GivingTuesday website:

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Meet the Stroke Specialists of Noran Neurological Clinic

We have 34 adult and pediatric neurologists at Noran Neurological Clinic, and all are very experienced in treating patients with neurological disorders of all kinds. Furthermore, each of our providers is expertly trained in evaluating and treating patients with stroke. However, several of our neurologists have developed a special interest in stroke and work closely with the other specialists at Abbott Northwestern Hospital in post-stroke evaluations and treatment planning. They each continue to work with all types of neurological conditions and have additional interests as well. We’d like to introduce the providers who have developed a subspecialty within the area of stroke. A link to each provider’s bio is included below.

Dr. David P. Dorn, MD






Tarrel_Ronald_webDr. Ronald M. Tarrel, DO






todd_adam_webDr. Adam J. Todd, MD







You can find bios for all of our doctors, Allied Health Professionals, and Neuropsychologists at our main bio page,

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Weekly trivia on Noran Clinic Facebook!

We are excited to be starting a weekly “Know Your Neurology” trivia on the Noran Neurological Clinic Facebook page! Check in weekly on Thursday anytime after 10:00 AM to see if you know the answer! Learn more about ways to keep your neurological system healthy, as well as facts about the conditions we treat every day as a comprehensive neurology practice. Be sure to post what you think the answer is, and we will post the correct answer the following Monday! (Also keep an eye out on our blog or facebook feed if you don’t know the answer, as we may have addressed the topic in a previous post.)

Plus, even better…the last Thursday of each month will be a trivia question with a bonus - be the first person to post the correct answer, and win a $5.00 gift card to Starbucks!

You do not need to be a patient or in any way connected to Noran Neurological Clinic to participate in our trivia, you just need to have “Liked” our clinic Facebook page in order to leave your answer in the comments section.

Thank you to everyone who participates, and good luck! Lets see how well you Know Your Neurology!


Trivia participants must be 18 years of age or older, and only one comment/guess is permitted per participant per bonus trivia on the last Thursday of each month. Winners will be announced in the comments section following the trivia, and will be contacted privately through Facebook messaging for information on receiving the indicated prize when applicable. Employees of Noran Neurological Clinic and its Centers are not eligible to receive a prize.

This trivia is in no way sponsored, endorsed, supported, or organized by Facebook. The recipient of the information provided by you is not Facebook, but Noran Neurological Clinic, PA. By participating in this promotion, you release Facebook from any and all liability in connection with Noran Neurological Clinic’s trivia.

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Noran Clinic Epilepsy Specialists interviewed for a Pioneer Press Special Epilepsy Issue

Earlier this year, The Pioneer Press, in collaboration with the Epilepsy Foundation of Minnesota, published a special “Celebrating 60 Years” feature edition about Epilepsy in celebration of the 60th anniversary of the founding of the Epilepsy Foundation. The neurologists at Noran Clinic who specialize in epilepsy and seizure as part of their practice were asked to answer several questions about Epilepsy, medications, and SUDEP.

See our doctors’ questions and answers below. To read the full feature, including the Q&A with Noran Clinic doctors on pages 4 and 5, you can view it here:



Q: What is Epilepsy? (Gerald Dove, MD) 

Epilepsy is used to describe a condition in which a person has a tendency for recurrent seizures.  A seizure is what happens when the brain has abnormal uncontrolled electrical activity. Having a seizure does not necessarily imply epilepsy. This is due to the fact that some seizures can occur due to provoking factors, even in persons with no tendency to continue to have seizures. Such examples of situations where seizures occur, due to provoking factors, but are not epilepsy, are seizures that occur due to alcohol withdrawal and hypoglycemia. In these instances, when these situations or provoking situations are avoided, seizures never occur or recur. On the other hand, someone with epilepsy can have seizures, even when these situations are avoided.

There are many causes of Epilepsy, some inherited or genetic and others acquired, such as brain trauma, brain tumors, strokes, or brain infections.

Dr. Gerald Dove

Dr. Gerald Dove







Q: When should someone seek a specialist for epilepsy? (Tacjana Friday, MD)

An epileptologist is a neurologist who specializes in the treatment of seizures and epilepsy, and has acquired expertise in seizures and seizure disorders, anticonvulsants, and advanced treatment options such as epilepsy surgery.  An epileptologist is mainly consulted when a patient has poorly controlled epilepsy requiring more complex medical management, requires further evaluation with an EEG (electroencephalogram) to help characterize their spells or seizures, and/or to discuss other treatment options.

