Our Services

Ambulatory EEG Testing

Ambulatory EEG testing is a noninvasive diagnostic procedure that continuously records the electrical activity of the brain over an extended period, usually ranging from 24 to 72 hours, while the patient goes about their normal daily routine. Unlike a standard in-office EEG, which captures brain activity for a short time in a controlled setting, an ambulatory EEG allows physicians to observe brain function during real-life situations such as sleeping, working, and performing routine activities. This extended monitoring significantly increases the likelihood of capturing abnormal brain activity that may not appear during a brief test.

During the procedure, small electrodes are gently placed on the scalp and connected to a compact, portable recording device that the patient wears comfortably. Patients are encouraged to maintain their usual activities and keep a diary of symptoms, sleep patterns, and events that occur during the monitoring period. This information helps the neurologist correlate recorded brain activity with reported symptoms, improving diagnostic accuracy.

Ambulatory EEG testing is commonly used to help diagnose seizure disorders and epilepsy, especially in patients who experience infrequent or unexplained episodes. It is also valuable for evaluating unexplained symptoms such as fainting spells, episodes of staring, confusion, or sudden changes in awareness. Additionally, this test can assist in identifying sleep-related neurological conditions and detecting changes in brain function that may affect behavior, cognition, or memory.

By providing a more comprehensive view of brain activity over time, ambulatory EEG testing offers greater diagnostic insight than a routine EEG. The detailed information obtained allows physicians to make more accurate diagnoses and develop personalized treatment plans tailored to each patient’s specific condition. Ultimately, ambulatory EEG testing plays a crucial role in guiding effective care and improving outcomes for individuals with complex or hard-to-diagnose neurological symptoms.

EEG Your doctor scheduled you for an EEG:

The EEG (Electroencephalogram):

Is a PAINLESS test that will take approximately 45 minutes to complete. The test is simply recording the brainwave activity of your brain. For all testing, please arrive at your appointment with clean and dry hair.

• You may not have extensions, braids, oils, lotions, conditioners, hair spray, gel, or color rinses in your hair for the test.
• Please DO NOT HAVE COFFEE, CAFFEINATED DRINKS, OR CHOCOLATE FOR 4 HOURS PRIOR to the exam. (If you fail to comply, your appointment will need to be rescheduled. We do ask that you continue taking your regular medications and eating your meals as usual)
• We will be placing a cap and gel on your head/hair.
• There are no needles involved. You may feel some sharp scratching on the scalp during the gel application process

24/48/72-hour Ambulatory EEG:

If your doctor has ordered an ambulatory EEG, you will come to the office to have the equipment set up. You will then wear the device for the specified amount of time

• You will NOT be able to shower or bathe for the entire duration of the test. You will need to STAY HOME during this time.
• Please wear clothing that buttons up the front (no T-shirts, pullovers, or sweaters).
• You will return to the office to have the equipment removed. Do NOT remove the equipment at home unless you are specifically instructed to do so.
• For most tests, you will be on camera at home

Sleep Deprived EEG:

If your DR has specified a Sleep Deprived EEG, you will need to be awake from midnight until the time of your test. If the DR specified this, and you FAIL to stay awake the night before your exam, your appointment will be rescheduled.

Multiple Sclerosis (MS) Evaluation

Multiple Sclerosis (MS) is a chronic neurological condition that affects the brain, spinal cord, and optic nerves. It occurs when the immune system mistakenly attacks the protective covering of nerve fibers (myelin), disrupting communication between the brain and the rest of the body. Because MS can present with a wide range of symptoms—such as fatigue, weakness, vision problems, numbness, balance issues, cognitive changes, and mood disturbances—a thorough and comprehensive neurological evaluation is essential for accurate diagnosis and effective management.

Our Multiple Sclerosis diagnostic services are designed to provide a detailed understanding of each patient’s condition. Evaluation may include MRI imaging of the brain and spine to identify characteristic lesions and assess disease activity. A comprehensive neurological examination helps evaluate motor strength, coordination, reflexes, sensation, and cognitive function. Laboratory testing is performed to assess autoimmune and inflammatory markers and to rule out other conditions that may mimic MS. In addition, evaluation of optic nerve function is often included, as visual symptoms are a common and early manifestation of MS.

Once a diagnosis is established, our specialists focus on ongoing management and close monitoring. Treatment plans are individualized and may include disease-modifying therapies to reduce relapse frequency and slow disease progression, along with symptom-based treatments to address pain, spasticity, fatigue, and mobility challenges. Regular follow-up and imaging allow us to track changes over time and adjust care as needed, with the goal of preserving function and maintaining quality of life.

In addition to MS care, we also evaluate sleep-related neurological conditions and changes in brain function that affect behavior or memory. Advanced diagnostic methods, including extended EEG monitoring when appropriate, provide a more complete picture than a brief in-office study. This comprehensive approach leads to more accurate diagnoses and personalized treatment strategies tailored to each patient’s unique needs.

