What we can do to address your symptoms?
Videonystagmography (VNG)
A test to detect irregular eye movements that could indicate the presence of disorder in the vestibular system.
- The vestibular system involves the inner ear, eyes, and brain to maintain the center of balance.
- Disorders in the vestibular system can cause dizziness, involuntary irregular eye movements, ringing in ears, and build-up pressure in the ears.
The VNG test is composed of three parts:
- Ocular testing. watch nonmoving dots to track eye movements.
- Positional testing. provider will move your head and body to see if changes in position causes for irregular/involuntary eye movements.
- Caloric testing. warm and cold water will enter the ears to check if the eyes react properly. For warm water/air, the eyes should move toward the ear and slowly back. For cold water/air, the eyes should move away and then toward the ear. A response that is different from the expected response indicates that there may be nerve damage in the inner ear.
Brain BPI
Brain Mapping
uses electroencephalography to measure electrical patterns on the scalp and detect dysregulated brain activity and specific brain regions that are impacted.
IMPORTANT: VNG and Brain BPI are performed by other providers. We often order these studies or help interpret them in order to provide better service and care for our patients.
Treatments/Therapy Based on Assessment
Botox Injections for Migraines
Background
Botox is a form of the botulinum toxin, which is a molecule created from the bacteria Botulinum clostridium. The botulinum toxin blocks chemical signaling between neurons and muscle cells and prevents muscle from contracting.
Treatment
Botox injections are injected in the neck and head, and cause muscles in these areas to relax and alleviate pain. It takes a couple of weeks to notice the effects of Botox injections, and these effects typically last for 3 months.
FDA-approved Botox injections are available to individuals who experience chronic migraines.
Outcomes
significant reduction in the frequency and severity of migraines and alleviated pain.
Neurofeedback
Treatment
Neurofeedback modifies brain electric activity patterns by rewarding desired brain waves and activity patterns, via auditory and visual stimuli.
Outcome
Training the brain to develop healthier activity patterns can alleviate symptoms and result in healthier brain functioning, lessen stress, anxiety, sleeping troubles, depression, chronic pain, hyperactivity, and more.
Ketamine Treatment
Background
Ketamine antagonizes the NMDA receptor (receptor for the excitatory neurotransmitter, glutamate) – inhibits action potential/neuron electric communication signals from hyperactive neurons.
Outcome
Regulates electric activity and normalizes brain wave patterns by acting as an anesthetic to reduce pain.
Occipital Nerve Blocks
Background
When irritated or damaged, the occipital nerve can cause for pain near the eye and head, and may cause headaches.
Treatment
An anesthetic and steroid is injected near the occipital nerve, located near the base of the skull. Pain relief will usually occur minutes after the injection and last for a couple hours, until the anesthetic wears off. The steroid takes approximately 2 weeks to take effect and relieve pain.
Outcomes
Temporary pain relief and decrease in headaches. Duration of pain relief varies for everyone.
Stellate Ganglion Blocks
Background
The stellate ganglion is a cluster of nerves found in the lower neck. Irritation or trauma to these set of nerves can cause pain in the face, neck, head, arms, and chest.
Treatment
An anesthetic and steroid is injected at the front of the neck, where the stellate ganglion is located. The injection may cause a droopy or red eye, warmness of the face, and/or a hoarse voice. These side effects are temporary and typically last a couple of hours after the injection.
Outcome
Pain relief, that may occur after some time after the injection.