Best Neurology Resources for Patients

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Neurology Services

Note: If there is a neurological condition that is not listed then please feel free to contact our office before making an appointment.
Procedures performed: Nerve study and Electromyography (EMG) and routine EEGs
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Notice of Privacy

Fill up The “Notice of Privacy Practices” Form.
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Caregivers- please use the patient’s name and DOB (and not yours) to fill out these forms
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We currently accept traditional medicare plan, Aetna, Clover and Humana. Until we secure contracts with other commercial insurance companies, patients who have out of network benefits may still be covered for their visits by their insurance. For those who have no insurance or would want to see us outside of their insurance plan, we have direct pay rates that you can inquire about by calling our office. You can use your FSA or HSA card for direct pay. We do NOT accept medicaid or medicaid managed plans at this time.

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Nerve Test/ EMG

Electromyography (EMG) is a form of electrodiagnostic testing that is used to study nerve and muscle function. It is commonly performed by a physiatrist or neurologist with special training for this procedure. An EMG nerve test can provide your doctor with specific information about the extent of nerve and/or muscle injury and can also determine the exact location of injury and give some indication whether the damage is reversible.
There are two parts to EMG:

01. Nerve conduction test- The nerves are stimulated at different points with small electric shocks, artificially activating them so their function can be measured.

02. Needle exam for muscle testing– Very fine needles are inserted into several muscles. Each needle has a microscopic electrode that picks up both the normal and abnormal electrical signals given off by a muscle.
At Prime Neurology, we understand that the test can be a little uncomfortable and hence our team uses methods/techniques to make it less painful. Most patients (99%) tolerate the procedure well. We would recommend all patients to complete the test, however if at any point you feel that the test is too painful you would let your technician or doctor know and the test will be stopped.
Preparation: There is no special preparation required for nerve test. We do ask that you do not put any lotion or oil or cream on your limbs when you come for testing as we would need to remove that.

Post test: No special instructions post EMG. It is a routine outpatient diagnostic test.

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Electroencephalography (EEG) is a method to record an electrogram of the electrical activity on the scalp that has been shown to represent the macroscopic activity of the surface layer of the brain underneath. It is typically non-invasive, with the electrodes placed along the scalp. The recording is done in office.
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Topics of Interest

A headache is very common causing pain and discomfort in the head, scalp, or neck. It is estimated that 7 in 10 people experience at least one headache every year. Not all headaches are migraines. There are different types of headaches and getting the correct diagnosis is very important so treatment can be tailored to that. Unfortunately, most headache types cannot be diagnosed with a blood test and hence seeing a neurologist who is experienced in diagnosing and treating headaches is important. Some links:

  • A migraine is not just a headache. Migraines are very strong, pounding headaches that are on one side of the head. 10 Expert Tips to Help Prevent Migraines
  • A cluster headache is commonly described as painful headaches occurring in clusters. These headaches are cycles of attacks, however they are followed by free periods. Finding Relief for Cluster Headaches
  • A tension headache is another common form of headache. It is usually caused by mild, moderate or intense headaches behind your eyes, head and neck. A tension headache may sometimes feel like a tight band around their forehead. What is a tension headache?

Tremor is an uncontrollable, rhythmic muscle contraction that causes shaking movements in one or more parts of the body. It is a common movement disorder that primarily affects the hands but can also affect the arms, head, vocal cords, torso, and legs. Tremor can be intermittent (occurring at different times with breaks) or constant. It can occasionally occur (on its own) or as a result of another disorder. It is very important to diagnose as to what is causing the tremor so that treatment can be customized for every patient. More information can be found on the link.
Parkinson’s disease can also cause tremors. Symptoms appear gradually, sometimes beginning with a barely noticeable tremor in only one hand. Tremors are common, but the disorder is also associated with stiffness or slowing of movement. Yoga May Help Ease Symptoms of Parkinson’s Disease
Assistive Devices for Tremors.
Tics are unexpected twitches, movements, or sounds that people perform repeatedly. Tics sufferers are unable to stop their bodies from performing these actions. A person suffering from a motor tic, for example, may repeatedly blink. Alternatively, a person with a vocal tic may unintentionally make a grunting sound. Diagnosing Tic Disorders.

Numbness and tingling are sensations that occur in our body, you often can feel them in your hands, fingers, feet, arms, or legs. The most common cause of numbness or tingling is a problem with nerve
function, which can happen due to an injury to the nerve, something pressing on the nerve, or an imbalance in the body’s chemistry interfering with nerve function. Neuropathy can also cause abnormal sensations. There are different types of neuropathy.
More information about Different Types of Neuropathy.

Memory loss is characterized by unusual forgetfulness. You may be unable to recall events, one or more memories from the past, or both. Memory loss may occur for a short period of time and then resolve (transient). Alternatively, it may not go away and, depending on the cause, may worsen over time. Such memory impairment may interfere with daily living activities in severe cases.
Dementia is a broad term that refers to a decline in mental ability that is severe enough to interfere with daily life. The most common cause of dementia is Alzheimer’s disease.
There are many different types of dementia.

Muscle weakness occurs when your full effort fails to result in a normal muscle contraction or movement. There are neurological conditions that can affect muscle strength. They can be acquired or genetic. Conditions that cause generalized muscle weakness include but are not limited to: Myasthenia Gravis, Polymyositis, Inclusion Body myositis, genetic myopathies, etc. Certain neuropathies can lead to muscle weakness as well.
More information listed in the link below:

A seizure is an electrical disturbance in the brain that occurs suddenly and uncontrollably. It may alter your behavior, movements, or feelings, as well as your level of consciousness. There are different types of seizures.
Fainting is a brief loss of consciousness caused by insufficient blood flow to the brain. It’s also known as syncope. It usually happens when the blood pressure is too low (hypotension) and the heart isn’t pumping enough oxygen to the brain. It may be harmless or a symptom of a more serious medical condition. What is POTS, and What Causes It?

