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Specialists

Information neurologist | Neurology

What is a neurologist?

A neurologist is a doctor who specializes in diagnosing and treating diseases that affect the nervous system. Neurology is the branch of medicine that deals with the study and treatment of disorders of the nervous system. The nervous system is a complex and sophisticated system that regulates and coordinates bodily functions.

The nervous system has two parts:

The central nervous system (CNS): CNS represents the brain and spinal cord.

The peripheral nervous system (PNS): PNS contains all the nerves outside the CNS.

Due to the complex nature of the nervous system, many neurologists focus on treating people or a specific population of people with specific neurological diseases. After completing their residency training, most neurologists will spend a year or more in a fellowship program where they will gain experience in their subspecialty.

Examples of subdivisions in the field of neurology:

  • Pediatric or child neurology
  • Neurodevelopmental disabilities
  • Neuromuscular medicine
  • Hospice Neurology and Palliative Care
  • Pain drug
  • Headache drug
  • Sleep drug
  • Vascular neurology
  • Autonomic disorders
  • Neuropsychiatry
  • Brain injury drug
  • Neurocritical attention
  • Epilepsy

What conditions do they treat?

Neurologists treat neurological conditions that affect the brain, spinal cord, and nerves. These conditions are:

  • Race
  • Epilepsy
  • Headaches and migraines
  • Brain tumors
  • Brain aneurysms
  • Peripheral neuropathy
  • Sleep disorders
  • Neurodegenerative diseases such as Parkinson’s disease and Alzheimer’s disease.
  • Neuromuscular diseases such as mastenia gravis, multiple sclerosis (MS), and amyotrophic lateral sclerosis (ALS)
  • Nervous system infections, encephalitis, meningitis, and HIV

What procedures do they do?

Neurologists perform a variety of tests and procedures to diagnose and treat neurological conditions. A neurologist can use a pelvic puncture to collect a sample of cerebrospinal fluid. They can use this approach to help diagnose the following conditions:

  • Meningitis
  • Encephalitis
  • Myelitis
  • Leukemia
  • Autoimmune diseases such as multiple sclerosis (MS)
  • Dementia
  • Bleeding in the brain

Neurologists can also use pelvic puncture to treat conditions that affect the spinal cord. Narcotics, antibiotics, or cancer treatments can be injected with a pelvic puncture needle.

Electromyography: One procedure that a neurologist can perform is EMG. A neurologist can use electromyography (EMG) to assess how a person’s muscles respond to the electrical stimulation of motor neurons, which are specialized nerves that control muscle movements.

During EMG, a specially trained technician inserts small needles into the muscle called electrodes. These electrodes record the different electrical activity that occurs in muscle tissue during movement and at rest. The EMG machine produces an electromyogram, which is a record of this action. Neurologists can use EMG results to diagnose neuromuscular diseases such as myasthenia gravis and ALS.

Electroencephalogram: Neurologists use electroencephalograms (EEGs) to measure and record electrical activity in the brain. Neurons in the brain communicate with other neurons through electrical impulses, which can pick up the EEG. The EEG also tracks brain wave patterns.

During the EEG, a technician places electrodes on the person’s head. These electrodes are connected to a computer that converts technical signals that technicians can view on screen or print on paper. Neurologists can use the EEG results to detect abnormal electrical activity in the brain and diagnose certain conditions:

  • Epilepsy
  • Convulsions
  • Brain tumors
  • Trouble sleeping
  • Tensilon test

Mastenia gravis is a rare neuromuscular disease that weakens the muscles of the arms and legs. The neurologist may use a blood test called a Tensilon test to diagnose Mastinia gravis.

Tensilon is the brand name for a drug called edrophonium, which inhibits the breakdown of the neurotransmitter acetylcholine, which stimulates muscle movement. Mastenia Gravis The immune system attacks acetylcholine receptors in muscle, reducing muscle fatigue and muscle mobility.

During a Tensilon test, a neurologist injects a small amount of Tensilon into the bloodstream. Then, they ask the person to do different movements, namely:

  • Got up and sat down
  • Holding hands above their heads
  • Crossing and spreading the legs

The neurologist will continue to give doses of Tensilone each time the person feels tired. If a person notices their strength returning after each Tensilon injection, this indicates that they are more likely to have myasthenia gravis.

