What We Do

• Tysabri:  We are a certified site authorized by the Biogen Idec TOUCH program to prescribe, dispense and infuse Tysabri, a disease modifying agent for the treatment of relapsing forms of MS.
• Solumedrol:  (acute MS exacerbations; acute migraine abortive therapy; other indications)
• Depacon:  (acute migraine abortive therapy) 
• IVIG:  (neuromuscular disorders such as Guillain-Barre Syndrome, CIDP, myasthenia gravis, and myopathies; various immunological, rheumatological, hematological and dermatological conditions)
• Novantrone (disease modifying agent for secondary progressive forms of MS)
• Rituxin (MS; other autoimmune disorders)
  
• Orencia  (rheumatoid arthritis)
• Remicade  (Crohn’s Disease, rheumatoid arthritis)
• Antibiotics  (acute and chronic infections)
  
• Hydration
• Vitamin B12 injections
  
• Emerging therapies:  In the next several years, we anticipate the release of many additional infusable medications to the market for the treatment of a number of neurological disorders (such as MS and Alzheimer’s Disease) as well as non-neurological conditions. 

**Please note, we accept direct referrals to our infusion center (CLICK HERE FOR FORM).  Patients referred for infusion therapy need not be current patients in our practice. 

Botulinum Toxin Treatment (Chemodenervation):

We offer treatment with botulinum toxin (Botox) injections which is now FDA approved for preventative treatment in adults with Chronic Migraine unresponsive to appropriate preventative medication.  Chronic Migraine is defined as 15 or more headache days a month with headache lasting 4 hours a day or more.  The injections are performed at multiple sites divided across 7 specific head/neck muscle areas.  In order to sustain any beneficial effect, the recommended re-treatment schedule is every 12 weeks. http://www.botoxchronicmigraine.com

EMG/NCV Studies:

Patients are often referred to our office for EMG/NCV studies.  The purpose of these tests is to diagnose or exclude peripheral nerve damage or dysfunction relating to disc compression in the neck or back, peripheral nerve entrapment in the limbs (e.g. carpal tunnel syndrome), neuromuscular disorders (e.g. ALS, myasthenia gravis, myopathies) as well as peripheral neuropathies.  Many patients show up for their appointment needlessly apprehensive, mainly because of lack of information about the procedure, or even worse, the propagation of misinformation!  Hopefully, a brief description of the procedure will allay any pre-test anxieties!

The procedure consists of 2 parts:

1.  Nerve Conduction Velocity study (NCV):  Small surface electrodes are placed on the skin over a limb muscle (to test motor nerve function), or ring electrodes are placed on selected digits (to test sensory nerve function).  These are the “pickup electrodes”.  A small device called a stimulator is then placed over the nerve to be tested and light shocks are administered sending current along the nerve.  A machine records the signals and measures the speed of conduction of the electrical impulse along the nerve from the stimulator to the pickup electrodes.  Slowing of nerve conduction speeds indicate nerve dysfunction or damage.  The sensation feels like a static electric shock. The stimulation is repeated multiple times along the course of the nerve.  The number of nerves that will be tested depends on the condition being evaluated.  The procedure is perfectly safe for all types of patients including those with cardiac pacemakers and defibrillators as well as women in all stages of pregnancy.

2.  Electromyogram (EMG):  It is important to understand that nerves control muscles in the body with electrical impulses.  These impulses result in muscle movement and contraction.  During the procedure, a thin sterile needle electrode is inserted into the muscle to be tested, and its intrinsic electrical activity at rest and during contraction is examined and interpreted.  In the presence of nerve damage, the muscle becomes “denervated” and it’s pattern of electrical activity is altered.  Knowledge of the nerve supply to each muscle is essential in selecting the appropriate muscles to test when attempting to find the source of any nerve damage.  Most patients consider the procedure mildly uncomfortable but tolerable.  The procedure is safe for all types of patients, including those on “blood thinners” (aspirin, Plavix, Aggrenox, Coumadin, etc.).

No special advance preparation for the test is required, although you may want to view our Requisition for Neurophysiologic Testing document. You can eat and take any medications as prescribed. We do ask that you avoid wearing any creams, lotions or ointments on your skin the day of the test.