Peripheral Neuropathy Testing

Peripheral neuropathy is a condition that affects the peripheral nerves, which are the nerves located outside of the brain and spinal cord. These nerves are responsible for sending sensory information, such as touch, pain, and temperature, to the brain, as well as controlling muscle movement. When these nerves are damaged or not functioning properly, it can lead to a wide range of symptoms. Common symptoms include numbness, tingling, burning sensations, sharp or shooting pain, muscle weakness, poor coordination, or sensitivity to touch. Symptoms may begin gradually and often start in the hands or feet, sometimes progressing upward over time.

Peripheral neuropathy can have many underlying causes. Some of the most common include diabetes, vitamin deficiencies (such as B12), autoimmune conditions, infections, medication side effects, toxin exposure, and inherited nerve disorders. In some cases, the exact cause may not be immediately clear, which is why a thorough evaluation is essential.

Your evaluation typically begins with a detailed medical history and a comprehensive neurological examination to assess reflexes, strength, sensation, and coordination. Based on these findings, additional testing may be recommended. This can include EMG and nerve conduction studies, which help measure how well your nerves and muscles are functioning and can identify the type and severity of nerve damage. Bloodwork is often ordered to rule out common and treatable causes such as diabetes, vitamin deficiencies, thyroid disorders, or autoimmune diseases. Depending on your specific symptoms, additional specialized testing may also be recommended.

Our goal is to accurately identify the type and cause of your peripheral neuropathy. By understanding the underlying problem, we can develop a targeted and effective treatment plan aimed at relieving symptoms, slowing progression, and improving your overall quality of life.

Botox for Migraine and Spasticity

Botox is a well-established, FDA-approved treatment widely used for managing chronic migraines and neuromuscular disorders associated with muscle spasticity. It has been extensively studied and proven effective for patients who experience frequent, debilitating headaches or muscle overactivity that interferes with daily functioning. When used therapeutically, Botox works by blocking the release of certain chemicals involved in muscle contraction and pain transmission. This action helps relax overactive muscles and interrupts pain pathways, reducing both discomfort and functional limitations.

For patients with chronic migraines, Botox can significantly decrease the frequency and severity of headache days. Many individuals who previously experienced migraines on most days of the month report noticeable improvements after treatment, allowing them to return to work, social activities, and daily routines with greater confidence and comfort. In neuromuscular conditions such as spasticity, Botox helps reduce muscle stiffness, involuntary contractions, and spasms, which can otherwise cause pain, restricted movement, and difficulty performing routine tasks.

Patients often experience a range of benefits, including fewer migraine days, reduced muscle tightness, improved range of motion, and enhanced overall quality of life. By decreasing muscle overactivity, Botox can also help improve posture, balance, and mobility, particularly in individuals recovering from neurological conditions or injuries.

Botox treatments are typically performed in the office and require only a few minutes to complete. The procedure involves a series of small, targeted injections and is generally well tolerated, with minimal downtime. Most patients begin noticing improvement within days to weeks, with relief lasting up to three months. With regular follow-up treatments, Botox can provide consistent, long-term symptom control and meaningful improvement in daily functioning.

Nerve Conduction Study (NCS)

A Nerve Conduction Study (NCS) is a diagnostic test that measures how quickly and effectively your nerves transmit electrical signals throughout the body. Nerves play a vital role in carrying messages between the brain, spinal cord, and muscles. When a nerve is damaged or compressed, these signals can slow down or weaken, leading to symptoms such as pain, numbness, tingling, weakness, or loss of coordination. An NCS helps physicians accurately identify the source of these symptoms.

During the test, small surface electrodes are placed on the skin over specific nerves and muscles. Gentle electrical impulses are delivered to stimulate the nerve, and the response is recorded. The test evaluates nerve speed, strength, and function, allowing providers to determine whether a nerve is functioning normally or showing signs of damage. The procedure is safe, minimally invasive, and typically well tolerated by patients.

Nerve Conduction Studies are commonly used to diagnose conditions such as

• Carpal tunnel syndrome
• Peripheral neuropathy
• Pinched nerves in the spine (radiculopathy)
• Nerve injuries caused by trauma or repetitive use

By pinpointing the exact location and severity of nerve involvement, NCS plays a critical role in guiding accurate diagnosis and personalized treatment planning.

Results from an NCS help your provider determine the most effective treatment options, which may include physical therapy, medications, injections, or other in-office procedures aimed at relieving nerve compression and inflammation. Many treatments are performed in the office and take only a few minutes to complete. Patients often experience improved mobility, reduced pain, and increased comfort following treatment, with symptom relief lasting up to three months in many cases.

