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ffi (, SourHnruv CaulroRlrr.r NeuRot,ocy Sprctnltsrs Mrotcal Gnoup !- August 13,2009 SUPPL-qMpNTAL REPORT To All Whom It Cllcerns: RE: DOB: DATE: KAUWE, Daniel 05/t2/77 08/13/09 U. MICHAEL TAHOAD, T,D, B0{rd ;d.!r:led Nauaolocltt i, rlo* A.r a,'can AsSoclrtlon oj - ..troor{S[us,tc FlCdrcinO MARTIII J. BACXTAN, T.O. Bo.rd Ccrliticd N.urologltl E lcctiodisgnoslic rftic.r: OUHTAIX VALLEY 1160 Warncr 4v6.. urto 'l t I runtain Valley, CA S?7O8 Et: (7141 546-5505 ,r: 1714) 54A-U25 {rTA ArA lzt S. Bristol St.. r'1. 105 fntr An., CA927U n: Qrl S1O-1E4O x: (711) 310-2318 rxTrficTox ttAcH 022 8.tdt glvd., n 119 nu.|glon 8..d| CA 92C17 t: 171,ll C11-9|.22 t: (lltl U1-t2dI u)ta WE 'dC.nto'' Ava,, nw qo CA iitllC Mr. Daniet Kauwe has treen m) patient since 12120(ii. This patient has r lri"ior'yol'lli,' infectioft,. neuiopathic pain, chronic fatigue, and attention deficit. Fie has bce:r tried on multiple medications for his neurological condition .r. Despite taking Provigil, Nuvigil, and in the past a trial of Adderall and Ritalin--the patient continues to have fatigue and it is very diflicult for him to perform daily activities. Even while driving, the patient can fall asleep. He has, instead. been riding a bicycle. The patient asked me to provide this information. If there are any further questions by any interested parties, please do not hesitate to contact my office. y1.n.o/-/ a&./ M. MICHAEL MAHDAD, M.D. Diplomate, American Board of Psychiatry and Neurology Fellow, American Association of Neuromuscular & Electrodiagnostic Medicine (A.A.N.E.M.) Dariush S. Lavi, M.D. Suite 109 1503 S. Coast Drive Costa Mesa, CA 92626 MMM:tlt cc: ffi , SoUTHERN I; :'t : ,'l !Mav 7.2009 'Dariush S. Lavi, M.D. , Suite 109 ,li tSOl S. Coast Drive, .r,i Costa Mesa, CA 92626 l - tr. ,' Dear Dr. Lavt: '.' l' { CnlrronxrA NEURoLocY Srpcnlrsrs Mpotcu, Gnoup RE: KAUWE. Daniel DOB: DOE: 05/t2/77 0s/07t09 NEUROLOGIC RE.EVALUATION T. TICHATL TAHOAD, T.O. Bo.rd Ccrllfl.d Ncurologbl Fotlow, Am.rlctn A3loclrtlon of E lcctrodl!gno!tlc Madlclna f,ARTtN J. BACTTAI|. I.D. Bo.rd Cartlfl.d Naurologltl El.ctrodl!gno.tlc ,ttlc..: :OUNTAIN YALLEY il160 Wamcf Avo., iuit. I t t :ount6in Valley, CA 927 08 '.t: (7111 5,16-5505 '.r: (714) il84125 iATTA A'IA 621 3. Brlr!,ol Sl., uitc105 rnt Ao., CA927O1 d: Qla) 54O-1|U0 tx: (7111c4,0-2419 utflxoTott tlActl tE22 8.tdt 4tu.t., tltt 119 nt&{rtsrS..dt,CAnUl rrt (7111o{14e22 tx: (7111Ul-C202 vna ?t(toE ilC.rryo''|f..; ff. tot 1.... :3+?!ia . : ^".$F" , '+rfjg Mc" Daniel Kauwe returned to my Fountain Valley office on May 7. 