NEUROLOGY SPECIALISTS of Monmouth County, NJ

IN OUR OFFICE


1:	Neurologic consultation in the office
2:	Electrodiagnostic testing (Electromyography, EMG)
3:	Electroencephalography (EEG)
4:	Botulinum toxin (BoTox) injections
5:	Spinal nerve blocks
6:	School evaluation for attention deficit disorder and hyperactivity

AT THE HOSPITAL


1:	Consultation
2:	Sleep studies
3:	Video EEG monitoring
4:	Lumbar puncture
5:	MDA Clinic
6:	Teaching

IN OUR OFFICE

1: Neurologic consultation in the office

Patients are referred to us for evaluation of a variety of neurologic complaints, including:

i	Numbness and tingling
ii	Neuropathy and nerve injuries
iii	Carpal tunnel syndrome
iv	Neuropathic pain and neuralgia
v	Weakness of the limbs and trunk
vi	Muscle diseases and dystrophy
vii	Double vision
viii	Myasthenia Gravis
ix	Spine problems and herniated discs
x	Poor balance and difficulty walking
xi	Headache and facial pain
xii	Parkinson’s disease, tremor, and other abnormal movements
xiii	Stroke and TIA
xiv	Multiple sclerosis
xv	Seizures, epilepsy and other spells of altered awareness

2: Electrodiagnostic testing (Electromyography, EMG)

We perform electromyography in our office for patients with suspected nerve disorders (neuropathy), muscle disorders (myopathy), nerve entrapments (pinched nerves) or spine disease. Two of our physicians have subspecialty training and additional board certification in electrodiagnostic testing. Testing usually involves recording nerve conduction responses from surface electrodes as well as inserting a small needle to record muscle responses. These tests are not performed in a standard manner, and testing is individualized to each patient depending on their symptoms. Therefore, this type of testing is best combined with neurologic consultation, and considered an extension of a more extensive neurologic evaluation.


Patient Instructions - Electromyography

3: Electroencephalography

We perform electroencephalography (EEG) and evoked potentials (EP) in our office. EP studies are often used to evaluate patient with suspected multiple sclerosis. EEG is used to evaluate patient with spells or seizures. Sometimes we ask for patients to come for EEG first thing in the morning after keeping themselves awake the night before. This is called a sleep-deprived EEG and improves the sensitivity of the test. Studies are read by one of our physicians who has subspeciality training and board certification in electroencephalography.

Patient Instructions - Evoked Potentials
Patient Instructions - EEG
Patient Instructions - Sleep-deprived EEG

4: Botox injections:

Dr. Ponce administers EMG guided botox (Botulinum Toxin) injections for patients with focal dystonia (hemifacial spasm, torticollis and writers’ cramp), muscle spasms-spasticity (post-stroke or multiple sclerosis, failed neck and back surgeries), and chronic migraine headaches.

5: Nerve root blocks:

Dr. Gennaro administers spinal nerve root blocks for relief of low back pain and sciatica. He also administers nerve blocks for relief of neuropathic pain from specific nerve injuries.

6: School evaluation for ADD and hyperactivity - Dr. Gilson

Dr. Gilson treats children age 5 and above with Attention Deficit Disorder and Hyperactivity (ADHD), and he evaluates children for learning disabilities for several school systems.

AT THE HOSPITAL

1: Consultation

Our physicians have privileges to see in-patients for neurologic consultation at Monmouth Medical Center and Riverview Medical Center. We participate in the stroke programs in both hospitals, and are available to evaluate patients emergently for consideration of thrombolytic therapy in acute stroke.

2: Sleep studies:

We interpret sleep studies (polysomnograms) performed in the sleep laboratory at Riverview Medical Center to evaluate patients with insomnia, restless legs syndrome, sleep apnea, narcolepsy REM sleep behavior disorder and other parasomnias.

3: Video-EEG monitoring:

Continuous video-EEG monitoring is sometimes necessary to determine whether spells of altered behavior and awareness is from epilepsy or some other disorder. Dr. Herman is medical director of a state of the art 2-bed video-EEG monitoring unit at Riverview Medical Center.

4: Lumbar puncture:

We refer some of our patients for lumbar puncture. This diagnostic test is performed by one of our physicians in the medical day stay unit at the hospital. Patient Instructions

5: MDA clinic:

Dr Holland directs an MDA clinic held at the Rehabilitation Hospital of Tinton Falls a joint partnership between Monmouth Medical Center and Health South. We evaluate patients with neuromuscular disorders in a multidisciplinary environment with the help of physical, occupational and speech therapists and nursing case managers.

6: Teaching:

Our physicians hold teaching (clinical faculty) appointment at Drexel University College of Medicine. Medical students from Drexel come to our office for clinical rotations in neurology. We also teach medicine and orthopedic residents from the Monmouth Medical Center.