- Welcome
- What is a Neurologist?
- Our Neurologist - Dr. Athni
- Our Staff
- Our Facility
- Illnesses We Treat
- New Patient Info
- Appointments
- Consent
- Payments
Welcome To Our Office!
- We offer the full breadth of neurological services, including Neurological Evaluations and Consultations, Independent Medical Examinations (IME), Records Review, Work Injury Evaluations, EMG/NCS, EEG interpretations, Cognitive Testing, and Autonomic Testing — all under one roof, in one convenient location, in North Macon.
- We also offer the full range of treatment options for your neurological condition – including Therapeutic Botox and Infusion Therapy.
- We also offer state of the art, “Hi-Tech” neurological treatment options, including Deep Brain Stimulation and Vagal Nerve Stimulation.
- We are involved in clinical research trials. If you qualify for one of these trials, you may be eligible for research medications through our office.
- Dr. Athni has multiple degrees in multiple disciplines.
- Fully USA trained: College –> Medical School –> Residency
- Dr. Athni is Board Certified by the Am. Board of Neurology & Psychiatry.
- If you are a new patient to our practice, please spend a few moments browsing the various pages published on this web site.
- We would also encourage you to consider downloading a pre-registration packet, as well as reviewing our insurance and payment policy under the “Insurance Information” section.
- If a service is not listed, please call our office and speak to our office manager
What is a Neurologist?
What type of training does a Neurologist have?
- A Neurologist is a Medical Doctor, specialized in the study of the Nervous System.
- The field of Neurology includes the study of diseases of the brain, spinal cord, peripheral nerves, and muscles.
- After 4 years of college and 4 years of medical school, a Neurologist obtains specialty training in the field of “Neurology”. This includes 4 years of Neurology Residency, during which time the “Neurology skills” are fine tuned.
What disorders are treated by a Neurologist?
- Some common “symptoms” evaluated by a Neurologist include: headaches, neck pain, lower back pain, weakness, sleep problems etc.
- Some common disorders diagnosed and treated by a Neurologist include: Multiple Sclerosis, Stroke, Alzheimer’s, migraine headaches, “pinched nerve”, Carpal Tunnel Syndrome, Peripheral Neuropathy, ALS, Myasthenia Gravis, Polymyositis, Obstructive Sleep Apnea, and Seizures.
How does a Neurologist evaluate a patient?
- A Neurologist will obtain a detailed neurological history and a detailed neurological exam to better understand your condition.
- The Neurological exam is probably very different from any previous medical exam you might have undertaken.
- This evaluation process may take anywhere from 30 minutes to 60 minutes.
What tests might be ordered by the Neurologist?
- After the evaluation, some diagnostic tests may be ordered, such as : blood tests, MRI, CT scan, EMG-NCS, Sleep Studies, EEG, VNG, Ultrasounds, or Neuropsychology tests – to name a few.
How is a diagnosis made?
- After reviewing the results of the diagnostic tests, in conjunction with the neurological evaluation, a diagnosis will be made, and a treatment plan will be recommended.
- This evaluation process may take numerous visits, over a period of 4-8 weeks. Please do not expect a firm diagnosis on your first visit.
Our Neurologist – Dr. Athni
Current Practice:
- Dr. Athni has been in Macon, Georgia since mid-1995. He is an independent physician and is not employed or managed by any outside agency or hospital.
- He is heavily involved in teaching student-doctors and resident-doctors-in-training
- Students and Residents rotate thru the office to learn one-on-one from Dr. Athni
- Dr. Athni has written peer-reviewed journal articles, and has co-authored a chapter in an academic textbook
- Aside from his clinical practice, he is the President of the Georgia Neurological Society
Board Certifications – Affiliations – Accreditation:
- President of Georgia Neurological Society
- Assistant Clinical Professor @ Medical College of GA
- Board Certified by the American Board of Neurology & Psychiatry (ABPN)
- *** Practice is limited to Neurology, and we do NOT provide Psychiatric services ***
- Board Eligible in Electrodiagnostic Medicine and Sleep Medicine (ABSM)
- Diagnostic Lab is Accredited by the American College of Radiology (ACR)
Added Certifications:
- Deep Brain Certification (DBS)
- Vagal Nerve Stimulation (VNS)
- Therapeutic Botulinum Toxin Injections (Botox and Xeomin)
Education:
- Dr. Athni grew up in New York, and received most of his post-high school education and medical training in Houston, Texas.
