As an HSG site, the UAMS HD Clinic will offer patients the opportunity to participate in tests of new medications for the disease. The National Institute of Medicine and the Huntington’s Disease Society of America are sponsoring various studies of medications which may prove to delay the onset of HD symptoms, alleviate symptoms, or even cure the disease. Previously, Arkansans with HD had to travel to Houston or St. Louis to receive experimental drugs.

The UAMS HD Clinic team includes the following members:

Samer D. Tabbal, M.D.
C. Winston Brown, M.D.
Roger D. Williams, Ph.D.
Richard Zraick, Ph.D.
Deborah Fewell, LPN II
Becky Butler, L.C.S.W.
Nancy Harris, L.C.S.W.
Alana House Hulen, L.S.W.
Genetic Services

Samer D. Tabbal, M.D., is medical director of the UAMS HD Clinic and UAMS HSG site.

He is an assistant professor of neurology in the Department of Neurology of the UAMS College of Medicine and at the Central Arkansas Veterans Healthcare System (VA) in Little Rock. He is also the movement disorder specialist of the UAMS Medical Center's Center on Aging. He completed his fellowship training in movement disorders in June 1999 at Columbia University, College of Physicians & Surgeons in New York City, under the supervision of Stanley Fahn, M.D., who is one of the most prominent worldwide authorities in the field. This was after three years of neurology residency training at UAMS. He graduated in 1993 from the American University of Beirut, Beirut, Lebanon after completing a B.Sc. in physics as premedical training.

Dr. Tabbal is certified by the American Board of Neurology and Psychiatry and is director of the Neurology Residency Program in the College of Medicine. His academic interests include movement disorders associated with dementia and aging, Parkinson’s disease, Parkinson-Plus syndromes (like progressive supranuclear palsy, corticobasal ganglionic degeneration, striato-nigral degeneration, and Shy-Drager syndrome), Huntington’s disease, cerebellar ataxias, tremors, gait/balance disorders, normal pressure hydrocephalus, dystonia (like torticollis, blepharospasm, facial/limb dystonia, writer’s cramp, generalized dystonia), Botulinum toxin therapy, tic disorders, myoclonus, tardive dyskinesias, and other drug-induced movement disorders.

He has lived with HD patients at a week-long camp in order to learn firsthand the problems of these patients and their families.

Dr. Tabbal also directs a Parkinson’s Study Group site at UAMS with Jana Patterson, R.N.

C. Winston Brown, M.D., is an associate professor in the Department of Psychiatry and Behavioral Sciences in the UAMS College of Medicine. He maintains an adult practice in the Adult Psychiatry Clinic and oversees the management and development of psychiatric services for the adult behavioral health programs at UAMS.

Dr. Brown earned his bachelor’s degree from the University of Arkansas at Fayetteville and his medical degree from the UAMS College of Medicine. He studied internal medicine at the Emory University Affiliated Hospitals for one year before completing a residency in adult psychiatry at Vanderbilt University. Before joining the UAMS faculty, Dr Brown practiced privately in LR from 1977 until 1993 and served as chief of the North Little Rock VA Mental Health Clinic from 1993 until 1996.

Dr Brown is certified by the American Board of Neurology and Psychiatry. At UAMS, he is active in investigating systems to assess the effectiveness of care for psychiatric disorders in routine practice settings and works with groups across the US in implementing such systems.

Dr. Brown provides optional diagnostic psychiatric evaluations for HD patients and treats patients who experience psychiatric symptoms, sometimes involving other mental health providers. He coordinates the use of psychiatric medications and sees HD patients outside regular clinic hours if necessary.

Roger D. Williams, Ph.D., is an assistant professor of geriatrics in the Donald W. Reynolds Department of Geriatrics in the UAMS College of Medicine. He is director of Neuropsychology Services at UAMS. He earned his Ph.D. in psychology from Indiana State University where he was the Imogene E. Okes Fellow and was elected to Phi Delta Kappa honor society in education.

Dr. Williams earned the master’s degree in psychology at the University of Notre Dame and completed a clinical psychology internship with specialization in neuropsychology at the Central Arkansas Veterans Health Care System (VA) in Little Rock. After completing his clinical training, Dr. Williams entered private practice in Terre Haute, Indiana. He was also a consultant for the VA Medical Center in Danville, Illinois, and an adjunct faculty member at Indiana State University. Before joining the Donald W. Reynolds Department of Geriatrics in the UAMS College of Medicine, he completed a fellowship in clinical geropsychology and neuropsychology at the VA in 1997.

Dr. Williams is certified by the Council for the National Register of Health Service Providers in Psychology. He is a member of the Clinical Psychology Internship Training Committee at the Central Arkansas Veteran’s Health Care System. He is the neuropsychologist for the Alzheimer’s Disease Center at UAMS. His academic interests include Alzheimer’s disease and related disorders, neuropsychological assessment, multi-disciplinary approaches to assessment, neuropsychological effects of pharmacological interventions, and movement disorders.