When to see a neurologist?

If you have a diagnosed neurological disorder or one of the above symptoms, it’s time to make an appointment to see a neurologist. A specialized team of specialists at Regional Neurological Associates has advanced training in the diagnosis and treatment of neurological disorders, so you can be sure you are receiving professional care.

A primary care physician may refer a patient to a neurologist if they have symptoms that indicate a neurological condition:

  • Frequent or severe headache
  • Muscular weakness
  • Confusion
  • Dizziness
  • Loss of coordination
  • Partial or complete paralysis
  • Sensory changes that affect the sense of touch, sight, smell, or taste

5 big signs you should see a neurologist

Sleeping Problems: We know that the most obvious causes of sleep problems are having a condition like sleeping too late, sleep apnea or anxiety, nightmares, or others, some sleep problems are neurological disorders. An example of this is narcolepsy, a chronic genetic disorder that has no known cause that affects the body’s central nervous system.

These symptoms may be part of a more neurological disorder. Your primary care physician is a great resource to help you decide whether or not to see a neurologist. However, if your symptoms are severe enough, or you still don’t trust your primary care doctor’s recommendations, you may need to make an appointment with a neurologist.

You have seizures: Seizures are disturbances in your brain. They can cause strange sensations, uncontrollable movements or loss of consciousness. To find the cause, the neurologist can test the brain and obtain images. Sometimes seizures stop when the cause is treated. However, some conditions that cause seizures, such as epilepsy, can be chronic. There are many medications that can prevent or reduce seizures. There are also policies that can help. A neurologist will find the best treatment for you and help you manage the condition. 

You have a brain or spinal cord injury: Car accidents fall, and sports injuries can damage your brain or spinal cord. Symptoms depend on the type of injury and the extent of the damage. Brain injuries can cause headaches, dizziness, seizures, and loss of consciousness.

They cause changes in your behavior, thinking, and memory. Spinal cord injuries can cause weakness and numbness. You may also lose mobility below the area of injury. A neurologist can design a treatment plan for your specific condition and coordinate your care. This can include medications, physical therapy, and mental health treatment.

Migraine: Migraine is a type of headache that affects many people. If you have frequent and persistent headaches along with other symptoms, you are suffering from a migraine. Symptoms of migraine:

  • Headache on one or both sides of the head
  • Headache aggravated by physical exertion
  • Pain or throbbing pain
  • Nausea and vomiting
  • Sensitivity to light
  • Sensitivity to sounds
  • Sensitivity to odors.

According to the American Migraine Foundation, migraine affects 37 million people in the United States and more than 144 million worldwide. If you have migraine symptoms that your primary care provider cannot treat, you should see a neurologist.

Neuropathy: Peripheral neuropathy, commonly known as neuropathy, refers to a group of conditions that affect the peripheral nerves of the body. The peripheral nervous system connects the central nervous system, which is made up of the brain and spinal cord, to the rest of the body. Neuropathy can take many forms, including:

  • Chronic pain
  • Balance is difficult
  • Poor coordination
  • Burning sensations
  • Numbness, weakness, or tingling in the affected part of the body.
  • Paralysis

There is a long list of conditions that can cause neuropathy, from autoimmune diseases to vitamin deficiencies. Diabetic neuropathy is a type of neuropathy that many people have heard of and how common diabetes is in the US.

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Specialists

Information About Pediatric Cardiologist | Cardiology

What is a pediatric cardiologist?

If your pediatrician has any questions about your child’s heart, he or she can refer him to a pediatric cardiologist. Pediatric cardiologists specialize in diagnosing and treating heart problems in children. In children requiring cardiac surgery, pediatric cardiologists work with pediatric cardiac surgeons to determine the best treatments and interventions.

Many heart conditions affect children. Some are structural differences from where they were born. Others have an electrical system that controls the heartbeat. Pediatric cardiologists are specially trained to diagnose and manage these problems. If you are concerned about your child’s heart, talk to your pediatrician if you need a referral to a pediatric cardiologist.

Education and training

Those who wish to become pediatric cardiologists must have a four-year undergraduate degree. Then they should also have:

  • Faculty of Medicine four years
  • Three years of pediatric residency
  • Three or more years of training in the subspecialty of pediatric cardiology

Pediatric cardiologists may focus on specialized skills such as cardiac catheterization, heart transplantation, or child care in the cardiac ICU during the last year or two of their training.