- He received his Bachelor of Science degree in Environmental and Civil Engineering from Rice University in Houston, Texas, graduating Magna Cum Laude.
- He then received his MD from Baylor College of Medicine, also in Houston, Texas, graduating with Honors.
- This was followed by his Internal Medicine and Neurology Residency at Baylor College of Medicine.
- While in Macon, Dr. Athni has also obtained his MBA (Masters of Business Administration) at Mercer University.
Work Summary:
- After his formal education and training, Dr. Athni initially worked as an educator and instructor in Houston at Baylor College of Medicine medical school.
- He then worked for an HMO in Dallas, Texas, before becoming the Medical Director for Neurology of Central Georgia in Macon, Georgia.
Hospital and University Affiliations:
- Affiliated with the Coliseum Health System, with consulting privileges at Macon Northside Hospital
- Assistant Clinical Professor of Neurology at the Medical College of Georgia
Publications:
- “Medicinal Plants: From Farm to Pharmacy” – Textbook published 2019 – Co-author of 1st Chapter “The Evolution of Modern Medicine: Garden to Pill Box“
- “Myotonic Dystrophy & Triplet Repeats” in Resident and Staff Physician, 3/95
- “Neuro-Anatomy” in Neurology Secrets, ’93, ’97, ’01, ’05, ’10 editor: Loren Rolak, MD
Military Experience:
- Captain in U.S. Air Force Reserves, Medical Corps – Honorable Discharge
Current Academic Position:
- Assistant Professor, Department of Neurology, Medical College of Georgia Augusta University, Augusta, GA
- Adjunct Clinical Instructor, Department of Family Medicine, Mercer University, Macon, GA
Our Office Staff
- Our office staff is available to assist you with scheduling appointments, billing, and processing insurance claims. They can also answer all non-medical questions.
- If you have any medical questions, they will take your message and a call-back phone number.
- Dr. Athni, (or someone from the office) will return your call before the end of the business day.
- If it is urgent, please inform us as such, and we will try to return your call as soon as possible.
Angela A. – Medical Assistant
- Angela is an integral part of our team. She handles scheduling and all clinical matters.
- She has developed a reputation for being courteous and prompt.
- With her medical foundation and experience, she is able to assist with patient care.
Tracy R. and Lauren H. – Certified Infusion Nurses
- Tracy and Lauren are our licensed registered nurses (RN) with special qualifications in Infusion Therapy
- Proficient and nationally certified to infuse Tysabri, Ocrevus, Lemtrada, IVIG, and numerous other intravenous medications.
- They have been with our team for numerous years
Ash. A. – Office Manager
- Ash handles referral processing, insurance verification and claim issues, and all financial matters, including payment and collections issues.
- If you have any questions regarding your account, Ash will gladly assist you.
Mike T. – Certified Ultrasonographer
- Mike has been assisting us since 2006. He is a board certified Ultrasonographer, with over 15 years of professional experience.
Andre M. – EEG Tech
- Andre joined our office in 2015. He has been performing EEG tests for over 20 years.
- He is a member of the ASET (American Society of Electrodiagnostic Technologists).
- He is very detail oriented and will make sure your EEG is done to the highest standards.
Our Facility
- Our office is a “smoke-free” medical facility. Our new facility is specifically designed for our neurology patients.
- Each room has “overhead music”, including the exam rooms. The bathrooms are “extra large” to accommodate wheelchairs, if necessary.
- The hallways are “spacious” (6 feet wide) to handle wheelchairs and walkers.
- The exam rooms are “sound proof” to provide for confidential discussions with the doctor.
- We also offer Free Wifi HotSpot access, which you can use to browse the internet while waiting to be seen.
- We are located one block east of Forsyth Road, near Macon Northside Hospital, just behind the “water tower”.
