Neurology

The Memory Disorders Program at NewYork-Presbyterian/Weill Cornell Medical Center is a leading patient care center that has set the standard of care for the management of memory disorders. It is one of the strongest patient care programs for people with Alzheimer's and other memory disorders in New York City, and attracts patients from across the country and around the world.

The Center for Sleep Medicine at New York-Presbyterian/Weill Cornell Medical Center is a state-of-the-art facility that provides patients with comprehensive, multidisciplinary treatment to improve sleep health. Learn more about the center.

The Epilepsy Center at Weill Cornell Medicine and NewYork-Presbyterian is a Level 4 Epilepsy Center — the highest possible level. We provide the most comprehensive and cutting-edge diagnostic and treatment resources available, as well as surgical and minimally invasive surgical treatments. Learn more.

Disorders of the nervous system can cause a broad array of general symptoms. Some patients may experience numbness and tingling. Others report memory loss. Patients may have tremors, balance issues, neck pain, or headaches.

Determining the cause of these symptoms is a complex task since they can be the result of any number of disorders. The neurologists at NewYork-Presbyterian/Weill Cornell Medical Center are puzzle solvers, evaluating each patient's symptoms and medical history and ordering the tests needed to make an accurate diagnosis ─ the first and most important step toward successful treatment.

Our physicians are able to offer patients effective care based on the most recent clinical innovations.

General Neurology is the first point of contact for many patients with neurologic symptoms. As members of one of the world's most prestigious medical, research, and teaching institutions, Weill Cornell neurologists have emerging technologies, the latest diagnostic tests, and a vast network of resources at their fingertips to provide comprehensive care to each patient who walks through our doors.

Patients may be referred for blood tests, specialized neurologic testing (such as carotid artery ultrasound, electroencephalography, or electromyography), and/or central nervous system imaging (a particular strength of Weill Cornell Medicine) to pinpoint the cause of their symptoms. All of these tests are available in one location: NewYork-Presbyterian/Weill Cornell Medical Center.

We refer patients who need the expertise of other subspecialists to our colleagues in the divisions of the Department of Neurology and Neuroscience or other departments of Weill Cornell.

The hospital's integrated electronic medical record system ensures that all of a patient's test and examination results are centralized in one place, so all of his or her healthcare providers at Weill Cornell have access to this vital information. Each patient's primary care provider also has access to this record, ensuring continuity of care. 

The neurologists at Weill Cornell take a very personal approach to the care of every patient, with attending physicians performing each examination and providing feedback based on years of specialized expertise. Our doctors are also available to provide second opinions.

While most headaches are not life-threatening, they can be debilitating and we understand they may negatively affect one's work and family life.

As global leaders in diagnosing and treating headache and migraine pain, our team of experts has the experience and tools to address your specific condition. We are dedicated to helping alleviate your pain and restoring your quality of life.

The Weill Cornell Medicine Multiple Sclerosis Center delivers the latest diagnostic and therapeutic services for patients with multiple sclerosis, optic neuritis and other autoimmune, inflammatory demyelinating disorders of the central nervous system. We provide world-class, compassionate, individualized clinical care.

Introduction
The Laboratory of Clinical Neurophysiology, directed by Dr. Douglas Labar, provides the full spectrum of diagnostic neurophysiologic testing (EEG, EMG/NCV, evoked potentials, sleep studies, and related clinical services) for adults and children undergoing neurologic evaluation.

Referrals to the Laboratory for routine or investigational diagnostic testing can be arranged through any of the members of the neurology group, as well as by neurologists and internists in the local community and the greater metropolitan area who desire routine or highly specialized neurophysiologic evaluations.

The Laboratory is conveniently located adjacent to the outpatient suite of the neurology group. Diagnostic studies are performed by highly-skilled technicians and interpreted by board-certified subspecialists. Examination results are generally available on the day of the examination. Most insurance and managed care plans are accepted.

