Neurological Disorders & Follow-Up Care
Migraine – Diagnosis & Modern Prevention
Assessment, Diagnosis, and Individualized Treatment
Migraine is a neurological disorder that can significantly impact daily life and quality of life. Recurring attacks, accompanying symptoms such as nausea, and sensitivity to light and sound make a thorough evaluation and treatment necessary.
At the Wilhelminenberg Medical Center, we offer a comprehensive neurological evaluation and—when appropriate—a personalized migraine prevention plan.
Diagnostic Evaluation of Migraine
These include:
- detailed medical history
- neurological examination
- Assessment of Triggers and Comorbidities
- further tests as needed (such as an MRI of the brain)
When is migraine prevention recommended?
Preventive treatment is considered when:
- Migraine attacks are frequent or very debilitating
- Acute medications are not effective enough or are poorly tolerated
- whose daily life or ability to work is significantly impaired
The goal is to reduce the frequency, intensity, and duration of the seizures.
Modern Forms of Migraine Prevention
Conventional medications (e.g., beta-blockers, antidepressants, antiepileptic drugs) can be effective, but they may not be sufficient for all patients or may be poorly tolerated.
Monthly subcutaneous injections (e.g., Aimovig®) can be self-administered, but are often considered uncomfortable and can cause local skin reactions that last for several days.
Quarterly infusions (e.g., Vyepti®) are the focus of our services. They are administered in the office, are generally very effective and well-tolerated, do not require self-injection, and are given only once every three months. As a result, they represent the most convenient and practical option for many patients.
Neuromodulation and nerve stimulation can be helpful for certain patients, but the effects vary from person to person and are generally less reliable than those of medication-based prevention.
Botulinum toxin ( Botox®) is a well-established treatment for chronic migraine, but we do not offer it at our practice. However, if it is indicated for you, we would be happy to provide information and help you navigate your options.
Joint Decision
Memory & Cognitive Changes: MCI, Dementia Evaluation
Assessment, Classification, and Support
Over time, many people notice changes in their memory, concentration, or mental performance. Not every instance of forgetfulness indicates dementia—but at the same time, it’s important to take these changes seriously and have them evaluated early on.
At the Wilhelminenberg Medical Center, we support people who are concerned about their own cognitive functioning, as well as family members who notice changes in older relatives.
When Memory and Performance Begin to Decline
Cognitive changes can manifest in various ways, such as:
- increasing forgetfulness
- Word-Finding Difficulties
- Difficulties with complex tasks
- more rapid mental fatigue
- Uncertainty in Everyday Life
Such symptoms can have many causes—ranging from stress, depression, or sleep disorders to early-stage neurological disorders. An early neurological evaluation helps distinguish between these conditions.
In addition, there are other vaccinations that may be advisable depending on an individual’s specific situation, such as certain pre-existing conditions, family history, or particular life circumstances.
Standard vaccinations are generally in stock and can be administered without any special preparation.
Mild Cognitive Impairment (MCI)
Mild Cognitive Impairment (MCI) refers to a measurable cognitive impairment in which the ability to perform daily activities is still largely intact. MCI is not dementia, but it may—though not necessarily—be a precursor to it.
Early diagnosis is particularly important at this stage, because:
- treatable or reversible causes can be identified
- vascular risk factors can be specifically targeted
- it will be easier to monitor how things develop
Early Detection and Types of Dementia
Dementia is not a single, uniform condition. Among the most common forms are:
- Alzheimer's dementia
- vascular dementia
- Hybrids
It is important to make a precise distinction, as treatment, prognosis, and support services vary significantly.
What Can Be Improved in Cases of Vascular Dementia
In vascular dementia, impaired blood flow to the brain plays a central role. There are often specific therapeutic approaches for this condition, including:
- Consistent blood pressure control
- Treatment of Lipid Metabolism Disorders
- good diabetes control
- Prevention of Blood Clots and Stroke
- Adjustment of Lifestyle Factors
Early treatment can slow the progression of the disease and help preserve existing abilities for longer.
Treatment Options for Alzheimer's Disease
What kind of assessments are necessary?
The dementia evaluation is conducted in a structured and interdisciplinary manner and may—depending on the specific issues—include:
- detailed neurological history
- neurological examination
- Psychological Assessment of Performance and Neuropsychological Diagnostics
- Imaging and laboratory tests (if necessary)
- Progress Checks
The goal is to arrive at a clear, comprehensible diagnosis and a realistic assessment of future developments.
