Neurological Testing and Treatments
The Mount Sinai Department of Neurology combines clinical skill, cutting-edge research, and personalized attention to provide comprehensive care for a range of neuropsychological disorders and conditions. Our diagnostic and treatment offerings include the following.
Testing and Diagnostics for Neurological Disorders
The optimal treatment plan begins with a comprehensive evaluation and diagnosis, and our tests include the following:
- Imaging studies: Our Department offers various forms of magnetic resonance imaging (MRI) and computerized tomography (CT) of both the brain and spinal cord. These tests include MRI angiography and CT angiography, which study the condition of blood vessels. Our tests also include carotid doppler ultrasound (which measures blood flow through the carotid artery to the brain) and specialized studies such as the plaque scan for Alzheimer’s disease.
- Hybrid PET/MRI testing: Our Department, in conjunction with Radiology, is one of five centers in the United States using this state-of-the-art multi-modality technology, which is the most advanced diagnostic tool available to evaluate patients for various neurological diseases such Alzheimer’s, Parkinson’s, and stroke. The combined technology provides both molecular and genetic information on the brain’s activity, therefore allowing more exact scanning and earlier detection of neurological disease. This new technology helps our neurologists locate salvageable brain tissue and prevent further cognitive decline.
- Physiological studies: We provide many types of electroencephalograms (EEG), including inpatient and long-term outpatient EEG monitoring (as used for epilepsy by the Epilepsy Monitoring Unit). We also offer nerve conduction studies / electromyogram (EMG), eye movement analysis, and electroneurogram (ENG), which is a method to assess the electrical activity of neurons in the central and peripheral nervous systems.
- Neuropsychological testing: The neuropsychological testing we perform involves components such as an interview with a clinician and paper-and-pencil tests in order to assess a patient in areas that include attention, memory, language, reasoning, and learning. Our testing is offered by programs such as the Center for Cognitive Health.
- Cerebrospinal fluid analysis: Also called a lumbar puncture, this test uses a needle to remove a small sample of fluid from the spinal canal in the lower back, which is then sent to the laboratory for study.
- Blood tests: We conduct a full panel of blood tests, which include genetic testing, therapeutic drug levels, and tests for antibodies and various systemic diseases that can cause neurological symptoms.
- Biopsies: We perform biopsies (the removal of a small sample of tissue for testing) of skin muscle, and nerves.
Treatments for Neurological Disorders
Following diagnosis, our Department offers a range of treatment options, including medications (topical, oral, and intravenous), device-based therapies (such as deep brain stimulation), surgeries (such as procedures to remove tumors), physical therapy, and rehabilitation. This range of therapies treats conditions that include the following:
- Movement disorder treatments: We offer a range of therapies for movement disorders such as Parkinson’s disease, dystonia, multiple sclerosis, and spasticity. Our treatments include botulinum toxin injections, which are also called Botox injections and block the release of acetylcholine at the junction where nerves meet muscle, thereby relieving symptoms. The device-based therapies we offer include deep brain stimulation for Parkinson’s disease, which is the surgical placement of electrodes in the brain to deliver electrical signals that control symptoms. We also offer a growing number of oral and injectable medications. These therapies are provided through programs such as the Corinne Goldsmith Dickinson Center for MS and the Robert and John M. Bendheim Parkinson and Movement Disorders Center.
- Multiple sclerosis treatments: The Corinne Goldsmith Dickinson Center for Multiple Sclerosis provides state-of-the art treatment strategies for patients with multiple sclerosis as well as those with less common demyelinating disorders including neuromyelitis optica. The comprehensive approach to treatment typically includes both a disease modifying therapy aimed at preventing relapse and progression of the disease as well as a treatment plan targeted at decreasing the symptoms that a patient may have. Disease modifying therapies for multiple sclerosis are currently available in injection, intravenous and oral forms. Symptomatic treatment plans are tailored to each patient’s needs and may include referral to specialists such as urologists, physiatrists and psychiatrists; oral medications; botulinum toxin; and emotional, cognitive, physical and occupational therapies.
- Cerebrovascular disease and stroke treatments: Therapies offered by the Mount Sinai Stroke Center include a range of medications to decrease the risk of recurrence (such as blood thinners, blood pressure control, and lipid control drugs) and medications to treat an acute condition (such as thrombolytic therapy, which is used to break up blood clots). We also offer radiotherapy as well as angiographic procedures to retract a clot or open up an artery. Our surgical offerings include procedures to remove tumors.
- NeuroAIDS treatments: Our Department’s NeuroAIDS Program offers a range of treatments for neurologic conditions that result from HIV infection, such as dementia, neuropathy, and disorders of the spinal cord and muscles. These treatments offerings include antiretroviral therapy, rehabilitation, physical therapy as well as oral and topical treatments for neuropathic pain and drugs for seizures.
- Epilepsy treatments: Our Epilepsy Center, which is a certified level 4 center in accordance with the National Association of Epilepsy Centers, offers a full range of diagnostic approaches and treatments for epilepsy including anti-epileptic medications as well as surgical therapies to remove the source of seizures to limit its ability to spread throughout the brain.
- Headache treatments: Our Center for Headache and Pain Medicine provides a range of oral and intravenous medications to control acute pain and prevent recurrence. We also offer botulinum toxin injections and biofeedback, a therapy in which clinician teaches a patient methods for controlling the body’s physical response to pain.
- Vestibular treatments: The vestibular system controls balance, and disorders of this system range from vertigo to motion sickness. Our Department provides a number of vestibular treatments, which include the Epley maneuver, an office-based maneuver in which a physician repositions the head to relocated particles in the inner ear to relieve dizziness. We also offer a growing number of non-drug treatments currently being research for disorders such as motion sickness and Mal de débarquement.
- Neuromuscular tisease treatments: Our Department offers a range of neuromuscular treatments such as topical and oral medications, botulinum toxin injections, and rehabilitation for conditions that include neuropathy, ALS, myopathy, and myasthenia gravis.
- Cognitive disorder treatments: Our Department’s Center for Cognitive Health provides a range of therapies that include medications, cognitive rehabilitation, and counseling.