2009 for a neurologic re-evaluation. The patient has not been taking any of his prior medications. His migraine is sorirewhat improved. However, he complains of intermittent pain throughout his limbs which has bebn ongoing for the past few years; afterwards, he becomes very fatigued. His examination, today, reveals symmetrical reflexes; plantar responses are downgoing. Vibration sensation is possibly slightly decreased in the toes. Gait is intact. MPRESSION Chronic pain; possible neuropathic pain. DIS CUS SION / RECOMMENDATIONS The patient wants to be referred to the UCLA Medical Center's Neurology Clinic. I will try to make those arrangements. Thank you, again, for this referral. Should there be any further questions, please do not hesitate to contact mv office. n,r.rh/ *A/ M. MICHAEL MAT{DAD, M.D. Diplomate, American Board of Psychiatry and Neurolory Fellow, American Association of Neuromusctlar & Electrodiagnostic Medicine (A.A.N.E.M.) MMM:tlt { SourHunn CllrroRNtA NguRorocv SpecrALtsrs MsurcaL GRoup RE: DOB: DOE: M. r|ICHAEL I{AHOAO. II.D. Soard Cortifl6d NourologlFl Fallow. Amorlcan Attocltllon ot E!ectrodlagnostic irodhlf It MARTIN J. BACKMAN. M.D. Eoard Certitiod Nsurologlqt E lactrodiagnostic tGNACtO lr. CARRILLO-I|Ul{EZ, n.D. Board Cortifiod Neurologls[ Otticos: FOUNIAIN VALLEY 11160 Warner Ave., Suita 1 1 1 tountain Valloy, CA 92708 lel; (714) 516-5505 . ax: (7 1 41 546-0425 iANTA A}IA 521 S. Bristol Sl., ;uite 105 ianta Ana. C492704 el: (711) 510-1810 ax: (714) 540-2319 UI{TII.IGTON BEACH 1822Bo.ch Blvd., uila 119 untlngton Botch, CA 92847 tt: (714) 841-9922 )ri (711r 841-3292 v|l{E 300 Ssnd Canyon Avc,, rll.809 'ilr.c, CA g2gl8 t: (910) {1-0625 OUIA HILtt 121 Ptt a d. V.l.ncll, it.tot .,, .t, ". Mr. Daniel Kauwe ieturned to my Fountain Valley office neurologic re-evaluatibn: The patient is complaining of poor concentration and however, they have not accepted him. He has moved a Nedrologist closer to his new residence. KAUWE, Daniel 05/t2/77 09/l l/08 on September I l. 2008 for a attention. He tried to go to UCLA; to Los Angeles and is tryrng to find He continues Wellbutrin XL 300 mg, daily. His migraines have reduced ramatically. He has used Imitrex once in the past 3 nronths. He is taking Topanrax 50 mg, twice a day. He wants to go back on Adderall. l. Attention Deficit Disorder. 2. Depression. 3. Migraines. DISCUSSION / RECOMMENDATIONS I wrote a prescription for Adderall XL 20 mg, take daily. I will forward all his records to the local Neurologist where he lives, after he finds one. Should there be any questions, please do not hesitate to contact my office. His neurological and regular, IMPRESSION MMM:tlt cci Dariush S,La.vi,M,D, 1503 S. CowtDnve,Suite 109 -*gta l: : *,j.. +2'i: ', examination, today, is intact. Blood pressure is 130/80; pulse rate is 72 *f4,r'fu/ 4//''/ M. MICHAEL MAHDAD, M.D. Diplomate, American Board of Psychiatry and Neurolory Fellow, American Association of Neuromusc ulu & Electrodiagnostic Mdlicine (A.A.N.E.M.) ( SouruBnx CnlrroRNrA Nnunolocv MsprclI, Gnoup May 29,2008 : Spncrnlrsrs II. MICHAEL XAHOAD, H.D. Bo{rd Ccrllflcd Ncurologlsl f sllow. Am6rlcaai /arsociallon af lloclrodiagnost;c M€dlclno MARTIN J. BACKilAN, T.D. Borrd Ccrlitiod Nrurologlst Eleclrodiagnostic