Botox is an injected prescription medication placed into the muscles. It is used to treat chronic migraine, upper limb spasticity (stiffness or tightness that may be painful), cervical dystonia (muscle tension in the neck), and blepharospasm (involuntary closure of the eyes). Many diagnoses must meet medical criteria.

Dysport is an injected prescription medication used to treat abnormal head position and neck pain in adults with cervical dystonia.

Electromyography and nerve conduction studies are important diagnostic tools that can help detect the cause of problems such as muscle weakness, numbness, spasms, paralysis or pain. They determine if the problem involves the nerves, muscles, spinal cord or brain. An EMG can measure the electrical activity of muscles. A NCS can measure the speed and intensity of electrical signals that travel along nerves and the time it takes muscles to respond to these signals.

Prep:
Do not use creams or lotions. Wear comfortable, loose-fitting clothing.  Please wear undergarments. For testing of the upper extremities, wear a sleeveless or short-sleeved t-shirt.  Hospital gowns will be available.

An Electroencephalogram (also called EEG or Brain Wave Test) is painless.  We record the electrical impulses received from the brain on a machine in order to assist the doctor with diagnosis and treatment.  To do this, electrodes are placed at specific intervals around the head, near the eyes, and sometimes on the neck and arms. In order to have a test that is free from artifact, each area that an electrode is applied to must be scrubbed vigorously with a cleansing lotion, and then the electrode is adhered to the skin with a vaseline-based gel.  This test also requires a cooperative participant who will be able to lie quietly with their eyes closed once the test has begun.

Prep:
• Be sure hair is clean and free from grease, oil or hairspray.

• If you take medication, you may take it as usual, unless otherwise instructed by your doctor.

• Be sure to have a meal prior to having the EEG, unless otherwise instructed by your doctor.  DO NOT have any coffee, tea or stimulants.

• If you are you are scheduled for a sleep-deprived EEG, sleep only from 1:00am to 5:00am the night before the exam.  DO NOT take a nap before the exam.

• Please call our office and ask for the prescription refill line.

• Leave a detailed message including your first and last name, the spelling of your last name, your telephone number, date of birth, the name of the medication and dosage, the pharmacy name, and whether you will be picking up the prescription in person or would like it mailed to you.

• Please allow 48 hours for your refill to be processed by our nurse.

• Please check with your pharmacy before calling our office to check on the status of your refill.

• You will not receive a call from our nurse unless there is a question about your refill.

• Please be advised the prior authorizations for medication can take a week or more.

A procedure used to aid in determining Small Fiber Neuropathy (SFN). Small fiber neuropathy is a type of peripheral neuropathy that affects small nerve fibers in the skin that transmit pain and temperature sensations and controls autonomic functions such as sweating.

Symptoms of SFN can include the following: numbness, tingling, burning, stinging or hypersensitivity in the arms, legs, back and torso.

Procedure:
The doctor will obtain a small section of your skin and send it to Therapath for Nerve Fiber Density testing. The complex testing measures the density of the nerve fibers found in your skin. Results take about 10-14 days.

There are effective treatments available for most sleep disorders, but the first step is recognizing that a problem exists. In order to better diagnose sleep disorders in our community, Parkland Medical Center established the Center for Sleep Diagnostics.

Board certified neurologist Jeffrey Rind, M.D., Ph.D. serves as Medical Director of the Center which also includes board-certified pulmonologist Gregory Smull, M.D. and neurologists George Neal, M.D. and Uladzimir Luchanok, M.D., Ph.D. All are specialists in sleep disorders and offer sleep consultations for the proper diagnosis of patients.

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.