Neurology

A neurologist is a medical doctor who is highly trained to identify and treat various diseases of the nervous system such as headache, stroke, neck and back pain, dizziness, Parkinson’s Disease, Alzheimer’s Disease, multiple sclerosis, and epilepsy. After obtaining a complete neurological and medical history, the neurologist does a thorough neurological examination and then discusses the findings with the patient and family to advise whether any further diagnostic testing is necessary and/or what medical treatment is indicated

Stroke & Brain Attack

Stroke is the 3rd leading cause of death in the United States, behind heart disease and cancer, and is a significant cause of disability. NENA neurologists work at the forefront of stroke evaluation and treatment, as well as in the prevention and care of secondary or recurrent stroke. New England Neurological Associates offers a multidisciplinary approach to individuals suffering from stroke. Our specialists treat numerous stroke conditions, including those from aneurysm, arteriovenous malformation, and brain attack. Our team includes specialists in carotid and vascular surgery as well as rehabilitation.

Patients with stroke or transient ischemic attack (TIA) benefit from a treatment plan that is individually tailored to their needs, and that takes into account a number of factors, including the pathomechanism of the ischemic event, patient’s age, gender, co-morbidities, as well as other variables. “Brain Attack” is another way of describing a stroke. A stroke, like a heart attack, is a medical emergency that requires immediate medical care. The symptoms of stroke may include weakness, numbness or paralysis - particularly on one side of the body - sudden blurred or decreased vision, speech difficulty, dizziness, or sudden and severe headache. Acute ischemic stroke is the result of a blood clot that blocks the flow of blood to the brain. If symptoms are recognized within three hours, clot-dissolving agents, such as TPA, may be used for eligible patients to reduce disability.

The NENA stroke team includes several neurologists with Fellowship training in Stroke, as well as sub-specialty Certification in Vascular Neurology. These specialists have worked closely with local hospitals in the development of protocols for use of TPA, the implementation of these protocols, and monitoring of TPA use over time. These efforts are aimed at ensuring the appropriate and timely use of TPA to help reduce the impact of strokes.
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Epilepsy & Seizure Disorders

Led by neurology specialists with advanced Fellowship training in epilepsy, New England Neurological Associates offers a comprehensive approach to the evaluation and treatment of patients suffering from epilepsy and other seizure disorders. A multidisciplinary approach offers a full range of sophisticated services and advanced technology, including neurological evaluations, electroencephalography (EEG), ambulatory EEG, and inpatient EEG with video monitoring, high resolution MRI, PET/CT scanning, and management of complicated intractable epilepsy with the latest pharmacological treatments available.

24 Hour Ambulatory Electroencephalographic (EEG) Monitoring
Brain wave electrodes are attached to a portable recorder that is carried at home 24 hours a day to study the brain’s electrical activity to aid in the diagnosis of seizures and other neurological conditions.

Adult and Pediatric Overnight Inpatient Video Telemetry
For those patients with poorly controlled seizures, the use of overnight inpatient video EEG telemetry is an integral part of evaluations. These studies are conducted at the New England Epilepsy Institute (NEII), a joint project of New England Neurological Associates and Lawrence General Hospital. NEII offers the only computerized digital video EEG in the region. This system utilizes state-of-the-art technology to record and analyze seizures captured by a combination of digital video and time-locked brainwave recording. This is critical to the understanding of the patient’s seizure type, and leads to the optimal medical or surgical management of this very common and debilitating condition.

Vagus Nerve Stimulation for Intractable Epilsepy Patients
For difficult to control seizure disorders, NENA offers implantation of the vagus nerve stimulator (VNS). This device may be implanted in patients with epilepsy who respond poorly to, or have poor tolerance for, multiple anti-epileptic drugs (AEDs) and who are not surgical candidates. The stimulator is a programmable, implantable device that delivers intermittent electrical stimuli to the vagus nerve in the neck. This may lead to reduced frequency of seizures or seizures of lessened intensity or shorter duration, possibly leading to reduced dependenceon AED regimens and improved mental awareness and energy. The stimulator device is implanted under the direction of a team consisting of the NENA neurologist/epileptologist and a NENA neurosurgeon. The procedure is usually done under general anesthesia, and the patient generally returns home the same day.