Illnesses We Treat
We will evaluate and treat the full range of Neurological diseases, including:
- Multiple Sclerosis
- Parkinson’s Disease
- Myasthenia Gravis
- Seizures
- Headaches
- Neck pain
- Back pain
- Neuropathy
- Trigeminal Neuralgia (facial pain)
- Dementia / memory problems
- Alzheimer’s Disease
- Carpal Tunnel Syndrome
- Concussions, TBI and Closed Head Injuies
- Plus many more …
In the process of making the above diagnoses, we will perform a variety of diagnostic tests.
Please take a look at our “Diagnostic Tests” page to read more about the various neurological tests
Also click on the “Educational” link to learn more about these diseases.
Information for New Patients
When should I come to the appointment?
- We request ALL new patients to arrive at the office at least 1 hour BEFORE their scheduled appointment. After you fill out the required paperwork, the office staff needs to enter all the information into our computer system before you can be seen by the physician.
- Arriving early will ensure that all paperwork and computer entry issues are completed before your scheduled appointment time. Otherwise, your consultation time will be delayed.
What paperwork will I have to fill out?
- You will be asked to fill out a “Registration” form, and a “Medical History” form.
- To minimize your office wait time, you may wish to download all the necessary registration forms, and bring the completed forms with you.
What should I bring to the office?
- To make the registration process easier, please bring ALL your medications with you. Also, bring your insurance card and your drivers license for identification purposes. We will make copies of these cards.
- If you have had any MRI scans, CT Scans, or any other X-rays which might be relevant to your condition, please bring the ACTUAL FILMS or CD of any imaging studies, paper copies of imaging reports, and paper copies of prior medical records with you on your visit (we will scan your medical records into our EMR system).
- Please do NOT drop off the films at the office prior to your visit.
Identification and Insurance Cards
- You must bring your current insurance card, as well as a valid government issued picture ID, such as your driver’s license, your passport, a state-issued-ID, etc.
- Per federal insurance laws, we must verify the identification of the patient. We will make copies of the insurance card and your picture ID. Without proof of insurance coverage or valid picture ID, we will not be able to see you as a patient.
What notes do we need before your office visit?
- You MUST make sure any and all relevant office notes from your primary care physician (PCP) are faxed or mailed to our office prior to your visit.
- If you have previously seen a different Neurologist, we must be forwarded all those notes before an appointment can be made.
If you are a minor, or if you are a student…
- If you are less than 18 years old or if you are still a student, you MUST be accompanied by a parent or guardian.
Who will be allowed into the exam room?
- If you are an adult, then only the patient and immediate next of kin, will be allowed into the exam room (unless another family member is needed for medical reasons).
- If you have small children, PLEASE make other arrangements for them, as they will NOT be allowed into the exam room.
What about my medications?
- Please bring ALL you medications to the office. Depending on the situation, Dr. Athni may want to see the actual meds.
Who will be taking the medical history?
- Our office does NOT use a “Physician Assistant” or a “Nurse Practitioners”.
Dr. Athni will personally take a detailed medical history and performing the detailed Neurological examination. - PLEASE NOTE: Although you will have filled out the registration forms, Dr. Athni will be re-asking many questions about your “past medical history” in great detail.
- Your visit will be a comprehensive one. Please do not expect Dr. Athni to just “read the old notes”. He will expect you to answer all questions in full detail.
Scheduling Appointments
- We are a “referral only” office. We require a referral from your primary care physician.
- As soon as our office receives your referral, we will first verify your insurance benefits to make sure we are part of your insurance network. (Please look at “Insurance Networks” on the web site to see our network affiliation.)
- We request you forward a copy of your medical records prior to scheduling your initial appointment. We will review your medical records before an appointment is given. We reserve the right to NOT schedule an appointment – after reviewing your medical records, we may decide we will not be able to participate in your medical care.
- Our office staff will then contact you directly to schedule the initial appointment.
- We try to see patients within 2 weeks of receiving the referral.
- We normally see new patients Monday mornings or Thursday afternoons
- We will try to accommodate your personal / work schedule to minimize any inconvenience.
- If the appointment involves a Work-Comp issue, we must obtain a written approval from the WC adjuster prior to scheduling the appointment.