IGIIACIO M. CARRILLO.NUNEA. il.D. Eoard Cortified Nourologlsl Ottic.s: FOUNTAIN VALLEY 1 1 160 Warnor Ave., Surt6 | 1l Folnfain Valley, CA 92708 Tal: (711) 548-5505 Fax: 1714) 346-0125 'AI{TA ATIA ?62t S. Brlslol St., iuite t05 lanta Ana. CA 52704 t.t:1714r 510-1U0 tar: (711r 310-2319 IUNTII{G7OII BEACH 7822 Beech Blvd., iuito 419 luatingf on Bc.eh, CA 92811 .t: (714, U1-5522 8xi (f11) 511-3292 lyDtE t300 8.od Ctoyon Avt,, ullo Coe tlnc, CAe261E ,t: l94g'l-3114625 touxA HltLt t521 ?.r.o dav./',nala, 'llt tOt gunt Hlllt, CA UtC6t tr 0$1 4QQ.0626 for a only L 2. He continues with Wellbutrin XL 300 mg, daily. His examination is unchanges. l',, IMPRESSION Migraine headaches Chronic cervical strain. Attention Deficit Disorder/Depression. DISCUS SION / RECOMMENDATIONS The patient may need to follow-up with a Neurobehavioral Neuroloeist in regards to his Attention Deficit Disorder complaints and/or his other neuropiycliological abnormalities. I will be available for further follow-ups. Should there be any questions, please do not hesitate to contact mv office. n, n"o/^/ oee/ MMM:tlt cc: Dariush S. Lavi, M.D. 1503 S. Coast Drive, Suite Costa Mesa, CA 92626 M. MICHAEL MAHDAD, M.D. Diplomate, American Board of Psychiatry and Neurolo gy Fellow, American Association of Neuromuscular & Electrodiagnostic Medicine (A.A.N.E.M.) 109 M. MICHAEL MAHDAD. II.D. Eoard eodiflcd Ncurologlst I r:i.w, .{msrl"]an A33oclallon ol elecif rdiagnostit M6dlclno MARI|I| J. BACKUAiI, n.O. Board Cortiti6d Nourologl3t Electrodiagnostlc IGNACIO M. CARRILLO.NUNEZ, T.D. Eoard Cortified Neurologlst Mr. Daniel Kauwclreturned to my Fountain Valley office on April 17. 2008 for a neurologic re-evaluafiiln. As far as his concent'ation ancl falling asleep through the day. he is doing better with the Wellbutrin XL 300 mg, daily. He states his migraines are getting worse; he is taking up to 12 Imifex nasal sprays per month; he used to have only 2 or 3 headaches per month. The headache is mostly in the front; it throbs at times. Imitrex usually helps with it. Also, he complains of some neck soreness and upper shoulder soreness. He has seen Chiropractors in the past. His recent cervical spine x-rays have been negative. His neurological examination, today, is otherwise unchanged and intact. IMPRESSION l. Migraine h'eadaches. 2. Chronic cervical strain. 3. AttentionDeficitDisorder/Depression. DISCUS SION / RECOMMENDATIONS The patient will continue with Wellbutrin XL 300 mg, daily. I will start him on Topamax 25 mg daily--to gradually increase up to 50 mg twice a day, as a preventive measure for his migraine headaches. He needs to continue with the exercise program for his neck. He will continue with imitrex. He will gontact my office if Topama"r were not helpful or if he has any side effects. Sourtrnnru April 17,2008 NEUROLOGIC RE.EVALUATION NOTE r MMM:tlt cc: Dariush S. Lavi, M.D. 1503 S. Cqast Drive, Suite 109 {r.i;: '.; ;r ' 