A patient that needs a neurologist, typically is faced with a chronic condition that will need periodic evaluation and ongoing treatment. Some of these conditions are more debilitating than others. Whatever your neurologic condition, our team is dedicated to providing health care tailored to our patient's individual needs. This is accomplished through professional collaboration and teamwork with other health care providers and professionals, therapists, social workers and family members.
· Altered vision
· Loss or alteration of taste
· Loss or alteration of smell
· Hearing loss
· Tinnitus (ringing in ears)
· Altered bodily sensation
· Abnormal movements
· Foot drop
· Learning disability
· Loss or alteration of consciousness
· Difficulty walking
· Loss of bowel/bladder control
· Neck pain
· Back pain
· Spinal discomfort
· Memory loss
· Head trauma
· Limb pain
· Nerve compression
· Carpal tunnel syndrome
A careful history taking process is followed by a complete and thorough examination, which then allows for the formulation of a thoughtful and intelligent assessment, or diagnosis. All diagnostic and treatment options are thoroughly discussed. Communication becomes the crucial link in the provider-patient relationship. We work together with the patient as a team to treat and manage your condition.
· In-depth history-taking interview
· Complete neurologic examination
· Discuss and review findings
· Diagnostic testing and treatment when appropriate
· Nerve Conduction Studies
· Electromyography (muscle testing/EMG)
· Electroencephalography Readings (EEG)
· Lumbar Puncture
· Evoked Potential
· Ambulatory EEGs
· Botox Injections for appropriate neurologic conditions
· Nerve Injections
Electromyography (EMG), often is done along with a nerve conduction velocity study, (NCV) which measures your muscle and nerve electrical activity. A small needle is placed in your muscles, and the results are recorded on a special machine. These tests are used to help determine if a person’s muscle weakness, pain, or numbness are due to nerve damage, slipped disc or some other muscle condition. This information is used by the neurologist to help diagnose and assess your condition.
The electroencephalogram (EEG), or brain wave, is a written record of the brain’s electrical activity. It is used to assist in the investigation of symptoms related to the central nervous system (i.e., seizures, blackouts, dizziness, headaches, confusion, or behavior concerns). An instrument called an electroencephalograph registers tiny bits of electrical brain activity then prints them as wavy lines on a moving strip either on paper or on a CD. The entire test is painless and takes about an hour.
When this study is ordered by your provider, our technician will hook the electrodes to the patient in our office on appointment. The patient will then go home with the electrodes on them. The patient will be instructed on how to operate the recording device, which is very simple. The patient will also be required to keep an activity log. At the end of recording time, the patient will come to the office to have the electrodes removed, and our physician will interpret the results to provide insight into the nature of their spells. The recording duration will be anywhere from 24 to 72 hours.
Understanding epilepsy has been greatly advanced by video - EEG Monitoring, which allows prolonged simultaneous recording of the patient’s behavior and the EEG. Seeing EEG and video data at the same time permits precise correlation between seizure activity in the brain and the patient’s behavior during seizures. This is all accomplished in the patient’s home environment.
Evoked Potential Testing
This test evaluates the function of nerve fiber pathways from the eyes, ears, arms, and legs through the spinal cord into the brain. This test is most helpful for diagnosing multiple sclerosis, optic neuritis, hearing loss and spinal cord diseases.
This specialized revolutionary treatment has been very effective in helping select patients with diagnoses of migraines, headaches, dystonia, blepharospasm, torticollis, hemiplegia, muscle spasms and multiple sclerosis.
Trigger Point Injections
Trigger point injection (TPI) is a simple procedure widely performed to relieve myofascial pain. It involves injection of medications into trigger points, or knots that form when muscles do not relax.
VNS: Vagus Nerve Stimulation
There’s one vagus nerve on each side of your body, running from your brainstem through your neck to your chest and abdomen.
With vagus nerve stimulation, a device is surgically implanted (by a neurosurgeon) under the skin on your chest. A wire is threaded under your skin connecting the device to the left vagus nerve. When activated, the device sends electrical signals along the vagus nerve to your brainstem, which then sends signals to certain areas in your brain.
Many people with epilepsy don’t respond to anti-seizure drugs. Vagus nerve stimulation may be an option to reduce the frequency of seizures in people who haven’t been helped by medications.
Vagus nerve stimulation may also be helpful for people who haven’t responded to standard depression treatments, such as anti-depressant medications and psychological counseling (psychotherapy).
The Food and Drug Administration (FDA) has approved vagus nerve stimulation for people who:
· Are 12 and older
· Have focal (partial) epilepsy
· Have seizures that aren’t well controlled with medications
Numerous patients have had the stimulator implanted for successful treatment of their seizures. If you would like to know more information about vagus nerve stimulation, our providers will be happy to explain the benefits of this form of treatment.
Small Fiber Biopsy
The only way to definitively diagnosis small fiber neuropathy is through a skin biopsy.
Small fiber neuropathy results from damage to the small, unmyelinated nerve fibers that convey pain and temperature sensations. Routine neurological exams such as EMG and nerve conduction studies can often be normal in patients with isolated small fiber neuropathy. The physician performs a skin biopsy to more accurately diagnosis a concern with the small nerve fibers. A skin biopsy followed by epidermal nerve fiber density testing can be the only way to make a diagnosis of small fiber neuropathy.
The biopsy can take 15 to 30 minutes depending upon how many sites are biopsied. This procedure is minimally invasive. We routinely do skin biopsy on one side at three sites, above the ankle (distal leg), above knee (distal thigh) and below hip (proximal thigh) using a three mm (diameter) punch biopsy. Since the biopsy size is so small, no stitches are needed. The biopsy sites will be healed within one week, but may leave a small scar.
Agnesian HealthCare is now offering emergency teleneurology coverage at Ripon Medical Center, St. Agnes Hospital and Waupun Memorial Hospital, in partnership with Specialists on Call (SOC), a national provider of telemedicine technology and solutions to hospitals and other health care organizations.
Teleneurology allows for rapid, real-time neurology consults when most needed - for stroke patients being evaluated for tPA administration, for other adult neurological emergencies, as well as emergencies arising in the hospital requiring an urgent neurologist consultation. Neurologists specialize in disorders of the brain, spine and central nervous system.
Using video conferencing software, providers - mainly in the emergency departments – will have immediate access to a neurologist. Other hospitals that use telemedicine services report that families find comfort in the expertise provided by highly-experienced, board-certified specialists during their time of emergency.
By providing teleneurology consultations to patients in emergency departments, SOC will support and collaborate with our staff by virtually reviewing cases and making recommendations for onsite staff. Together with SOC, Agnesian HealthCare providers and staff are also solving time-sensitive issues and building better care plans for patients.
With a board-certified neurologist available to see stroke patients virtually, eligible patients can receive treatment, such as thrombolytic agents faster. Alteplase IV r-tPA works by dissolving the clot and improving blood flow. If administered within three hours, it may improve the chances of recovering from a stroke.
*Please verify insurance plan coverage before scheduling an appointment.