Conditions treated by a pediatric cardiologist

  • The cardiovascular collapse in childhood
  • Heart failure in infants and children
  • Cyanosis in newborns and beyond (where the skin is blue due to lung, lung, or circulatory problems)
  • Children with a heart murmur
  • Children and adolescents may experience chest pain, palpitations, or fainting.
  • Patients with congenital heart disease
  • Cardiovascular abnormalities in neonatal intensive care
  • Fetal heart abnormalities
  • Pediatric heart transplant
  • Evaluate a child before heart surgery
  • Evaluation of Children with Heart Disease Undergoing Heart Surgery
  • Management of children with heart problems
  • Great arterial transfer

Types of treatment

  • “Congenital heart disease” (birth defects in children), such as perforations between the chambers of the heart, valve problems, and abnormal blood vessels.
  • “Arrhythmia” or abnormal heart rhythms caused by the electrical system that controls the heartbeat.

Some pediatric cardiologists also treat “pulmonary hypertension” (pulmonary hypertension), while in some parts of the country pulmonary hypertension is treated by pediatric pulmonologists.

Some pediatric cardiologists can treat “systemic hypertension” (hypertension), but in some parts of the country, systemic hypertension is treated by pediatric nephrologists.

What conditions and diseases does a pediatric cardiologist treat?

The pediatric cardiologist treats conditions and diseases that include:

  • Arrhythmia, abnormal heart rhythm (the heart beats too fast, too slow, or irregular)
  • Bacterial endocarditis, a type of heart infection.
  • Cardiomyopathy, weakening or dilation of the heart muscle.
  • Congenital heart defects, including patented ductus arteriosus (PAC), atrial septal defect (ASD), and ventricular septal defect (VSD)
  • Cardiac syndromes, including genetic syndromes that affect the heart, such as Down syndrome and Marfan syndrome
  • Clogged pulmonary and aortic valves with heart valve defects
  • Kawasaki disease causes heart problems such as coronary artery aneurysms, leaky heart valves, and fluid retention
  • Myocarditis, inflammation of the heart.
  • Pulmonary hypertension, high blood pressure in the blood vessels that carry blood from the heart to the lungs.
  • Serious risk factors for cardiovascular conditions, including high blood pressure and high cholesterol

Procedures and interventions

  • Electrocardiogram (ECG)
  • Advanced imaging – CT / MRI
  • Diagnostic and therapeutic catheterization
  • Exercise test
  • Recording of cardiac events
  • Pulmonary radiography
  • Balloon atrial septostomy – A small hole is created in the two upper chambers of the heart to increase oxygen saturation
  • Pediatric heart transplant
  • Ultrasound of the heart
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Disease

An Introduction to Neuropalliative Care | Neurology

What is neuropalliative care?

Neuropalliative care helps children with serious medical conditions. Caregiving can help families set goals and make treatment decisions for children.

Palliative medicine, by definition, describes medical care that focuses on relieving symptoms, discomfort, or stress caused by a serious illness. Traditionally, this has meant supporting children with cancer. It is also estimated that almost half of the children who can benefit from palliative care services live with neurological, degenerative, or genetic conditions.

Neuropalliative care is designed to meet the ongoing needs of children with chronic neurodevelopmental deficiencies such as cerebral palsy, muscular dystrophy, spinal muscular dystrophy, and spina bifida. Neuropathic care does not mean life-long care or palliative care; Ultimately, it improves the child’s enjoyment of life and spends more time with the family.

Neuropalliative care is an important resource for patients and families confronting severe brain injury. Although many clinicians equate brain injury with certain death or futility, survivors have substantial needs that might be met by palliative care expertise. This chapter suggests that the boundaries of palliative medicine include those with severe brain injury, most notably those in the minimally conscious state and that with this nosological expansion practitioners of palliative care reflect carefully on often nihilistic attitudes directed towards patients with disorders of consciousness. This chapter establishes how to better meet the needs of these patients and their surrogates, reviewing definitional criteria for the vegetative and minimally conscious states, highlighting advances in diagnostic and therapeutic interventions (such as neuroimaging, drugs, and deep brain stimulation), and considering what neuroprosthetic devices tell us of the capacity of patients to experience-and functionally communicate-pain, distress, and suffering.

