IN OUR OFFICE
1: Neurologic consultation in the office
- Numbness and tingling
- Neuropathy and nerve injuries
- Migraines and other headaches
- Sleep disorders
- Multiple Sclerosis
- Carpal tunnel syndrome
- Neuropathic pain and neuralgia
- Weakness of the limbs and trunk
- Muscle diseases
- Double vision
- Spine problems and herniated discs
- Poor balance and difficulty walking
- Parkinson’s disease, tremor, and other abnormal movements
2: Electrodiagnostic testing (Electromyography, EMG)
Patient Instructions for Electromygraphy: You can expect the test to last up to 1 hour. The first part of the study is usually the nerve conduction test. This involves stimulating nerves using a tiny electric current, and recording the responses with surface electrodes on the outside of the skin. The electrical current causes tingling and some muscle twitches, but is not usually painful. The second part of the test is the needle examination. This involves inserting a tiny needle into some muscles in your arm or leg, and recording the electrical activity. Please take all of your medications as usual on the day of the test. Please do not put any kind of lotions on your skin on the morning of the test, as this can interfere with the recordings. You will be able to do normal activities after the test. Please wear gloves one hour before the test so that your hands are warm. Note to all Medicare patients: please note Medicare (and secondary insurance) will deny payment for the use of disposable needles during the test. The charge for this is $20.00, and will be expected at the time of service.
Patient Instructions for EEG: Wash and dry your hair completely the morning of your appointment. Please refrain from using hairspray, styling gel or mousse. You may eat and take your usual medications normally before the test.
Patient Instructions for Sleep Deprived EEG: You must be sleep deprived from 6pm the night before the test. Avoid all stimulants, including caffeine, the night before the test. Wash and dry your hair completely the morning of your appointment. Please refrain from using hairspray, styling gel or mousse. You may eat breakfast and take your usual medications normally on the morning of the test. Sedation may be administered, unless otherwise instructed by your physician. Please have someone accompany you for the test to drive you home afterwards.
4: Botox injections:
5: Nerve root blocks:
6: School evaluation for ADD and hyperactivity - Dr. Gilson
7: Evaluation of concussion and head injury
8: Sleep Disorders
AT THE HOSPITAL
2: Sleep studies
3: Video-EEG monitoring
4: Lumbar puncture
Patient Instructions for Lumbar Puncture: The procedure will usually be conducted in a hospital room in the medical day stay unit at the hospital. It normally takes about 20 minutes. You will be asked to sign a consent form. You will change into a gown. You will either lay on your side, or sit up on the side of the bed leaning forwards onto a pillow on a side table. Your spine will be cleaned with Betadine antiseptic. The physician will feel your spine, and then infiltrate local anesthetic into the spine at the appropriate level. You will feel a prick from the needle, and then the anesthetic burns a little at first. Then the physician will insert the spinal needle into this inter-space. Sometimes, as the needle enters the spinal canal, it “tickles” the nerve roots, and causes numbness or burning in one leg. If that happens, let the physician know right away so that the needle can be redirected. Once the needle is inserted into the spinal canal, the physician can collect the spinal fluid required for the research study. The commonest adverse effect from the procedure is a headache. There are several measures to help prevent this from occurring. After the procedure, you will be kept in bed for at least 2 hours. Even after you go home you should stay laying flat for the remainder of the day. You should just get up to eat or go the bathroom. You should drink plenty of fluids, preferably containing caffeine (like coke or ice tea), and keep hydrated. Hopefully you will feel fine by the next day. If you do have a headache, you should keep lying flat as much as possible for the next day or two, keep drinking plenty of fluids, and take Advil or Tylenol. The headache will usually resolve within 2-3 days. If you still have a severe headache more than 2-3 days after the procedure, you should contact your physician.