Overall, a Nerve Conduction Study is a valuable tool that provides clear insight into nerve health, supports early intervention, and helps restore function and quality of life.

Occipital Nerve Block

An occipital nerve block is a minimally invasive, in-office procedure used to relieve pain associated with chronic headaches, migraines, and occipital neuralgia. These conditions often originate from irritation or inflammation of the occipital nerves, which run from the upper neck to the back of the scalp and play a key role in transmitting pain signals from this area. When these nerves become overly sensitive or inflamed, patients may experience persistent head and neck pain, scalp tenderness, or headaches that radiate toward the forehead or behind the eyes.

During the procedure, the patient is comfortably positioned while the provider identifies the location of the occipital nerve at the back of the head. A small amount of local anesthetic, sometimes combined with a corticosteroid, is carefully injected near the nerve. The anesthetic works by temporarily blocking pain signals, while the steroid, when used, helps reduce inflammation around the nerve. The injection itself takes only a few minutes and is generally well tolerated, with minimal discomfort.

Many patients experience immediate pain relief shortly after the injection, often within minutes. For others, improvement may occur gradually over the next few days as inflammation subsides. The duration of relief varies from patient to patient; some individuals experience benefits lasting several weeks, while others may enjoy pain reduction for several months. Occipital nerve blocks can also help confirm whether the occipital nerve is the source of a patient’s pain, guiding further treatment decisions.

Overall, an occipital nerve block is a safe and effective option for patients who have not achieved adequate relief with medications alone. By reducing pain intensity and frequency, this simple procedure can significantly improve daily functioning, quality of life, and the ability to participate in normal activities with greater comfort.

Vagus Nerve Stimulation (VNS) Therapy

Vagus Nerve Stimulation (VNS) therapy is an established treatment option for patients with epilepsy who do not achieve adequate seizure control with medication alone. Many individuals with epilepsy continue to experience seizures despite trying multiple anti-seizure medications, and VNS therapy offers an additional, non-pharmacological approach to help improve seizure management and quality of life.

VNS therapy involves the surgical implantation of a small medical device, similar in size to a pacemaker, under the skin of the chest. During the procedure, a thin wire is carefully connected from the device to the vagus nerve, a major nerve that runs from the brain through the neck to the chest and abdomen. Once implanted, the device delivers mild, intermittent electrical pulses to the vagus nerve at programmed intervals.

These electrical pulses travel to areas of the brain involved in seizure activity and help regulate abnormal electrical signals. Over time, this modulation of brain activity can lead to a reduction in the frequency, severity, and duration of seizures. While VNS therapy does not cure epilepsy, many patients experience meaningful improvements, including fewer seizures, shorter recovery times after seizures, and improved alertness or mood.

Our neurologists play a central role throughout the VNS treatment process. They begin with a comprehensive evaluation to determine whether a patient is a suitable candidate for VNS therapy. After implantation, the device is carefully programmed and adjusted during follow-up visits to achieve the best possible results while minimizing side effects. Ongoing monitoring and management ensure that the therapy continues to meet the patient’s needs over time. Through personalized care and advanced treatment options like VNS therapy, our team is committed to helping patients achieve better seizure control and an improved quality of life.

Neurocognitive Testing

A neuropsychological evaluation is a comprehensive assessment designed to understand how well different areas of the brain are functioning and how these functions affect everyday life. It examines the relationship between brain health, thinking skills, emotions, and behavior. This type of evaluation is commonly recommended when there are concerns about memory, attention, reasoning, or changes in personality or behavior.

During the evaluation, several key cognitive domains are tested. Memory and attention are assessed to determine how well a person can learn new information, retain it, and stay focused over time. Problem-solving and executive functioning are evaluated to understand skills such as planning, organization, judgment, and decision-making. Language abilities are tested to measure understanding, word-finding, reading, and communication skills. Processing speed is also examined, which reflects how quickly and efficiently the brain can take in and respond to information. In addition, mood and behavior are carefully reviewed, as emotional health can significantly influence cognitive performance.

Neuropsychological testing plays a vital role in diagnosing and differentiating neurological and psychological conditions. It can help identify disorders such as

• Dementia
• Attention-deficit/hyperactivity disorder (ADHD)
• Cognitive changes related to stroke
• Traumatic brain injury
• Learning disorders
• Other conditions that affect brain function.

The results provide detailed insight into an individual’s strengths and areas of difficulty, often detecting subtle changes that may not be visible on imaging studies alone.

Most importantly, the findings from a neuropsychological evaluation help guide personalized treatment and support plans. These may include medical recommendations, cognitive rehabilitation, academic or workplace accommodations, and strategies to improve daily functioning. By offering a clear picture of cognitive health, neuropsychological evaluations support early intervention, informed decision-making, and improved quality of life.