Support for neuropalliative care

Many of our patients with neurological disorders experience chronic, life-changing conditions due to their diagnosis.

Neuropathic care focuses on the physical and psychological management of neurological conditions, supporting family, friends, and caregivers affected by the patient’s diagnosis and prognosis.

Patients affected by the following conditions can benefit from assisted care:

  • Amyotrophic lateral sclerosis (ALS)
  • Huntington’s disease
  • Multiple sclerosis (MS)
  • Muscular dystrophies
  • Parkinson’s disease (PD)

Our care for Neuropalliative care

We work with your current providers to create a roadmap for your care. Starting conversations early in managing your illness can prepare you and your loved ones well for the road ahead.

Our program includes the following:

  • Physical, mental, and cognitive problems, including memory, pain, and anxiety
  • Counseling for spiritual, social, and psychological problems related to your illness
  • Transitions in Future Planning and Care: End-of-Life Options, Advance Instructions, and Palliative Care
  • Access to social resources
  • Communication between caregivers and patients
  • Caregiver support and rest 

Conditions Neuropalliative care treatment

Neuropalliative care consultations are useful for children or adolescents:

  • Experiences that cause physical symptoms, such as recurring pain, shortness of breath, or trouble eating
  • You have new or chronic health problems that require long-term maintenance
  • Shows signs of deteriorating health
  • We are faced with important care decisions in months or years
  • They were hospitalized for a long time with no clear discharge goals
  • Experience multiple hospitals in six months
  • You live with a life-limiting condition or have been recently diagnosed
  • Have concerns related to physical, spiritual, or emotional needs
  • Palliative care can help families develop strategies to address medical crises, illnesses, and interventions
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Specialists

Information About Neuro-Ophthalmologist | Neurology

Who is a neuro-ophthalmologist?

Neuro-ophthalmology is a super specialty that integrates the fields of neurology and ophthalmology. Neuro-ophthalmologists are qualified for the diagnosis and control of a number of systemic diseases of the nervous system that affect vision, eye movements, and alignment, as well as pupillary reflexes.

Neuro-ophthalmologists receive specialized training and experience in eye, brain, nerve, and muscle problems. These physicians complete at least five years of clinical training after medical school and normally receive a board certificate in neurology, ophthalmology, or both. Neuro-ophthalmologists have unique abilities to diagnose and treat a wide variety of problems in patients from a neurological, ophthalmological, and medical point of view. Expensive medical exams are often avoided by consulting a neuro-ophthalmologist.

What are the conditions treated by neuro-ophthalmologists?

Conditions that are treated by neuro-ophthalmologists, which include:

  • Unlimited blinking, squeezing, or closing of the eyes
  • Brain tumors or strokes that affect vision
  • Defects in the visual field
  • Double vision
  • Droopy eyelids
  • Eyelid or facial spasms
  • Headache and migraines
  • Idiopathic intracranial hypertension
  • Involuntary eye movement, including nystagmus (also known as “dancing eyes”):  Unusual condition in which the eyes move rapidly in a reversible pattern – sideways, up or down, or in a rotating pattern. This can significantly reduce vision, either temporarily or permanently. It can be inherited or caused by metabolic or neurological problems, including multiple sclerosis, and sometimes in people with an inner ear problem.
  • Microcranial nerve palsy
  • Myasthenia gravis
  • Optic neuritis or neuropathy
  • Pseudotumor cerebri
  • Unequal pupils
  • Unexplained vision loss

Neuro-ophthalmology examinations

Neuro-ophthalmology testing starts with a careful review of the patient’s difficulties and related problems, followed by an evaluation of vision and eye movements, usually with visual acuity, color vision, and visual field tests. The eyes are examined under a microscope (slit lamp) with special attention to the optic nerve and the retina. In most cases, dilating drops are given to enhance the testing of these important structures. Eye movements are also evaluated, which may include the use of prismatic lenses and special graphics.

Also, the pressure and size of each eye can be examined. For unequal students, points can be assigned to identify the cause of the problem. Visual field testing is done using a machine that displays lights in different areas, but the patient presses a button to detect each light and assesses patterns of visual field damage leading to diagnosis. Lastly, neuro-ophthalmologists sit down with their patients to discuss their disease and possible treatments or management strategies.

