Meritas Health Neurology treats a variety of neurological disorders, including multiple sclerosis, migraine, Parkinson's disease, epilepsy, and dementia, as well as disorders of muscle and the peripheral nerves. Our office is equipped to perform neuromuscular diagnostic services with nerve conduction studies and electromyography (EMG), and provides treatment for dystonia and migraine with Botox® (botulinum toxin).
Botulinum toxin A (Botox, Xeomin®) is a common and useful treatment option for patients with chronic migraine headache and other neurological conditions, including cervical dystonia, blepharospasm, and limb spasticity. Treatment is accomplished by injecting the medication in the affected areas, and may be repeated every 3 months. EMG may be utilized, in some cases, to guide in the placement of medication within the muscle. Our staff will help you decide if this therapy will be helpful for you, and assist in insurance authorization.
A neurological consultation is a type of evaluation and management service provided by a neurologist, at the request of another physician, for a specific neurological condition or problem. Depending on the specific condition or problem, the neurologist may either recommend care, or may accept responsibility for ongoing management of the patient’s care, for that specific condition or problem. This would include a thorough review of the history of the problems, as well as a comprehensive neurological examination.
Electromyography and Nerve Conduction Studies (EMG/NCS)
An EMG is a test of the muscle and nerves. This test may be a helpful tool in the diagnosis of various types of peripheral nerve and muscle disorders (e.g. carpal tunnel syndrome, cervical or lumbosacral radiculopathy, inflammatory or degenerative muscle diseases, as well as conditions such as myasthenia gravis and amyotrophic lateral sclerosis).
The first portion of the test involves light shocks given to the nerves in the upper or lower extremities in specific locations. This helps determine how well the peripheral nerves are conducting. The second part of the test involves inserting a very small needle into various muscles in the extremities. This needle records the electrical activity in the muscles being tested.
Although an EMG may be uncomfortable at times, it is not usually painful. To ensure the best results, and minimize discomfort, it is important that patients relax during the study. In preparation for the test, it is helpful for patients to avoid shaving or applying any creams or lotions to their skin on the day of testing. It is also important for patients to avoid taking any muscle relaxants within 24 hours of testing, as muscle relaxants can alter the outcome of the study.
Patients should inform their physician if they are on blood thinning medication (e.g. warfarin) prior to testing.
After having an EMG, patients may notice minor bruising or soreness near the areas of testing. Red or warm areas should be reported to the performing physician.
Occipital Nerve Block
An Occipital Nerve Block is a local anesthetic injection of the occipital nerve, located in the back of the head. This procedure may be done to help relieve pain and headache associated with irritation of this nerve, on one or both sides of the head. Vagal Nerve Stimulator A Vagal Nerve Stimulator (VNS) is sometimes used in the treatment of seizure disorders that do not respond to medications alone. This FDA-approved medical device is implanted in the upper chest, with leads extending under the skin to the vagus nerve in the neck. The VNS can be programmed to help reduce the frequency and severity of seizures, sometimes reducing the need for medication.