3. t'1"1. ' ':.1,i, ( CIUToRNIA NEURoLoGY Mnotclt, Gnoup RE: DOB: DOE: Spectrtt tsrs KAUWE, Daniel 05/r2/77 04tr7t08 M. MICHAEL MAT{DAD, M.D. Diplomate, American Board of Psychiatry and Neurolory Fellow, American Association of Neuromusculu & Electrodiagno stic Medicine (A.A.N.E.M.) Offlces: FOUNTAIN VALLEY 1 I 160 Warnor Ave.. Ssite 1 11 Fountain Valley, CA 92708 rst: (7141 546-5505 Fax: (714) 546-0425 SAIITA AI{A 2621 S. Eristol Sl.. Suita 105 9anta Ana, CA 92704 lel: (714) 540-1U0 .ar: 1714) 540-2XS IUNT'IIGTOI{ BEACH 792? geacn A|f,d.. iuite 419 luntinglon Baach. CA 92447 et: (714) 811-9922 ex: (711) 811-3292 !vlltE t300 Sand C.nyon Av... ull. 609 ilnc, Q,A 92618 )t:194913414525 tourf^ HttLt 621 P.t od.V.l.ncl., ll. tot ,un. Htllr, CA 9266N r. {er9! 4^f-t!r?! ' n,,'il *A/ -fr= i"f rvinr, CA 92610 i t.: r*t:1Q191t114626. . ., I I tlice3l f OUNTAIN VALLEY ' : 1 6J lvarn€r Avo., :rite 111 irunlain Valloy, CA 92708 : .t. 1714r 546-5505 r ax (711) 546-0425 SANTA ANA 2i2l S. Eristol St., 5.ile t05 Sarrta Ana, CA 92704 12t: 1.714) 540-1840 F ax: (714) 540-2319 XUNTIilGTOII BEACH trA22 Beach Blvd., 9tile 419 ; i Hlnlington Bcach, CA e2gal ret: (711) 841-9922 .i Fat l7t4) E11.?202 ,: rRv0{E l 1 6300 S.nd Crnyon Aya,; 3r,;rle 609 t' t Sourn r nN CA [.t FoRN tA Ne u nolocy S pECt At.ls-t-s lltnptcnr, GRoup M. [|rcHAEL MAI{OAD, M.p. .toa.d Cortifiod Neurologlst loll$w, Amo.ic6n Aotoci6tldn ot i l{ictrodrignorlic Modiclnc UART[il J. AACKI{A||. u.D. $crrd Certlti6d NeurologiSt E loclrodragnoslic tcNActo M. cARRILLO.t{Ut{EZ, I.O. 6oa.d C€rtrfi6d N6urologist January 24,2008 NEUROLOGiC RE.EVALUATION NOTE }' ' i:r iMMM:tlt RE: DOB: DOE: KAUWE, Danicl 05/t2t77 0u24t08 M. MICHAEL MAHDAD, M.D. Diplomate, American Board of Psychiatry and Neurology Fellow, American Association of Neuromusc ular & Electrodiagnostic Medicine (A.A.N.E.M.) Mr. paniel Kauwe ret'[med to rny Fountain Valley office on Januarv 24. 2008 for a neuroldgic re-evaluation. The patient rvas not helped by Adderatl; he actually felt edgy & tremulous with it. He has had trouble with Ritalin in the past, as rvell. His neLrological examination, today, is intact otherwise. IMPRESSTON As before. DISCUSSION / RECOMMENDATIONS I discussed with him in detail that it is doubtful,that he has a pure A.D.D.; he might have depression. He te[s that about a year ago, he was on Lexapro'qnd that helped rvith his symptoms to some degree. As he has fatigue, I started him on Wellbutrin XL 150 mg, daily. The patient rvill contact my office over the next 2 or 3 rveeks with the results of the treatment. frl,r:/n/ 4&./ '.. "t,L.t:.: .^AU'{^H'LL' t.1,52' P)'',o.ta lufti lOC ,.t . r,,, agwt HNt, CA 1i tr: lg10l lAJ{Cill ') oourHERN Cauronnm Nnuno[*" SpEcHl,lsts Mnprc.lr, Gnoup r. IICHAEL TAHDAO. X,D. 8o!rd Ccrlitlad Nourologlrt Follow, Am.rlcan A$oclallon ot Elrctrodirgnosllc MGdlclnr ilART|l{ J. 8ACKtAil, n.D. Borrd Ccrtificd Nburologllt Eloclrodiagnorlic rcilAcro r. cARRILo-ilUNEZ, r.O. Board Cartifiod Neurologisl December 27,2007 INITIAL NEUROLOGIC EVALUATION/ oFTrcE NOTE I jl Mr. Daniel Kauwe wab,seen for an office, on December 27. 