Whats are the treatments done by neuro-ophthalmologists?

Treatment depends on the specific type of disorder being diagnosed but includes vision restoration therapy (VRT). VRT is a non-invasive treatment that helps repair vision loss as an outcome of a traumatic brain injury such as a stroke. Using a specially designed computer device, VRT promotes visual stimulation to increase visual activity in the brain. This has helped some patients to lose their vision.

After making an appointment, you should be ready to see a neuro-ophthalmologist. The test begins with a complete review of your problems. Your vision is then checked, which often includes visual acuity, visual field tests, and color vision. Eye movement is also assessed using prismatic lenses and graphics.

You can also go through a CT scan or MRI to check if the brain is damaged. Some common diseases and their treatments:

Optic neuritis: This is a condition of a sudden loss of vision, which can be due to information from the optic nerve. It is usually caused by an infection and is associated with multiple sclerosis. If you have optic neuritis, your neuro-ophthalmologist will use antibiotics and corticosteroids appropriately, which can help clear the infection and prevent further damage.

Papilloma: Characterized by inflammation of the optic nerve and can be easily detected by a doctor during an evaluation of the retina. It is usually due to increased pressure in the brain and may be due to a tumor or infection.

If it is due to stress, then medications are used to shrink the joint within the skull, but due to this ridiculous enlargement, you may need surgery.

Nutritional optic neuropathy: In this case, the toxins found in tobacco alcohol can damage the optic nerve. It is also caused by a lack of various nutrients and a deficiency of the vitamin B complex. Your ophthalmologist will prescribe vitamins and lifestyle changes.

Diabetic retinopathy: The cause of this disease is usually diabetes, and if diabetes is not diagnosed, it is advisable to control and treat diabetes before further damage to the blood vessels occurs.

What are the services given by neuro-ophthalmologists?

Your care begins with a detailed evaluation. Our neuro-ophthalmologist takes a close look at the interactions between the eyes and the brain, getting to the root of the problem. We recommend personalized treatments to restore vision. If other treatments are unsuccessful, we will not stop until you have the relief you need.

Your care may include:

  • Special Exam: You have access to the latest imaging technologies, including ocular coherence tomography (OCT). This test uses light waves to examine the layer of tissue in the eye through layers. We are also one of the few multifocal electrocardiogram (ERG) programs offered locally to detect retinal problems.
  • Medications: If you have symptoms due to an infection, you may feel better after taking antibiotics. If you experience inflammation, you may need a stronger dose of steroids.
  • Surgery: If surgery is required, you have access to all available surgical treatments. Our neuro-ophthalmologist will perform some procedures. You may also receive care from other members of the Storm Eyes team, including specialists in reconstructive eye surgery.
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Specialists

Overview of Electrophysiologist | Cardiology

What is an electrophysiologist?

An electrophysiologist is eligible to perform specialized tests of your heart’s electrical system, such as electrophysiology or ablation. Blood pumping is a mechanical problem that involves the heart muscle and vessels. Many cardiologists deal with the mechanical function of the heart. Remembering to pump blood is an electrical problem. The heart has an electrical system that sends impulses for muscle contraction.

When there are problems with the electrical signals in the heart, the result is an arrhythmia-irregular heartbeat. These problems are treated by electrophysiologists.

Electrophysiologists can use many tests and treatments just like other cardiologists. However, electrophysiologists can also perform specialized tests called electrophysiology studies (EPS), which can also allow procedures such as pacemaker placement, insertion of an implantable cardioverter-defibrillator (ICD), or catheter ablation to treat arrhythmia.

Difference between a cardiologist and an electrophysiologist?

The heart has two main functions: to pump blood throughout the body and to do it efficiently and rhythmically. The actual pumping of blood is very mechanical and the problems that arise in this area are of a circulatory or structural nature.

Cardiologists are medical professionals who treat and correct problems such as coronary heart disease, congestive heart failure, cardiac arrest, or peripheral artery disease.

Heart rhythm disorders, on the other hand, arise from problems in the heart’s electrical system that controls the heartbeat. When there is a problem here called arrhythmia, the heart beats too fast, too slow, or with inconsistent manipulations.