Support for Family Members
We therefore offer:
- clear and understandable information
- Guidance on Dealing with Change
- Support in Decision-Making
- Information on Additional Support Services
Our Approach
Early assessment means:
- Clarity Instead of Uncertainty
- Taking Action Instead of Waiting
- Relief for Those Affected and Their Families
Stroke – Follow-up Care and Prevention
Care Following a Neurological Event
A stroke or a transient ischemic attack (TIA) is often a life-changing event for those affected and their families. Even after acute treatment, many questions remain unanswered: regarding further treatment, the prognosis, lasting limitations, and how to prevent future episodes.
At the Wilhelminenberg Medical Center, we provide long-term neurological care to people who have suffered a stroke or a TIA —with the goal of stabilizing their functions, reducing risks, and offering guidance on how to proceed.
After the Acute Phase—What's Important Now
After being discharged from the hospital, a phase begins that can be challenging both medically and logistically. In addition to physical recovery, the focus is on:
- Adjustment and Review of Medication
- Assessment of Residual Neurological Deficits
- Dealing with Cognitive or Emotional Changes
- Planning for Rehabilitation and Follow-up Care
A structured neurological follow-up care program helps ensure that this phase is managed safely and transparently.
Hypnosis does not replace medical treatment, but rather complements it in areas where the body and mind work closely together.
Neurological Follow-Up Care After a Stroke or TIA
Our neurological care includes, among other things:
- Follow-up Care After a Stroke or TIA
- Assessment of Motor, Sensory, and Cognitive Functions
- Assessment of fatigue, concentration, or memory problems
- Assessment of Dizziness, Unsteady Gait, or Speech Changes
- Assessment of Daily Functioning and Resilience
In doing so, we keep an eye on both the visible and less obvious consequences of a stroke.
Secondary Prevention – Preventing Future Strokes
A key component of post-stroke care is secondary prevention—that is, the targeted reduction of the risk of further strokes. This includes:
- Consistent blood pressure control
- Treatment of Lipid Metabolism Disorders
- Management and Treatment of Diabetes
- Coagulation Assessment and Treatment (e.g., for Atrial Fibrillation)
- vascular follow-up examinations
These measures are tailored to individual circumstances and reviewed on a regular basis.
Cognitive and Psychological Consequences
- Memory or attention disorders
- more rapid mental fatigue
- emotional instability
- depressive symptoms or anxiety
We consciously take these aspects into account and, when necessary, collaborate across disciplines with psychological assessment, psychiatry, and therapy.
Interdisciplinary Support
- Physical Therapy to Promote Mobility, Balance, and Safety
- Psychological Assessment for Cognitive Issues
- Psychiatry for Emotional or Psychological Stress
The goal is to provide care that is tailored to real-life needs.
Support for Family Members
We offer:
- Clear explanations of test results and the course of the condition
- Guidance in Decision-Making
- Support in Coping with Change
Our Approach
Polyneuropathy & Nerve Disorders
Assessment, Diagnosis, and Care for Nerve Damage
Sensory abnormalities such as tingling, numbness, burning, or pain in the feet or hands are often tolerated for a long time or investigated in a nonspecific manner. It is not uncommon for these symptoms to be caused by polyneuropathy —a disorder of the peripheral nerves.
At the Wilhelminenberg Medical Center, we offer a structured neurological evaluation and long-term care for polyneuropathies of various causes.
What is polyneuropathy?
Common symptoms include:
- Tingling, numbness, or a “pins-and-needles” sensation
- Burning or stabbing pain
- reduced sensitivity to temperature
- Unsteadiness when walking
- Loss of strength or rapid fatigue
In addition, there are other vaccinations that may be advisable depending on an individual’s specific situation, such as certain pre-existing conditions, family history, or particular life circumstances.
Standard vaccinations are generally in stock and can be administered without any special preparation.
Possible causes
- Diabetes mellitus
- Alcohol consumption
- Vitamin deficiency (e.g., B12)
- Side effects of medications or chemotherapy
- inflammatory or autoimmune diseases
- Circulatory Disorders
- idiopathic polyneuropathies (with no clear cause)
A thorough evaluation is crucial, as treatment and prognosis vary significantly depending on the cause.