A stroke is a condition which affects the arteries in the brain. A stroke occurs when a blood vessel carrying oxygen and nutrients to the brain becomes blocked or ruptures (bursts). This means that the area of the brain supplied by the blocked or ruptured blood vessel cannot receive the oxygen and nutrients it requires. Nerve cells cannot function in the absence of oxygen.
The American Stroke Association demonstrates that whenever you are having a stroke, you should follow and become familiar with the letters in F.A.S.T to spot any symptoms.
F: Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
A: Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S: Speech Difficulty – Is speech slurred?
T: Time to call 911
If you have suffered from a stroke before, stroke recovery may appear to be very overwhelming at first, but rehabilitation can help you regain your strength, courage, and independence.

Dizziness can occur for a variety of reasons. It frequently occurs as a result of environmental factors or an underlying health condition. Vertigo is typically caused by conditions affecting your vestibular system, which is located in the inner ear. Your vestibular system aids in providing information to your brain about your movement, positioning, and location in space.
To read more about Dizziness and Vertigo, you can visit this website for more information.

Imbalance and coordination difficulties can be linked with multiple disorders. Difficulties with balance can often be associated with the signals sent to our brain by our ears, eyes and/or nerves. Imbalance may cause someone to not be able to stand or sit straight, and also struggle with doing simple tasks such as walking. Difficulties with coordination is often the cause of damage to the cerebellum (a structure in the brain that controls balance and coordination. Loss in coordination, just like balance can make simple tasks such as picking up a pencil or catching a ball difficult. Read more about Loss of balance

Insomnia is categorized as a sleep disorder that often tends to cause people to feel that they are unable to stay asleep or fall back to sleep. Due to inconsistent sleep, people often find themselves extremely tired which affects their ability to function throughout the day. Most people think of sleep that would just come when they hit the bed. Unfortunately, that’s not the reality. Thankfully, there are studies that show that sleep can be controlled- yes, you heard us right- you have more control over your sleep than you think you do.
Things that you do during the day affect the onset and quality of your sleep. So how can you sleep better at night?

  • After 30-60 minutes of waking up, take time to view the sunrise, and sunset later in the day- Viewing sunlight or artificial light can help to “wake up” your circadian clock. You do NOT have to look directly at the sun, and you shouldn’t. But do not wear sunglasses or a wide brimmed hat- that would not wake up your circadian rhythm. We like to suggest that you go for an outdoor walk, if you safely can.
  • Wake up at the same time every day and go to sleep when you first start to feel sleepy- Pushing through that sleep and going to sleep too late is why some people wake up at 4 am and cannot fall asleep again.
  • Avoid caffeinated beverages or energy drinks within 8-10 hours before bedtime- Some experts even recommend that you avoid caffeine/energy drinks 12-14 hours before bedtime.
  • Hypnosis- If you have sleep disturbances, insomnia, or anxiety about sleep, try the research-supported protocols on the Reveri app (for iPhone). Do the Reveri sleep self-hypnosis 3x a week at any time of day. It’s only 10-15 min long and will help you rewire your nervous system to be able to relax faster.
  • Avoid viewing bright lights-especially bright overhead lights between 10 pm and 4 am. Here is a simple rule: only use as much artificial lighting as is necessary for you to remain and move about safely at night. Blue blockers can help a bit at night but still dim the lights. Viewing bright lights of all colors are a problem for your circadian system. Candlelight and moonlight are fine 6. Limit day time naps to less than an hour, or none at all.
  • If you wake up in the middle of the night- (which, by the way, is normal to do once or so each night) but you can’t fall back asleep, consider doing an NSDR protocol when you wake up. Enter “NSDR” into YouTube and the top 3-4 options have different voices, durations for you to select from. Read more about NSDR Protocols
  • Feeling alert before bedtime- Our natural circadian rhythm causes us to feel alert or have a burst of energy a few hours before we may go to sleep. This is normal and you should not freak out if that happens. 

  • Maintain a cool temperature and a dark room- Keeping a cool temperature and a dark room is important for having a restful night. Our body temperature needs to drop approximately 1-3 degrees to both fall and stay asleep. Often a reason people might find themselves waking up is due to the increase of body temperature.
  • Avoid consuming alcohol before you sleep- Drinking alcohol before you sleep disturbs the release of melatonin in our body. Once again if our body is not producing enough melatonin, it makes it very difficult to have and maintain a good night’s sleep.
  • Adjust to your body’s sleep needs with age- Age plays an important role when it comes to maintaining good sleep. Our body produces less melatonin as we age, with these changes in hormone production (melatonin and cortisol) it can make it much more difficult for people to fall and stay asleep. Read more about Aging and Sleep
           Content Credit Huberman Lab- Toolkit for sleep

Functional neurological disorder a newer and broader term that includes conversion disorder is characterized by nervous system (neurological) symptoms that cannot be explained by a neurological disease or other medical condition. The symptoms, on the other hand, are real and cause significant distress or problems functioning. What is FND?

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That would be done at an imaging center. After the neurological evaluation if it is determined that the patient needs imaging then our neurologist would write you a prescription for the same.

Unfortunately, we do not at this point.

Some of the conditions that a neurologist treats are:

  • Alzheimer’s disease
  • Amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease)
  • Back pain
  • Brain and spinal cord injury or infection
  • Brain tumor
  • Epilepsy
  • Headaches
  • Multiple sclerosis
  • Parkinson’s disease
  • Peripheral neuropathy (a disease that affects your nerves)
  • Pinched nerves
  • Seizures
  • Stroke
  • Tremors (uncontrollable movements)
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