Staff
The medical staff of the Laboratory consists of doctors who are full time academic members of the Department of Neurology and Neuroscience. The staff physicians are specially trained in areas of neurology and pediatrics related to epilepsy and seizures, neurologic monitoring, infant development, neuromuscular disease, and sensory physiology. In addition to performing diagnostic tests, the physicians contribute to medical progress and education through their research, lectures, and teaching activities.

Laboratory technicians are fully trained to serve you and to conduct the test your doctor has requested. They have had formal training in the tests they perform and maintain their professional abilities with ongoing training in electrodiagnosis.

Diagnostic Services
We perform several basic diagnostic tests that evaluate how specific parts of the nervous system work. They are:

• Electroencephalography (EEG). This is an examination of spontaneous brain activity.
• Electromyography and nerve conduction studies (EMG/NCS). These are examinations of nerve and muscle activity.

   

• Evoked potentials (EP's). These are examinations of brain activity related to sensory stimulation. Three common varieties are performed: sight (VEP's), hearing (BAEP's, and touch SSEP's.
• Polysomnography (PSG's). This is an examination of brain, eye movements, breathing, and other activity during sleep.

As a group, these studies evaluate the function (physiology, or how it works) of parts of the nervous system. In this respect, they differ from MRI, CT, and related tests, which examine the structure (anatomy, or what it looks like) of the nervous system. Conditions in which physiological testing is useful include (but are not limited to) epilepsy and seizures, sleep disorders, disorders of nerve, muscle, and movement, multiple sclerosis and related conditions.

Specialized Services
In addition to the basic diagnostic tests described above, the Laboratory provides highly specialized services to inpatients at NewYork-Presbyteriain Hospital/Weill Cornell Medical Center, the Hospital for Special Surgery, and Memorial Sloan-Kettering Cancer Center. These services are important to patients who may be undergoing neurosurgical procedures that place the brain, spinal cord, or nerves at risk.

Intraoperative neurological monitoring consists of EEG, EMG, or EP's (see above) performed during surgical procedures. These techniques provide an assessment of function of the nervous system during a surgical procedure, and help the surgeon minimize the risk of damage.

In collaboration with the Comprehensive Epilepsy Center, directed by Dr. Douglas Labar, we provide intensive monitoring to identify the source of seizures in epilepsy patients who are considering surgery.

In collaboration with the Functional Magnetic Resonance Imaging (fMRI) Laboratory at Memorial Sloan-Kettering Cancer Center, directed by Dr. Joy Hirsch, we provide a multimodal approach to neurosurgical planning. This technique, which consists of fMRI imaging prior to surgery and electrophysiological study during surgery, helps to identify identify important brain areas, and thus reduce the risk of impairment.

Fees, Billing, Managed Care, and Insurance
In order to help keep costs at a minimum, we expect payment in full at the time of service. There are two charges: one from NewYork-Presbyterian for the technician's services, and one from the Weill Cornell Faculty Practice Plan for the doctor's services. We will provide you with a receipt that you can send to your insurance company. Fees vary according to the complexity of the procedures, and the doctor and technician time required. For your convenience, we accept major credit cards.

Our physicians participate in a large number of managed care programs. Managed care approval requirements and fee arrangements vary widely and change rapidly, and it is wise to consult with your managed care provider to be sure that your visit will be covered. We also encourage you to speak with our Accounts Representative at (212) 746-2340 if you have questions on these matters.

Reports and Confidentiality
Your doctor will receive a written report of your test within a few days. He or she will also speak with your doctor if he requests us to call or if there are major or unexpected findings. Because it is important for your test to be reviewed with your complete medical record, we do not inform you directly of the test result. We maintain your record in a confidential manner to protect your privacy.

The Neuromuscular Service at NewYork-Presbyterian/Weill Cornell Medical Center features neurologists who are highly experienced in the evaluation and management of patients with neuromuscular diseases. They provide comprehensive diagnostic, therapeutic, and supportive care to patients with neuromuscular diseases, as well as support and guidance for their families.