Neurological Evaluation
The assessment is conducted on an individual basis and may include:
- detailed neurological history
- neurological examination
- Classification of Pain and Sensory Patterns
- Targeted laboratory tests
- Progress Checks
The goal is to identify treatable causes and to realistically assess the prognosis.
Treatment Options
- Treatment of the underlying condition (e.g., better blood glucose control)
- Adjustment or Change in Medication
- Pharmacological Treatment of Neuropathic Pain
- Complementary non-pharmacological measures
Not all cases of polyneuropathy are completely reversible—the goal is often to slow the progression of the disease, alleviate symptoms, and improve safety in daily life.
Interdisciplinary Support
- Pain medicine, particularly for chronic neuropathic pain
- Physical therapy to improve balance, strength, and stability while walking
- Psychiatry: When Chronic Symptoms Cause Psychological Distress
Support in Everyday Life
In addition to medical treatment, safety in daily life is an important consideration, such as:
- Fall Prevention
- Dealing with Loss of Sensitivity
- realistic assessment of resilience
Here, too, we provide personalized, practical advice.
Our Approach
Epilepsy – Diagnosis & Support
Classification and Diagnosis
Epilepsy is a neurological disorder characterized by recurrent epileptic seizures. However, a single seizure does not automatically mean that a person has epilepsy. This makes a thorough neurological evaluation all the more important in order to correctly identify the causes, risks, and appropriate management.
At the Wilhelminenberg Outpatient Center, we care for people with diagnosed epilepsy, as well as patients who have experienced a first-time or unexplained seizure, in close collaboration with specialized centers.
What is epilepsy?
Generally speaking, the following distinctions are made, among others:
Focal epilepsies, in which seizures originate in a localized area of the brain. These can manifest, for example, as:
- sudden pauses or "being absent"
- unusual sensations (tingling, warmth, smells)
- involuntary movements of individual body parts
- Speech disorders or temporary difficulties with comprehension
- altered perception or brief confusion
Generalized epilepsies in which both hemispheres of the brain are involved from the onset. Typical manifestations include:
- brief lapses in consciousness (e.g., absence seizures), often lasting only a few seconds
- sudden loss of muscle tone or muscle stiffness
- generalized seizures with loss of consciousness
- sudden collapse without warning
Here, too, the severity and nature of the symptoms vary widely.
Not every seizure is epilepsy
- Acute Metabolic Disorders
- Fever
- Lack of sleep
- Effects of alcohol or medication
- syncope (fainting)
A neurological evaluation helps distinguish between epileptic and non-epileptic events.
Neurological Evaluation for Seizures
- Detailed medical history (including information provided by family members)
- neurological examination
- Classification of the seizure type
- Review of Possible Triggers
- Coordination of further diagnostic tests (e.g., EEG, imaging)
For specific issues, we work closely with specialized epilepsy centers.
Treatment and Course of the Disease
Epilepsy is usually treated with medication. The choice of medication is individualized and depends on:
- Type of epilepsy
- Age and Life Circumstances
- Comorbidities
- Compatibility
The goal is to achieve the best possible seizure control with as few side effects as possible. The treatment requires regular follow-up visits and adjustments.
Daily Life, Safety, and Counseling
- Work and Resilience
- Driving and Fitness to Drive
- Sleep, Alcohol, and Lifestyle
- Safety in Everyday Life
We help you make sense of these issues and provide personalized, realistic advice.
Collaboration and Networking
- specialized epilepsy centers
- Psychiatry (e.g., in cases of psychological distress or comorbidities)
- additional therapeutic services as needed
Our Approach
Our goal is to explain epilepsy in a way that is easy to understand, to alleviate fears, and to provide long-term, reliable support to those affected—regardless of whether a diagnosis of epilepsy is confirmed or not.
School Anxiety – When Everyday School Life Becomes a Burden
After the first few weeks of the new school year, it often becomes clearer how children and teenagers are really doing. While some
Back to Everyday Life—When It’s Hard to Get Back into a Routine
For many people, the second half of August is a time of transition: vacation is coming to an end, everyday life is drawing nearer—and not
Exercising in the Summer Heat—What Your Body Needs
Exercise is good for your health—even in the summer. At the same time, the heat poses additional challenges for the body. Many people find that their usual exercise routines
OUR Offer
for
Patients
Our care is tailored to the different stages of life and challenges that people face when they come to us. We have identified four key areas in which we focus our medical and therapeutic services.