Services available through the clinic include:

• Consultative services
• Multiple sclerosis (MS) clinic with dedicated MS nurse
• Intravenous infusion service
• Neurodiagnostic laboratory testing
  
• Polysomnography (sleep studies)
• Neurolysis procedures ("BOTOX")/Trigger Point injections
• Magnetic resonance imaging (MRI)
• Computerized tomography (CT)
• Lumbar puncture, spinal fluid examinations
• Routine laboratory bloodwork.

ANA is pleased to offer the full complement of neurodiagnostic testing provided only through board-certified technicians and physicians.

• Nerve Conduction Velocity Testing (NCV): This test is used for the diagnosis of common nerve entrapment syndromes (e.g. carpal tunnel syndrome, ulnar nerve palsy) and peripheral neuropathy.
• Electromyography (EMG): This test is complimentary to the NCV and used to aid in the diagnosis of nerve and muscle diseases. The EMG allows the physician to take an 'electrical biopsy' of several muscles to help pinpoint the problem. Examples of EMG diagnosed problems include pinched nerves in the spine from ruptured disks, muscle weakness from severe nerve entrapments, and diagnosis of more rare muscle disorders from polymyositis or cholesterol medicine toxicity.
• Electroencephaolography (EEG): This test allows the neurologist to non-invasively monitor the electrical activity of the brain. The most common use is to diagnose patients with seizures via a 30 minute office based test. The EEG has been around for decades, but computers and miniature electronics have revolutionized the EEG in the past few years. Now we have equipment that one can wear home like a 'walkman' and monitor for seizures over several days. We also provide video-EEG where both the EEG and the visualized event on camera are correlated on the electronic record.
• Autonomic function testing (AFT): This test is used to diagnose disorders of nerves that control heart rate, blood pressure, and gastrointestinal function.
• Polysomnography (PSG): This test is similar to EEG and performed overnight to study a person's sleeping patterns. The PSG used EEG to monitor the stages of sleep controlled by the brain, in addition to monitoring heart rhythm, respiratory movement, oxygen levels, and limb movements. The disorders that are diagnosed with this test include sleep apnea, periodic limb movement disorder, 'restless legs,' and narcolepsy.
• Vagus Nerve Stimulator (VNS): The VNS is an FDA approved therapeutic device used for the treatment of medically refractory epilepsy. The device is implanted similarly to a heart pacemaker by our surgical colleagues with the stimulator wires going to the vagus nerve in the neck. There is no brain surgery required. The device is then monitored by our neurologists and adjusted according within the neurodiagnostic lab. Although the VNS is an invasive device, the stimulator is well-tolerated, tends to improved quality of life measures, and has been shown to improve depression/mood. This is in contrast to multiple oral seizure medications which may adversely affect cognition and mood. Office based procedures
• Neurolysis procedures ("BOTOX"): Using two commercially available preparations (BotoxT and MyoblocT), our trained neurologists can help relieve abnormally contracted muscles from dystonia, stroke, spinal cord injury, and cerebral palsy. We often employ our EMG skills (see above) for added safety and acute delivery of medicine.
• Trigger Point injections: Utilizing a combination of local anesthesia and anti-inflammatory steroids, this treatment can help muscle spasm commonly encountered with tension headache and neck pain.
• Lumbar puncture: Performed under local anesthesia, this procedure remains the mainstay for aiding in the diagnosis of inflammatory conditions of the brain and nerves. Spinal fluid examination is useful to diagnose multiple sclerosis, inflammatory neuropathy, meningitis, and encephalitis. We utilize the latest spinal needle technology to minimize the risk of post-procedure headaches.
• Intravenous infusion service: Our trained infusion nurse, Jodie Seila, with over 20 years critical care experience performs these IV procedures in the office. Medications we are currently offering include-solumedrol, gamma globulin (IVIG), Depacon (valproic acid), and Tysabri (natalizumab). Conditions treated with these medications include multiple sclerosis, inflammatory neuropathy (e.g. CIDP), and migraine.
• Routine laboratory bloodwork: Last but not least, we have a professional phlebotomist on site to draw your lab studies without the need for you to have to travel to another site (provided your insurance allows us to do bloodwork at the point of care)

