StatementofIntendedUse/DisclaimersAllinforma,on,data,andmaterialcontained,presented,orprovidedinthisprogram/presenta,on(“Informa,on”)isforgeneralinforma,onpurposesonly and solely theopinionof the authors andpresenters. The Informa,on shouldnotbe construedorintendedasprovidingpersonalizedmedicalorlegaladvice.TheInforma,onisnotnecessarilyconsideredmainstreamhealthcare.ItislePtothediscre,onandjudgmentandisthesoleresponsibilityoftherecipientoftheInforma,ontodetermineifproducts,procedures,treatments,tests,andtherapiesdescribedareappropriatefortheclient.NeitherthespeakersnorthesponsorsofFunc,onalNeurologySeminarscanbeheldresponsiblefortheInforma,on,opinions,orany inadvertent errors or omissions in the prepara,on or presenta,on of the Informa,on. The Informa,on should not beconstruedasaclaimregardinganyprocedure,treatment,therapy,test,orproduct.ItisthesoleresponsibilityoftherecipientofthisInforma,ontocomplywithlocal,state,andfederallawsregardingtheuseofsuchInforma,on,asitrelatestothescopeandtypeofuser’sprac,ce.ItistheconcernoftheDepartmentofHealthandHumanServicesthatnohomeopathicand/ornutri,onalsupplementbeusedtoreplaceestablished,conven,onalmedicalapproaches,especiallyincasesofemergenciesorseriousorlife-threateningdiseases,orcondi,ons.Func,onalNeurologySeminarssharesinthisconcern,asreplacingconven,onaltreatmentwithhomeopathicand/ornutri,onalsupplements,especiallyinseriouscases,maydeprivetheclientofnecessarytreatmenttherebycausingharmandcouldalsoposeamajorlegalliabilityforthehealthcareprofessionalinvolved.TheInforma,onhasnotbeenevaluatedbytheFoodandDrugAdministra,on.Anynutri,onalproductorprocedure reported in this presenta,on is not intended to diagnose, treat, cure, or prevent disease. Various forms of caredescribed in the FNS seminar series should not be used to replace conven,onal neurological care or replace other forms ofmedicallynecessarycare.Dr.Da,sKharrazianhasthefollowingfinancialinterests.HeisamemberofApexEnerge,cs,Inc.'sScien,ficAdvisoryBoard,isapaidconsultanttoApexEnerge,cs,andreceivesroyal,esonthesaleofDVDsandCDs. Dr.KharrazianisalsoamemberoftheeditorialboardoftheJournalofFunc,onalNeurology,Rehabilita,on,andErgonomics.Hereceivesnofinancialcompensa,onforhis par,cipa,on on this board. Dr. Kharrazian serves on the Curriculum Advisory Commi\ee of the Ins,tute for Func,onalMedicine.Hereceivesnofinancialcompensa,onforhispar,cipa,ononthiscommi\ee.Dr.Brockhasthefollowingfinancialinterests.Dr.BrockisapaidemployeeofCerebrumHealthCentersandownerandoperatoror Drbrocklectures.com and does consul,ng work for various clinics. Dr. Brock is a paid instructor for the Academy ofOsteopathicScience,unpaidvicepresidentof the Interna,onalAssocia,onofFunc,onalNeurologyandRehabilita,on,unpaidmember of the human council of human func,on and an unpaid board member of the American Associa,on of Integra,veMedicine.Dr.BrockisapaidlecturerforApexEnerge,cs.Dr.BrockhasbeenengagedasanindustryexpertbyMolecularaLaboratoriestoassistinthedevelopmentofeduca,onallecturesandtoeducatehealthcareprac,,onersinitstechnologyandtheapplica,onofitstes,ng.Assuch,hereceivescommissionsfromMolecularaaspermi\edbyandincompliancewithfederalandstatelaws,codesandregula,ons,includingStarkandotheran,-kickbackprovisions.HeisnotanemployeeofMolecularaanddoesnotownanystock.Dr.KharrazianhasbeenengagedasanindustryexpertbyCyrexLaboratories,LLCtoassistinthedevelopmentofclinicalassaysandtoeducatehealthcareprac,,onersinitstechnologyandtheapplica,onofitsarrays.Assuch,hereceivescommissionsfromCyrex as permi\ed by and in compliancewith federal and state laws, codes and regula,ons, including Stark and other an,-kickbackprovisions. He is not anemployeeofCyrex anddoesnotownany stock. Allmarks and their use are therebydulygovernedbytherespec,veownersandanyandall rights inconnec,onwiththosemarksareen,relyreserved.Thepresenterreceivesaspeaker’sfeeandisreimbursedforhis/hertravelandrelatedaccommoda,onsbythesponsor,ApexEnerge,cs,Inc.Dr.KharraziannorDr.BrockhaveanyfinancialinterestsinLaboratoryCorpora,onofAmerica,QuestDiagnos,cs,Incorporated,Diagnos-Techs, Inc.,PrincipalLab, Inc,Metametrix, Inc.,MetabolicSolu,onsDevelopmentCompany,LLC, ImmunosciencesLab,Inc.,RealTimeLaboratories, Inc.,Direct LaboratoryServices, Inc.,orGenovaDiagnos,csorother labsmen,oned in this seriesotherthanthoselistedinthisdisclaimer.