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Multiple Sclerosis

Multiple Sclerosis (MS) is the most common neurological disorder diagnosed in young adults, with most people experiencing first symptoms between the ages of 20 and 40. There are some 400,000 reported cases of MS in the United States. MS symptoms can vary from person to person, depending upon the area of the nervous system affected. In some persons, symptoms may be mild, such as limb numbness, or severe, such as loss of vision of paralysis. Some patients may experience initial symptoms for a short time period and then be symptom-free for an extended period of time, while others may experience a more steady progression of disease.
Common symptoms of MS may include: balance and coordination problems; blurred or double vision; depression; vertigo; fatigue; spasticity; slurred speech; swallowing disorders; tremor, and; limb weakness. While there is no cure for MS, effective treatments exist that can help reduce the severity and frequency of attacks and help to manage the symptoms of MS. The diagnosis of MS is based upon medical history, a complete neurological examination, imaging studies such as MRI, evoked potentials, and lumbar puncture.
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Headache & Facial Pain

The neurologists of New England Neurological Associates have extensive experience in treating various types of headache and facial pain, including migraine, tension type headache, cluster headache, post-concussion headache, and Trigeminal Neuralgia. Trigeminal neuralgia and other pain disorders are treated by a team that includes neurologists, pain management specialists, and neurosurgeons. The majority of patients respond to medication, but a full range of surgical options is available for patients who do not respond to medicine. The optimum treatment plan for each patient will be developed on an individual basis.

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Movement Disorders

A group of dedicated neurologists and neurosurgeons is available to evaluate and treat patients with a number of movement disorders, including Parkinson’s Disease, essential tremor, ataxia, dystonia, myoclonus, and spasticity. After a thorough evaluation, an optimal treatment plan is developed to treat individual patient’s needs. Treatment options include medications, Botox injections and, for appropriate patients, surgical options, such as implantation of a deep brain stimulator (DBS) that sends electrical impulses to specific parts of the brain. Implantation of the DBS is guided by high resolution MRI that localizes brain targets, and refined using sophisticated electrode brain mapping to ensure the highest likelihood of success. DBS can be beneficial for essential tremor, dystonia, and Parkinson’s Disease.
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Neuromuscular Disorders

The Division of Neurology includes several neurologists who are Fellowship-trained in neuromuscular disorders and electrodiagnostic testing. NENA neurologists have extensive experience in the initial evaluation, treatment, and monitoring of patients with a variety of neuromuscular disorders, including cervical and lumbar radiculopathies, diabetic polyneuropathy and neuropathy from other causes, carpal tunnel syndrome, ulnar neuropathy, and other mononeuropathies, myopathy and muscular dystrophy, neuromuscular junction disorders such as myasthenia gravis, and amyotrophic lateral sclerosis (ALS).
Needle electromyography (EMG) and nerve conduction studies (NCS) studies play a key role in the evaluation of patients with a wide variety of neuromuscular disorders. Through mild electrical stimuli, these tests measures the electrical activity in muscles and the functioning of nerves for the diagnosis of various disorders of the nerves, muscles, and spinal cord.
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Post Concussion Program

Concussions have been increasingly recognized as a public health problem affecting many age groups, and particularly among young people who experience sports injuries. The NENA Post Concussion Program offers multidisciplinary care for patients with intractable symptoms such as headache, neck pain, vertigo, behavioral changes, or cognitive dysfunction.

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Botox for Neurological Disorders

The specialists of New England Neurological Associates employ Botox injections as a therapeutic tool in the treatment of a variety of neurological and ophthalmological disorders. Botox is a naturally derived product that acts to reduce unwanted muscle activity. Clinical applications of Botox therapy include treatment of: blepharospasm (involuntary eyelid closure); hemifacial spasm (involuntary twitches of the eyelids and facial muscles); movement disorders involving tremor; spasticity and rigidity; torticollis; intractable migraine and chronic headache; and dystonias.
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