Neuropsychology Evaluation

A neuropsychological evaluation consists of a thorough diagnostic interview with the patient, a review of the medical record, and the administration of tests to measure brain function. Such exams make up a critical component of care for many patients with neurological symptoms and disorders. The results of neuropsychological assessments can help clarify a diagnosis, guide a doctor in determining the most appropriate treatment, evaluate how a disease or disorder is progressing, and assess a patient's recovery.

Unlike imaging exams, such as CT or MRI (which show changes in the structure of the brain) or electroencephalography (EEG, which can identify electrical abnormalities in the brain), a neuropsychological assessment examines how well the brain is working based on an individual's responses to or pattern of responses on formal tests of cognitive functioning, such as measures of memory, attention, perception, and problem-solving.

The Weill Cornell Neuropsychology Service is an outpatient program of the Department of Neurology. Our staff members are highly experienced in the evaluation of patients with a wide variety of neurologic disorders affecting cognition (thought processes). Neuropsychological evaluations can be useful following a concussion, serious brain trauma, stroke, or other neurologic injuries, or when there is a suspicion of a neurodegenerative disorder such as Alzheimer's disease or another type of dementia. 

Common Reasons for Evaluation

Our team commonly performs neuropsychological evaluations to:

• Diagnose memory and attention problems
• Distinguish dementia from depression 
• Differentiate the signs of normal aging from symptoms of early dementia
• Determine if there are cognitive side effects from toxic exposures, substance abuse, or certain medications
• Evaluate the cognitive impact of seizure disorders
• Assess a person's capacity or level of disability
• Objectively document a person's recovery from a neurologic injury or illness

With neuropsychological testing, our clinicians can generate a better picture of how the patient's thought processes are being affected, and use this information to customize the best course of care.

What Happens During a Neuropsychological Evaluation

The cognitive testing performed during a neuropsychological evaluation is not invasive. For the most part, the patient works one-on-one with an examiner, responding to questions. We use a standard test to assess attention, memory, reasoning, problem-solving, visual-spatial skills, language, motor functions, academic skills, and emotional functioning. The types of tests that we use depend on the question the referring physician is asking. Our specially trained examiners conduct the testing, tailoring the evaluation to each patient's needs.

The length of the evaluation generally ranges from three to six hours and may be conducted over the course of two or more appointments, if necessary. Patients should bring all sensory aides (such as glasses and hearing aids), records from any prior cognitive testing, and a list of current medications to the exam. 

How We Use the Test Results

The Weill Cornell Neuropsychology Service offers evaluations that can:

• Diagnose cognitive disorders and inform treatment planning 
• Define the patient's strengths and weaknesses
• Objectively document cognitive changes over time
• Evaluate a patient's response to treatment
• Determine the patient's need for assistance with daily activities

We can refer patients to the most appropriate team of neurologists for their continued care, as well as specialists in psychiatry, social work, cognitive rehabilitation, and occupational therapy.

Contact us today to make an appointment or to learn more about the services we offer.

The Parkinson's Disease & Movement Disorders Institute provides compassionate outpatient care to people with Parkinson's disease and other movement disorders such as ataxia, dystonia, Tourette's syndrome, as well as other tic disorders, chorea, and hemifacial spasm. Patients receive care based on the latest medical and surgical advances, and also have the opportunity to participate in clinical trials of promising treatment approaches.

The Peripheral Neuropathy Center provides comprehensive, expert care for patients suffering from peripheral neuropathy. Our mission is to provide the best diagnostic and therapeutic services available, as well as to promote research to find a cure. Learn more.

As one of the first accredited primary stroke centers established in New York City, Weill Cornell Medicine — in partnership with NewYork-Presbyterian, New York's top hospital for more than a decade — has an extraordinary track record for providing excellent care based on the latest medical advances to hundreds of patients each year. Learn more.