2

Dr.Da+sKharrazianDC,DHSc,DACNB,DABCN,FACN,CNS

Dr.Da,sKharrazianisanAssociateClinicalProfessoratLomaLindaUniversitySchoolofMedicine.Hehascontributedsignificantlytothefieldoffunc,onalneurologyasaneducator,author,andresearcher.Heiscreditedwithintegra,ngthefunc,onalmedicinemodelwithrehabilita,veneurologytoevolvethespecialtyintoamorecomprehensivetreatmentmodelofbraindysfunc,on.Hedevelopedseveralpost-graduateprograms,protocols,examina,onforms,andques,onnaireformsinthefieldoffunc,onalneurologythatarebeingbeenusedbythousandsofhealthcareprofessionals.HispeersatthefirstInterna,onalAssocia,onofFunc,onalNeurologyandRehabilita,on(IAFNR)annualmee,ngrecognizedhimwiththe“ClinicalTrailblazer”Awardforhiscontribu,ontoevolvingthefieldoffunc,onalneurology.Hehasalsoreceivednumerousaccoladesforhisdevelopmentoffunc,onalmedicineprograms.Heistheauthorofthebest-sellingbook,WhyIsn’tmyBrainWorking?Thisbookhasreceivedhundredsofposi,vetes,monialsandfivestarreviewsfromreadersthroughouttheworldandisbeingtranslatedintoseveralotherlanguages.Manyreviewershavecalledhisbookthemostcompleteandinnova,vecompila,onofworkforfunc,onalneurologynutri,onalconcepts.Dr.Kharrazianteachesneuroscienceandhumanbraindissec,onatBastyrUniversityCaliforniaandisanAdjunctProfessoratNa,onalUniversityofHealthSciences,whereheisdevelopingpost-graduateprogramsinfunc,onalneurology.Hehasdevelopeda30-partNeuroendocrine-ImmuneSeriesandaMasteringBrainChemistrycoursethathasbeentaughttothousandsofhealthcareprofessionalsthroughoutthecountryandapprovedbytheUniversityofBridgeportPostgraduateDepartment.Dr.KharrazianisalsoafacultymemberoftheIns,tuteforFunc,onalMedicine(IFM)andsupportsprogramdevelopmentinfunc,onalmedicine,func,onalneurology,neurologicalphysicalexamina,on,andneurologydiagnos,capplica,onstobrain-baseddisorders.TheIFMprovidesmedicalphysicianswithcon,nuingmedicaleduca,oncreditsrequiredforphysicianre-licensureandisaccreditedbytheAccredita,onCouncilforCon,nuingMedicalEduca,on.Dr.KharrazianisaFellowoftheAmericanCollegeofNutri,on,aDiplomateoftheBoardofNutri,onSpecialists,ADiplomateoftheAmericanChiroprac,cNeurologyBoard,andaDiplomateoftheAmericanClinicalBoardofNutri,on.HeearnedaMasterofSciencedegreeinHumanNutri,onfromtheUniversityofBridgeport,aDoctorofHealthSciencefromNovaSoutheasternUniversity,andaDoctorofChiroprac,cdegreefromSouthernCaliforniaUniversityofHealthSciences.Heiscurrentlycomple,nghisPh.D.degreeatNovaSoutheasternUniversitywithdoctoralresearchinautoimmunityandimmunology.Dr.Kharraziancompletedaone-yearpost-doctorateclinicalscholarresearchprogramatHarvardMedicalSchoolandisanassociatealumnimemberofHarvardUniversityandHarvardMedicalSchool.Hehaspublishedseveralscien,ficpapersinthefieldsofnutri,on,autoimmunity,toxicology,andisconduc,ngresearchinautoimmunemolecularmimicryandenvironmentallyinducedimmunereac,vity.Heisonthescien,ficeditorialboardfortheJournalofFunc,onalNeurology,Rehabilita,onandErgonomicsandAlterna,veMedicineTherapiesinHealthandMedicine.Heisalsoisarequestedscien,ficreviewerforseveralscien,ficjournals,includingtheBri,shJournalofMedicineandMedicalResearch.Inaddi,ontohiscontribu,ontofunc,onalneurology,Dr.Kharrazianhaswri\ennumerouspapers,manuals,andclinicaleduca,onalmaterialforbloodchemistryanalysis,hormoneandendocrineanalysis,compleximmunologytes,ng,gastrointes,nalanalysis,andfunc,onalmedicine.Hehastrainedmorethan20doctorstoteachhismodeloffunc,onalmedicinethroughoutthecountry.Dr.Kharrazian’sapproachandclinicalmodelaretaughtatmorethan200loca,onseachyear.Dr.Kharrazianisalsotheauthorofthebest-sellingbook,WhyDoIS,llHaveThyroidSymptomsWhenMyLabTestsareNormal?ThisbookledreaderstodevelopofthelargestHashimoto’scommunity(Hashimoto’s411)onFacebook,andthedevelopmentofanon-profitpa,entadvocacygroup(Hashimoto’sAwareness)tosupportthyroidpa,entsfromaroundtheworld.Dr.KharrazianservesontheNutri,onLeadersCouncil.Thisisanen,tythatdirectlycontributestotheAccredita,onCouncilforNutri,onProfessionalEduca,on,ACNPE(universitynutri,onprogramaccredita,on),BoardforNutri,onSpecialists,BCNS,(creden,alingBodyandAdvocacy),andtheAmericanNutri,onAssocia,on,ANA(educa,onalandadvocacyorganiza,on).Dr.Kharrazianisaconsultanttothenutri,onindustryandhasformulatedmorethan100products,whichareusedbyhealthcareprofessionals.HealsoservesasaconsultanttoCyrexLaboratory,whereheprovidesexpertclinicalopiniononthedevelopmentofcompleximmunologyprofiles.Dr.Kharrazianhasaprivateprac,ceforpa,entsfromaroundtheworldseekingnon-pharmaceu,calalterna,vestomanagechroniccondi,ons.Heusesdiet,nutri,on,neurologicalrehabilita,veexercises,andlifestyleapplica,onsinhisprotocols.Hisprac,cehasatwo-yearwai,nglistandislimitedtopa,entssufferingfromchroniccondi,ons.MostofDr.Kharrazian’spa,entsarereferredfromotherhealthcareprofessionalsbothna,onallyandinterna,onally.Asaneducator,researcher,andclinician,Dr.Kharrazianhasblendedhisscien,ficresearchwithclinicalexperiencetodevelopeffec,veconceptsandapplica,onsforcomplexhealthdisorders,whichhavebeenusedbythousandsofhealthcareprofessionalsandpa,entsaroundtheworld.