2007. RE: DOB: DOE: KAUWE, Daniel 05/12/77 12t27t07 initial neurologic evaluation, in my Founfain Valley Oftlc.r: FOUNTAI'{ VALLEY ' t 1 160 Warnsr Avc., Suite 1t I Fountain Vallsy, CA 92708 Tsl: (714) 546.5505 Far: (714) 546-0.125 SAIITA ANA 2621 S. Iristot St., Suito 105 Ssnta Ana. CA 92701 Tel: (714) 5{0-1840 Far: (7ta) 540.2319 HUI{TII{GTOil BEACX '17822 Beach 8lvd., Suitc 4t9 Hunlinglon Blrch, CA 926a7 Tol: (71a) E41.9922 Frr: (71r1) 84'l-3292 IRVINE 18300 Ssnd Canyon Avc., Sullc 809 rrvlnc, CA 9261! rcl: (9'10) 3{1.0525 ,AOUt{A fitLLt '352t P!r.o da V!l.ncl!, iui|. 10t tgutr Hill., CA 020t3 cl: (019) 'l5t-0t26 HISTORY OF INJURY-ILLNESS/TREATMENT HISTORY/CURRENT COMPLAINTS This is a 3O-year-old, ambidextrous man who--for the past few years--has been having fatigue, lack of concentation, and attention deficit. He has seen a,Neuropsychologist and a Neurologist in the pas! he had neuropsychological testing a sleep study, an MRI scan, and an EEG. All of this was negative, except for a neuropsychological test that was suggestive of A.D.D. He was hied on futalin in college; however, he iquld not tolerate it and he has not taken any medication. Most recently, he had acquire a job in a payroll departnent where he cannot make any mistakesn and he states that by the middle of the day he cannot concentate very well--and, he is afrfid of losing that job. r i PAST MEDICAI HISTORY / SOCIAL HISTORY / FAMILY HISTORY The patient's past medical history is negative--except for a sinus surgery and he has seasonal allergies. He also has a history of migraines, although not intense at this time. He is single, with no children. He is a non-smoker and a non-drinker. Current Medications / Allereies Zyrtec; Singulair; occasional Imitrex; and another medication that the patient cannot remember. .. No known allergies to medications. NEI.JROLOGICAL EXAMINATION Blood pressure 1101601' pulse rate 72, and regular. CraniaL nerves tr-)il wtre intacf funduscopic ex,rm was normal. Motor exam rwealed full sfiength in the upper and lower extremities, symmetrically; pronator sign was negative. Gait was ntact-incfudngtandqn gut. \\ere was no cerebellar ataxia or dysmetria. There were no carotid or cranialbruits. I "-.ii;)pli:iue,i!, n€.:rl' Tail€'" ; KAUWE' Daniel ? t December 27,20A7 .t! IMPRESSION 1. History of Attention Defioit.Iiisorder, associated with fatigue. 2. Possible underlying dppression. t & I started the patient on Add@l)G,'20 qgdaily. I will re-evaluate him in 4 weeks. Should there be any furthe questions, pleasg d0 nothesitate to contact my office. ?. MMM:tlt M. MCHAEL IvIAIIDAD, M.D. Diplomate, American Board of, Pqrchiatry and Neurology Fellow,'66oican Association of Neuromiscular and Electrodiagnostic Medicine(A.A.N.E.M.), ,