Richard Zraick, Ph.D., CCC-SLP, is an assistant professor in the Department of Audiology and Speech Pathology in the UAMS College of Health Related Professions. He was awarded his Bachelor's degree in 1984 (Psychology) and Master's degree in 1987 (Speech-Language Pathology) by the University of Arizona, and his doctoral degree (Speech-Language Pathology) in 1998 by Arizona State University. He joined the UAMS faculty in July 1997.

Dr. Zraick holds the Certificate of Clinical Competence (CCC-SLP) awarded by the American Speech-Language-Hearing Association, and is completing board certification in adult neurological communication disorders by the Academy of Neurological Communication Disorders and Sciences. A practicing clinician since 1987, Dr. Zraick routinely diagnoses and treats persons who have lost some or all of their ability to communicate or swallow due to acquired medical conditions such as stroke, head injury, and neurological disease. 

Dr. Zraick is a published author, with research grants and research articles, and book chapters in the areas of neurogenic speech-language disorders, voice disorders and speech perception. He has been an invited speaker about these topics at state and national scientific conventions. In 1999, Dr. Zraick was awarded a New Investigator Grant from the American Speech-Language-Hearing Association. The Arkansas Speech and Hearing Association honored Dr. Zraick with its annual Researcher Award in 2000.

Deborah Fewell, LPN II, is a nurse in the Department of Neurology at UAMS. She joined UAMS in 1995. She performs nerve conduction studies in the Electrophysiology Laboratory and is research coordinator for studies involving stroke, ALS, epilepsy and Huntington's disease. Fewell is also the nurse coordinator of the Motor Neuron Disease and Huntington's Disease Clinics. She coordinates the Muscular Dystrophy Motor Neuron Disease Support Group and is co-coordinator of the Huntington's Disease Interactive Video Support Group.

As the HD nurse, Fewell coordinates the entire clinic visit of each patient from scheduling appointments to instructing patients upon discharge. She develops and implements the plan of care to meet nursing and psychological needs of patients and their family. She also attends to patients needs between clinic visits, including supportive counseling and psychological emergencies.

”I have widespread clinic responsibilities,” Fewell explains. “I help our team of physicians assess the patients and their families during their HD Clinic visits. Working with the other team members, I develop a health care plan to meet nursing and psychosocial needs of the patient and family. I am available during the week to answer questions, refill medications, and provide supportive counseling. I can also be reached in case of a HD crisis.”

Becky Butler, L.C.S.W., is a social worker and has a special interest in genetic counseling for patients who may be at risk of passing a genetic disorder on to children. She helped organize the HD Clinic and coordinates bimonthly HD Support Group meetings through interactive video. She also is coordinator of telegenetics for the Department of Obstetrics and Gynecology in the UAMS College of Medicine.

Nancy Harris, L.C.S.W., is a psychotherapist. HD has a profound impact on the social and emotional functioning of patients and their families. Harris is available to patients and family members who request therapy services as they adjust to the impact of HD. Sessions can focus on adjusting to the functional changes in the patient and family, grief work related to role and functional losses, teaching and facilitating communication, problem-solving and conflict resolution skills, stress management, self-care for caregivers, and helping children understand and cope.

For patients who do not live in the immediate area, Ms. Harris can assist with referrals to nearby mental health services.  

Harris earned the bachelor’s degree from the University of Memphis and the master of social work from the University of Arkansas at Little Rock (UALR).

Alana House Hulen, B.S.W., is a social worker.  She provides resources, such as information about financial assistant, to patients, caregivers, and families.  She conducts periodic functional assessments of patients. Hulen earned a degree in social work from Lyon College and has experience in medical social work and as director of social services in a nursing home.  She is completing work on the master of social work degree at UALR.

Genetic Services in the HD Clinic include genetic counseling referrals to Mary Curtis, M.D., a board-certified clinical geneticist, and counseling by Erica Burner in the Clinical Genetics Division of Arkansas Children’s Hospital (501-320-2966).

Links on This Page

Huntington Study Group: http://huntington-study-group.org/
Huntington’s Disease Society of America: http://www.hdsa.org/
Department of Neurology: http://www.uams.edu/neurology/index.htm
Parkinson Study Group: http://www.parkinson-study-group.org/
Department of Psychiatry: http://www.psych.uams.edu/
Department of Geriatrics: http://centeronaging.uams.edu/
Alzheimer’s Disease Center: http://alzheimer.uams.edu/
Department of Audiology an Speech Pathology: http://www.ualr.edu/~audiology/
Department of Obstetrics and Gynecology: http://www.uams.edu/obgyn/obgyn.htm

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