Integrated Neurology Services Simon Fishman, M.D.

Our services include:

• Spasticity Management
  • BOTOX® injections
  • Medtronic intrathecal baclofen pump refills

• EMG/NCV (electromyography/nerve conduction velocity) studies

• IVIG (intravenous immunoglobulin) infusion therapy for patients with abnormal immunity

• Pain management

• Treatment of...
  • CIDP, chronic inflammatory demyelinating polyneuropathy
  • Cerebral palsy
  • Movement disorders
  • Myasthenia gravis
  • Spasticity
  • Stroke disorders

Medtronic ITB Therapy (Intrathecal Baclofen Therapy)
ITB eases intractable spasticity in patients with cerebral palsy, multiple sclerosis, traumatic brain injury, spinal cord injury, and stroke by delivering Lioresal Intrathecal (baclofen injection) directly to the intrathecal space in small, precisely controlled doses using a surgically placed pump. It is important to keep your pump filled with medication by attending scheduled refill appointments. For patient information, see Medtronic's ITB website.

EMG/NCV (Electromyography/Nerve Conduction Velocity) Studies
Electromyography (EMG) and nerve conduction velocity (NCV) studies are helpful when a nerve or muscle disorder is suspected. NCV is administered before EMG and measures the speed at which nerves transmit electrical signals.

During NCV, electrodes are placed on the skin over the nerve of a specific muscle or muscle group. A mild, brief electrical stimulus is delivered through the electrode, and the muscle response is detected, amplified, and displayed. The strength of the signal is also measured. Neurological conditions can cause the NCV to slow down or become slower on one side of the body.

EMG measures nerve impulses within the muscles. Tiny electrodes are placed in the arm and leg muscles. The electronic responses are observed using an oscilloscope. As muscles contract, they emit a weak electrical signal that can be detected, amplified, and tracked, providing information about how well they are working.