EVALUATION AND MANAGEMENT
HNI offers consultation services to our referring physicians, new patient evaluation for individuals without referring physicians, and second opinion consultations. All new and follow-up evaluation is by appointment. Urgent and Emergent evaluation is available for new patients referred by physicians and for established patients.
EMG/NCV or Electromyography and nerve conduction studies are physiologic studies performed in our offices to determine the integrity of the peripheral nervous system. Damage from herniated discs, diabetic neuropathy, and muscle diseases can be quantitated using EMG/NCV. All HNI physicians have additional expert training to perform EMG/NCV studies. The studies are performed in the office using state of the art equipment in the most comfortable way possible. Our nerve conduction technician is board certified and the EMG portion of the study is always performed by the physician. EMG/NCV may be performed on referred patients with or without neurological consultation for many disorders including carpal tunnel syndrome and pinched nerves. Studies are done three days a week in both the Pasadena and Pearland offices and can many times be done the same day as requested.
EEG or electroencephalogram is also a physiologic study but is specialized to monitor functions of the brain. EEG is extremely valuable for determining the presence and type of epilepsy and is also helpful for evaluating other disturbances of brain function such as medication effects on the brain, memory loss, and confusion. EEG services are performed in both the HNI Pasadena and Pearland offices on patients over the age of 11. Studies include routine EEG, sleep deprived EEG, video recorded EEG, ambulatory EEG, and prolonged technician attended in office EEG overnight.
Polysomnography (also called a sleep study) is a physiologic technique used to evaluate certain functions of the brain, peripheral nervous system, respiratory, and cardiac system during sleep. Sleep studies can determine the presence of disturbances in sleep architecture, quality, and quantity as well as help determine the cause of the disturbance. Obstructive sleep apnea, periodic leg movement disorder of sleep, sleep inefficiency states, and nocturnal seizures are common disorders detected by this technique. Sleep studies may be performed on referred patients with or without consultation. Studies are performed at the Pasadena and Pearland location each night. The labs are independently certified by the American Society of Sleep Medicine for full accreditation. Each of our clean comfortable sleep rooms are equipped with a queen size bed, television with cable TV, and a recliner. Studies are performed by board certified sleep technicians to ensure our patient's safety, comfort, and the diagnostic quality of testing.
PATIENT TREATMENT OPTIONS
All HNI physicians and our physician assistants are trained in advanced medication and therapeutic treatments in an effort to treat the whole patient in the outpatient setting. Physical therapy and surgery options are referred when appropriate. In addition several other treatments are available at both the Pasadena and Pearland locations.
Infusion Services: Many times IV therapy is required to treat and prevent diseases such as Multiple Sclerosis, Guillian Barre syndrome, Myasthenia Gravis, Chronic Inflammatory Polyradiculoneuropathy (C.I.D.P.) and migraines. A fully staffed infusion suite is located in the Pasadena office location to treat patients in a comfortable outpatient setting under direct supervision from our physicians and physician assistants. Our infusion nurses and pharmacist use the highest standards of care to deliver intravenous treatments in a safe comfortable environment. Clean well-padded recliner chairs, televisions, and natural lighting add to an ambience intended to foster healing. Drapes are used to improve privacy but many patients choose to leave them open and share experiences and support with each other. Infusion services include numerous immunomodulatory treatments including glucocorticoids (steroids), IV chemotherapy, Remicade therapy, IV DHE, and IV Depacon.
Vagal nerve stimulators (VNS): Patients with refractory epilepsy may require more than daily medication to stop seizures. A vagal nerve stimulator can be placed as a “brain pacemaker” and programmed by the physician at HNI with state of the art programming software.
Deep brain stimulation (DBS): In patients with tremor and other symptoms of Parkinson’s disease not controlled with medication, placement of electrodes in the brain to control these symptoms may be indicated. HNI physicians, physician assistants, and nurse are specially trained to evaluate these patients, determine if DBS is appropriate, and program these patients post operatively. Programming sessions are done in a private, comfortable room with TV and room for family members so ample time can be spent programming the patient.
Botox: Patients with disabling migraines, stiff arms or legs following stroke or spinal cord injury, and patients with cervical dystonia require Botox injections. Botox therapy is performed at both locations by our physicians for migraine headaches, dystonia, spasticity, and hemifacial spasm. Patients may be eligible for $0 out of pocket costs for Botox treatments.
Intrathecal Baclofen Pumps (ITB therapy). Intrathecal (delivery via catheter directly into the spinal column) is used to deliver medication to the central nervous system without requirement of higher dosing required by mouth. This is an effective delivery method in patients with spasticity or stiff muscles following strokes, traumatic brain injury, and spinal cord injury. The pumps allow accurate drug delivery with fewer side effects and more specific targeting of the medication the site where it is needed. Evaluation of appropriate patients for baclofen pumps, refilling of the pumps, and programming of the pumps is done by our specialty trained physicians, physician assistants, and nurses at HNI.