We provide treatment and disease management for new and ongoing neurological conditions. Every patient is unique, and therefore every treatment plan is individualized based on past medical history, test results and the patient’s personal preferences. For chronic conditions, this often entails tailoring medications so that your health is optimized through prescription adjustments; prescribing a new medication based on updated information, or possibly re-evaluating all of your medications to ensure we are using the latest pharmacology. We can often offer immediate relief for some conditions by performing treatments in our office. If the required treatment is outside our area of specialty, we refer out to the appropriate provider.
Sleep Disorder Treatment
Sleep study results are available approximately five days after the tests have been performed. Once complete, you will again meet with your provider at CNSM to develop an individualized treatment plan. Treatment options vary depending on diagnosis, but may include:
Sleep Apnea – There are five treatment options for sleep apnea: CPAP, a dental appliance, weight loss, or two surgical procedures (UPPP).
The preferred treatment option for obstructive sleep apnea (OSA) by the American Academy of Sleep Medicine is CPAP. CPAP is a medical device that delivers pressurized air via a facial/nasal mask to keep the airway open. Another option is for a dental appliance to be formed by your dentist to advance the jaw and open the airway during sleep. Weight loss is another method, as a significant drop in body weight (10-15%) can decrease the severity of sleep apnea by 50%. Inspire, an implant is newly approved by the FDA. It works through the stimulation of the hypoglossal nerve resulting in an open, unobstructed airway. Lastly, an ear, nose, and throat specialist may complete a surgery called an uvulopharyngopalatoplasty, or UPPP, to enlarge the airway and decrease the severity of sleep apnea.
Narcolepsy is typically treated with pharmaceuticals such as Provigil, Nuvigil or other stimulants.
Insomnia is treated with traditional medication, Cognitive Behavioral Therapy (CBT), adjustments to sleep patterns, or a combination of the therapies. CBT for insomnia is a non-medication approach to the treatment of insomnia. CBT includes the modification of behaviors and beliefs about sleep. This is a tailored treatment plan designed to meet each patient’s specific needs regarding sleep behaviors.
Restless Leg Syndrome (RLS) can be overcome simply through medications such as Mirapex and Requip. When indicated, iron supplements may also be prescribed.
Some of the treatment options we provide include:
BOTOX ® : Botulinum toxin may be injected in small doses for various neurologic conditions. Although it was first used for cosmetic purposes, we use it to treat a variety of medical conditions. BOTOX ® may be injected in the forehead and neck for migraine headaches, near the eyes for blepharospasms (uncontrolled blinking of the eyes), torticollis (involuntary, painful turning of the neck muscles), hemifacial spasms, and spasticity involved with various neurological disorders including stroke, MS, and cerebral palsy.
Occipital Nerve Block: Lidocaine and steroid are injected where the greater occipital nerve goes through the fascia in the back of the neck and skull. This treatment has been proven to abort a migraine. The procedure takes minutes and afterward the patient often is headache free and is always able to drive home.
Trigger Point Injections: Trigger point injections are used to relieve myofascial pain or pain over tender “trigger” spots often found on the back or shoulders. These injections are completed with saline mixed with 1% lidocaine. Pain relief typically occurs within 15 minutes and may last approximately one month.
VNS Adjustment for Epileptic Seizures: A Vagus Nerve Stimulator (VNS) is an implanted device used to help to control epileptic seizures. After being implanted by a neurosurgeon, the device can be programmed and adjusted in our office. This programming is painless and lasts approximately 5 minutes.
Cognitive Behavioral Therapy (CBT): Adjustments to sleep patterns or a combination of the therapies. CBT for insomnia is a non-medication approach to the treatment of insomnia. CBT includes the modification of behaviors and beliefs about sleep. This is a tailored treatment plan designed to meet each patient’s specific needs regarding sleep behaviors.