Dr.JoelBrandonBrockMSN,BSN,RN,DC,NP-C,DCM,DCN,DAAIM,BCIM,DCBCN,DACNB,FACNB,FICC

Dr.BrandonBrockisaCer,fiedFamilyNursePrac,,oner,Chiropractorandafunc,onalneurologydiplomatewithmul,pleclinicalinterests,includingFunc,onalIntegra,veNeurology.InDallasTexasheservesasastaffclinicianatCerebrumHealthCentersanddoesworkatInnova,veHealthandWellnessGroupandFounda,onPhysiciansGroup.Alongwithbeingaclinician,Dr.Brockhasapassionforlecturingandprovidinglearnerswithdidac,candacademicskillsinawaythatiseasytodigest,comprehendandu,lizeinaclinicalsehng.Hehasdevelopedthousandsofmul,disciplinaryhoursofcurriculumthatheorothershavepresentedpertainingtoneurology,nutri,on,physicaldiagnosis,pharmacology,immunology,endocrinology,andthishasimpactedstudentsofmul,pleeduca,onalandclinicalbackgrounds,includingmedicaldoctors,nurseprac,,onersandchiropractors.Offeringeduca,onalsupportforPhysicalandOccupa,onalTherapists,Die,,ans,Naturopaths,Acupuncturists,OrientalMedicalPrac,,oners,HealthCoachesandlaypeoplethatwanttolearnhowtoliveahealthierlifeisalsopartofDr.Brock'smission.HeenjoysteachingforApexEnerge,csaswellasprovidingeduca,onandsupporttofacilitatelearningformul,plegroupsandagencies.Thisincludesstateassocia,onmee,ngstogovernmentalpanels.Dr.Brockisalsoenjoyingtheprocessofdevelopinginparthisownfunc,onalneurologyprogram(Func,onalNeurologySeminars),andshorteduca,onallecturesthatmanyhealthcareandmedicalproviderscanlearnfromoveravarietyoftopics.Dr.BrockiscurrentlyaclinicallecturerofPharmacologyattheIns,tuteofHealthcareProfessions,clinicalneurologylecturerattheAcademyofOsteopathicScienceandvicepresidentoftheInterna,onalAssocia,onofFunc,onalNeurologyandRehabilita,on(IAFNR)andaboardmemberoftheAmericanAcademyofIntegra,veMedicine(AAIM).HewasrecentlychosenasamemberfortheCouncilofHumanFunc,onandhasbeenanexpertonTAPIntegra,ve.Dr.Brockreceivedthemostoutstandingfunc,onalneurologyteacheroftheyearfromtheACAcouncilofNeurologyfouryearsstraightandtwo,mesfromIAFNR(Interna,onalAssocia,onofFunc,onalNeurologyandRehabilita,on).ThisyearDr.BrockreceivedthehumanitarianawardasaresultofhisresearchoninjuredMilitaryVeteransandPTSDandtrauma,cbraininjuryfromIAFNR.Dr.Brockisalsothehonorablerecipientofthepres,giousLivingLegacyAwardfromSamfordUniversi,esIdaMoffe\SchoolNursingin2015andhewasrecentlynamedthespotlightstudentofhisdoctoralprogramatDukeUniversity.HeholdsdiplomatestatusinNeurology,Conven,onalMedicine,Nutri,on,Integra,veMedicineandafellowshipfromtheInterna,onalCollegeofChiropractorsaswellastheAmericanChiroprac,cNeurologyBoard.CurrentlyDr.BrockisworkingonaDoctorateofNursingPrac,cefromDukeUniversityandheisplanningonimmediatelyuponcomple,onoftheprogramatDuke,star,ngaconjoinedPhDprogramwithamajorinnursingandaminorinbehavioralneuroscience.Dr.Brock’suniqueblendofclinicalandteachingexperiencealongwithabackgroundinmedicine,chiroprac,c,neurologyandnutri,onhascreatedaveryuniqueclinicalbackgroundthathashelpedhimtreatdifficultcasesandofferscomprehensiveandmul,---perspec,veanglesoneduca,onandclinicalpresenta,ons.Ul,matelyyoucantypicallyfindhimspending,mewithhisnewwifeTaraorhischildren,Addy,Zoey,KennedyandConner.Theyalllovetotravel,read,learnandlivelife.Dr.Brock'swifeisafantas,cEnglishteacheratSunnyvaleHighSchoolandDr.BrockpointsoutthathiswifeTaraisthebestandmostgroundedthinginhislife,alongwithhiskids,co-workersandfriends.