Dr. Tacjana Friday

Dr. Tacjana Friday







Q: Will I be on anti-epileptic medication for the rest of my life? (Syed Shahkhan, MD)

Most people with well-controlled seizures would like to stop taking their seizure medicines. In some cases, this can be done with the supervision of your doctor. You have the best chance of remaining seizure-free without medication if:

  • You had few seizures before you started taking seizure medicine
  • Your seizures were easily controlled with one type of medicine
  • You have normal results on a neurological examination
  • You have a normal EEG

Children with symptomatic epilepsy (epilepsy due to a known cause like brain injury, infections, tumor, and brain mal formation), adolescent onset, and a longer time to achieve seizure control are associated with a worse prognosis. In adults, factors such as a longer duration of epilepsy, an abnormal neurologic examination, an abnormal EEG, and certain epilepsy syndromes are known to increase the risk of recurrence. Even in patients with a favorable prognosis, however, the risk of relapse can be as high as 20% to 25%. Most doctors will consider tapering the dosage and discontinuing your seizure medicines after a seizure-free period of 2 to 4 years.

A decision about whether to stop taking seizure medicines should only be made after a long conversation with your neurologist, weighing all the risks. Are the possible results of another seizure (like injury or loss of your driver’s license) more acceptable than the continued effects of your medication?

Dr. Syed Shahkhan

Dr. Syed Shahkhan







Q: A stat is out about how seniors will be the largest population with seizures in the next 5 years.  Does a physician have any tips or special concerns a senior might need to know about having epilepsy? (Rupert Exconde, MD)

Epilepsy frequently affects the elderly. Relative to younger populations, the over-65 age group has a higher prevalence of epilepsy.

The clinical presentation of epilepsy in the elderly may be quite different from what is typically seen in younger people. In addition, common illnesses of older people can be easily mistaken for epileptic seizures, and vice versa. The elderly are more likely to present with nonspecific symptoms, such as altered mental status, memory lapses, episodes of confusion and loss of consciousness.  Because of the atypical presentation, the diagnosis is usually delayed by several months even in the care of an experienced neurologist.

It is important to recognize that freedom from seizures can be achieved in the vast majority of elderly epileptic patients. However, the morbidity associated with epilepsy is substantial, so once a successful treatment regimen has been established, lifelong treatment may be important for selected individuals.

Dr. Rupert Exconde

Dr. Rupert Exconde







Q: What is SUDEP and what do I need to know about it? (Rupert Exconde, MD)

SUDEP (sudden unexpected death in epilepsy) is the leading cause of epilepsy-related deaths. It accounts for close to 20% of deaths in individuals who suffer from epilepsy. It is diagnosed if death occurred while the patient is in a reasonable state of health, death happened during normal and benign circumstances, death was not the direct result of a seizure or status epilepticus (prolonged seizure) and an obvious medical cause of death could not be determined at autopsy.

Known risk factors for SUDEP include: young age (25 to 35), male gender, developmental delay, use of alcohol and recreational drugs, uncontrolled generalized convulsive seizures, night time seizures, concurrent use of multiple anti-seizure medications, subtherapeutic anticonvulsant levels, and treatment other than medication (surgery, vagus nerve stimulator, ketogenic diet).

The goal for decreasing the risk for SUDEP is optimal seizure management. Adherence with medication intake is essential. Avoidance of alcohol, illicit drugs, seizure-provoking situations, and high-risk situations (e.g., driving, swimming) are of paramount importance.

Dr. Rupert Exconde

Dr. Rupert Exconde







Q: Thoughts on medical marijuana as an epilepsy therapy? (Beth Staab, MD)

Medical marijuana is a hot topic in the national media and the medical community.  With it’s recent legalization in Colorado the medical community is now more aggressively looking into potential therapeutic options for marijuana-including its use in epilepsy.

Currently, there is only a small controlled clinical trial that was performed in 1980 showing its potential effectiveness in humans.  There are case reports of medical marijuana being effective for medically intractable epilepsy in children.  In animal studies, there is a suggestion that tetrahydrocannabinol (THC-the active ingredient in marijuana) can control seizures not responsive to other therapies.

Before marijuana becomes a mainstream therapy for medically intractable epilepsy, we need more clinical trials to determine dose and administration method but there is hope that this may be able to be added to the armamentarium that neurologists have to treat seizures.

Dr. Beth Staab

Dr. Beth Staab







If you have additional questions about epilepsy or seizure and would like to schedule an appointment with a neurologist experienced in the management of this condition, please contact Noran Neurological Clinic at 612-879-1500.



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