Due to the nature of electricity, treating arrhythmias requires additional and specialized training by the physician, who must complete one to two years of additional training beyond the standard cardiology scholarship. Cardiac electrophysiologists are doctors who have completed this unique cardiovascular workout.

What does an electrophysiologist do?

The heart muscle produces electrical signals that travel through the heart muscle to contract. These signals are small but can be taken on an EKG machine. The electrocardiogram (ECG) can help, but often the signs that doctors need to see are so small that they cannot be seen or hidden on the ECG. The electrophysiologist can perform ablation studies and/or procedures on your heart’s electrical system and timing.

When do you need an electrophysiologist?

In a normal, healthy heart, the upper chambers (atria) and the lower chambers (ventricles) work together, alternately contracting and pumping blood. Sometimes your rhythm shoots up and you have an irregular heartbeat, either too fast (more than 100 beats per minute) or too slow (less than 60 beats per minute). An electrophysiologist can help you cope with arrhythmia, the most common of which is atrial fibrillation, where the upper two chambers shake without coordinating their contractions.

Purpose of electrophysiologists

A cardiologist may recommend an EP study when a standard EKG, Holter monitor, event recorder, stress test, echocardiogram, or angiogram do not provide adequate information to evaluate an abnormal heart rhythm known as an arrhythmia.

The EP study may also help diagnose suspected arrhythmia in a patient with arrhythmia symptoms, but this has not been found in other tests.

The purpose and great value of the EP study are that it provides the physician with more detailed information about the electrical activity of the heart than the non-invasive tests mentioned above because the electrodes are placed directly on the heart tissue.

EP studies may help assess:

  • Some tachycardia or bradycardia of unknown cause
  • Resuscitated patients after experiencing sudden cardiac death
  • Various symptoms of unknown causes such as chest pain, shortness of breath, fatigue, or syncope
  • Response to antiarrhythmic therapy

Conditions of electrophysiology

Common conditions that we treat in our laboratory, including atrial fibrillation and other types of arrhythmias. Using cardiac maps, our electrophysiologists can identify the cause of irregular heartbeat and often correct it by ablation. This procedure corrects electrical conduction problems that cause a problematic and abnormally fast heart rate.

Our electrophysiologists can perform additional treatments as needed in the laboratory. For example, if you are experiencing a cardiac defibrillator that provides a slow heart rate or electrical impulses, pacemakers can be set to help the patient’s heart return to a normal rhythm after experiencing a severe arrhythmia.

Electrophysiologists procedure

The EP study is an invasive test similar to angiography and is performed in a catheterization laboratory. After the patient is operated on under local anesthesia (or in some cases, general anesthesia), the catheter is inserted into a blood vessel through a site in the groin or neck and guided through the catheter and images of the myocardial fluoroscopy.

Once the catheter reaches the heart, the electrodes on its tip collect data and a variety of electrical measurements are made. This “electrical mapping” helps the cardiac arrhythmia specialist to locate the area where the current is interfering.

The electrophysiologist then administers various medications or electrical stimuli to determine the ability to terminate the arrhythmia and restore normal heart rhythm. Sometimes a specialist will perform cardiac ablation or insert an implanted cardioversion device (ICD) or pacemaker. The procedure usually takes about two hours.

Treatments of electrophysiologists

  • Atrial fibrillation ablation
  • Device interrogation
  • Electrical cardioversion
  • Monitoring
  • Implantable cardioverter-defibrillator (ICD)
  • Pacemaker implantation

Study of electrophysiologists

When an abnormal heartbeat is found, your doctor or cardiologist may recommend an electrophysiology study (EPS).

This study is performed by an electrophysiologist who inserts one or more specialized electrode catheters in the groin or neck into the blood vessel leading to the heart.

Using catheters, the electrophysiologist sends electrical signals to your heart and records the electrical activity of your heart.

The EPS will help determine:

  • Source of abnormal heartbeat
  • What medicines work to treat your arrhythmia
  • If you need an ICD (implantable cardioverter-defibrillator) or pacemaker
  • If you need catheter ablation (using a catheter to destroy a very small part of the heart that causes arrhythmia).
  • Your risk of complications such as cardiac arrest

New technology and Innovative procedures

Our ability to perform 3-D models of the heart in real-time can help us determine the best treatment options, such as medications, surgical procedures, or devices such as defibrillators or pacemakers with remote monitoring by specialized personnel.