Additional services provided through our hospital partnerships include:

• Inpatient video-EEG monitoring
• Plasmapheresis/plasma-exchange
• Intraoperative neuromonitoring
• Evoked potentials testing
• Positron emissions tomography (PET)
• Inpatient acute physical rehabilitation.
• Neurodiagnostic Laboratory Testing

Hospital Services

• Plasmapheresis/Total plasma exchange (TPE): This procedure is used to literally filter out the bad antibodies and certain blood bourne factors that cases neurological diseases such as: Myasthenia Gravis, Guillain-Barre syndrome, Chronic Inflammatory Demyelinating Polyradiculoneuropathy, and rarely Multiple Sclerosis. Dr. Poling provides the medical directorship for this procedure within the ARMC critical care unit by specially trained nurses for both inpatients and outpatients.
• Acute Neuro and Ortho- rehabilitative services: Dr. McCord Smith provides medical directorship for a 20-bed physical medicine rehab unit located on the newly removed 5th floor of St. Mary's Hospital. Patient referrals largely derive from the stroke service, orthopedics, and neursurgeons. The unit employs an intensive rehab program under speech-language pathologists, occupational therapists, and physical therapists.
• Evoked Potentials (EPs): These electrical neurodiagnostic tests have been largely replaced by advanced neuroimaging such at CT and MRI. They are still helpful though for diagnosing multiple sclerosis and intraoperative neuromonitoring.
• Intraoperative Neuromonitoring (IOM): This service is provided to spine and brain surgeons to help monitor the function of the nervous system during surgery while the patient is under anesthesia. As the nervous system is a very delicate structure which often does not repair itself well, this monitoring allows the surgeon to have another layer of safety while performing intricate procedures. The age of the internet now allows us to watch what is going on with the IOM functions in real time from our office while the surgeon and IOM technician are working at the hospital.

Neuroimaging Services

• Athens Neurology is pleased to offer the most up-to-date imaging services through our affiliations with Athens Diagnostic Center, Royston Diagnostic Center, Cowles Clinic/Alliance Imaging, Open MRI of Athens, and the area hospitals.
• Magnetic resonance imaging (MRI): Arguably the most important tool the neurologist has for accurate diagnosis of brain and spinal disorder, this safe and non-invasive test is revolutionizing medicine with the neurological sciences at the forefront. Without using any x-ray radiation, the MRI uses a strong magnetic field to provide high resolution pictures of structures deep inside the body.
• Magnetic resonance angiography (MRA): A test that uses the same MRI machine, but studies the blood vessels in the brain rather than the brain itself. ANA is pleased to offer the lastest in contrast enhanced (ceMRA) to provide the best non-invasive picture of your arteries from the neck-up. The MRA is useful for studies cases of blocked arteries and aneurysms.
• Computerized tomography (CT): Available since the late 1970s, this test uses x-rays and computerized reconstruction methods to rapidly assess the brain for bleeding or large strokes. The main utility is for emergency evaluation such as in the hospital ER or for patients with heart pacemakers who cannot have MRIs. I think an accurate analogy of MRI versus CT is the picture from a new 5 megapixel color camera versus looking at an old black and white photo. A notable exception to this rule is the evaluation of the bones and sinuses which are still better evaluated by the CT scanner.
• Ultrasound/Transcranial Doppler (US/TCD): A non-invasive way of looking at the blood vessels of the head and neck using ultrasound. This test uses the same technology the police use to monitor the speed on your car. By using 'ultra' sound waves, the speed of blood in the vessels can be calculated and then the size of the vessel determined to find areas of blockage.
• Positron Emission Tomagraphy (PET): Available as a research tool mainly in past years, this test has recently found a small clinical niche. PET can aid in the diagnosis of certain dementias such as Alzheimer's disease and movement disorders such as Parkinson's. PET has the ability to detect Alzheimer's disease in its earliest stages even before a patient may have any symptoms or when patients have mild cognitive impairments without dementia.