4

Copyright © 2011, Datis Kharrazian SMUCGS01(0111).PPT

7

Dot-Blot with Monoclonal Anti-Gliadin and Protein Antigens

Clinical Concepts

Reviewofthecomponentsofthecerebellarexamina+on:

• Observa,on• Speech• Reflexes• Posture• Motor• Gait• Eyes

12

Observa2on (Step One) Demonstra2on

Afewthingscanbedonetomakesurethecerebellumisworkingwell

• PosturalSway•  Makesurethisisnotorthopedicordrug-related

•  Inten+onorac+ontremor•  Notatrest–basalganglionic

• Midlinetremoror+tuba+on•  Headshakethatissmallandhighfrequency.

Makesurethereisnotneurodegenera+vedisease,thyrotoxicosis,orthosta+ctremor,enhancedphysiologictremorduetopheochromocytoma,orhypoglycemia.

13

Speech exam and demonstra2on

Checkthepa,entfordysarthria•  Makesuretheydonothaveaphasia.•  Makesuretheydonothavenervedamage,infec,on(i.e.,acutedisseminatedencephalomyeli,s),autoimmunity(i.e.,MS),neoplasm(i.e.,primarybraintumorormets),vasculardamagetothebrainstemorcerebellum,TBI,alcoholism,orseizure.

Checkthepa,entfordysphagia

•  Ruleoutinfec+on,esophagealstricture,extrinsiccompression•  Makesuretheseextrinsicfactorsarenotafactor:

•  Cervicalspinepathology•  Lymphnodeissues•  CNissues•  Thyroidpathology

Observespeechandpalpatetheneckandthecervicalspine.

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Reflexes and Demonstra2on

DoyourMyotac+cStretchReflexes(MSRs)•  Compareuppertolower,sidetoside,andextensortoflexor.Lookforalossoftonewithlossofcoordina,onandenergywithnolowermotorfindings.

Doyourpathologicalreflexes•  Uppermotorlesionsaretypicallynotclearunlessundercertaincondi,ons.

•  Foot–hand–superficialabdominalreflex.Checkformuscletone

•  Palpatefortonesidetoside,lePtoright,uppertolower,andproximaltodistal.

Lookforpendulousreflexes•  Notalwaysaclearsignbutcanbehelpfulwhenusedinconjunc,onwiththeothertes,ng.

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Movement

• DoRomberg’s(sway).• Havethepa,entraisearmstolookfordriP.• Doreboundcheck(aPerarmraise).•  Lookfordysmetria(fingertonose).•  Lookfordysdiadochokinesia(rapidalterna,ngmovements).

•  Lookfordyssynergia(withcorestrength).•  Lookforataxia(withanteriorcerebellum).•  Lookforalossinarmswing(hypotoniaandataxia).

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Gait demonstra2on

•  Havethepa,entdoaheeltoshin(startoutlayingdown).

•  Thenhavethepa,entstand,observehowtheygetup(thismightbedifficultduetotoneandcoordina,on).

•  Havethepa,entwalkintandem(maybehardduetowide-basedgait).

•  Determinepathologicaldifferencesinfrontal,basalganglionic,cor,cospinal,andcerebellarissuesifthereisaproblem.

•  Lookforataxiaandothercauses.•  DDX:Friedreich’sataxiaversusCMTversusrootlesionversuspolyneuropathyversusmononeuropathy.

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Summary Eyes

•  Difficultywithfixa,on•  Possiblever,calnystagmus•  Difficultywithgazeholding•  Endgazeorsaccadichypermetria•  Impairedsmoothpursuits•  Tonicgazedevia,on•  Ipsipulsion•  Contrapulsion•  Hypermetricsaccadesorabnormalan,saccades•  VORpersevera,on

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