- We request ALL new patients to arrive at the office at least 1 hour BEFORE their scheduled appointment.
- This will ensure that all paperwork issues are completed before your scheduled appointment time. Otherwise, your consultation time will be delayed.
Consent – Who Can Accompany Patient Into Exam Room
- If you are being seen thru Worker’s Comp, we will only allow the patient in the exam room. If a NCM or Adjustor wants to meet with Dr. Athni, they will need to schedule a separate appointment with the front office.
- If you are an adult and are being seen thru your private insurance or Medicare or Tricare, we will allow your spouse into the exam room.
- BUT, for anyone else, we will need a Medical Power-of-Attorney (Medical POA) or a Notorized letter stating the third-party is allowed to be involved in the patient’s care. This would include friends or a parent of a patient or an adult child of a patient.
- This is a standard practice in Psychiatric offices. Although we are not treating Psychiatric illnesses, many of our patients have cognitive issues. To make sure decisions are being made in the best interest of the patient, we require such a POA. Even if you do not have any issues which involve your cognitive abilities, we have one policy for all patients.
- We hope you understand the rationale for this policy. We are merely trying to make sure unauthorized people (who may not have the patient’s best interest) are not involved in medical decisions.
Expected Payments
If you are a Work Injury or IME patient – No payment is required at time of office visit
- If you are being seen as an authorized Work Injury patient or as an authorized IME, you will NOT be asked to pay anything. All your bills will be handled through your Worker’s Compensation Insurance Company or your attorney.
What is your payment if you have Medicare?
- If Medicare is your primary insurance, then we expect 20 percent of your “Medicare allowable charges” and any deductible required for the calendar year.
- Per federal regulations, the Medicare deductible for calendar year 2022 is $226.
What is your payment if you have commercial (PPO or HMO) insurance?
- We will typically verify your insurance before you arrive at our office.
- If we are a “participating provider” for your insurance plan, then we will only collect the co-pay (either a set dollar amount or percentage).
- You may also be asked to pay any deductible that may not have been met for the calendar year.
What if we are NOT in your insurance network?
- If we are not in your insurance network, you may be asked to pay your bill in-full.
Please discuss this with our office manager prior to your office visit.
What if you have NO insurance?
- If you are a NEW patient without a valid verifiable insurance, we will NOT be able to see you as a patient
- If you are an existing patient and have lost your insurance or we are no longer in your insurance network, then we expect full payment at the time of service.
Insurance Verification:
- We will verify your insurance PRIOR to your office visit.
- This verification will inform us of your insurance contract stipulations, including any co-pays you are required to pay.
WHEN to Pay:
- We expect payment at the time of service.
TYPE of Payment:
- Our office prefers cash or credit card (MC, Visa, Discover, and Amex).
- You may also pay On-Line thru this web site. We offer a Secure Payment process, powered by Pay-Pal.
- Due to the high number of “bounced checks”, we do NOT accept checks as a form of payment.
Important Pages
Services Provided
Services Provided
Neurology Consultations
Out-patient, Office Consultations
- Dr. Athni is available for detailed Neurologic Consultations in our office.
- During your initial visit, we will do a detailed Neurologial history and physical exam.
- If a firm diagnosis can be made during the initial visit, we will set forth a treatment plan.
- If additional testing is necessary, we will delineate, schedule and follow thru with a diagnostic testing plan, after which a follow-up visit will be scheduled to discuss the results of the diagnostic tests.
- After the results are discussed, we will set forth a treatment plan as medically appropriate.
- Most diagnostic testing is done in “steps”, starting with the least invasive and slowly progressing to more invasive testing as the need arises.
In-patient, Hospital Consultations
- We are affiliated with the Piedmont Hospital Health System
- For in-patient evaluations, we expect you to be admitted by a Hospitalist, your Internist or your Family Practitioner
- If a neurological problem arises which cannot be handled by your admitting physician, he or she will call the Neuro-Hospitalist for a formal hospital consultation
Infusion Therapy
What is “Infusion Therapy”?
- Infusions are medications that are administered via an IV. These medications are dissolved in an IV bag, and delivered thru a peripheral vein or a central port.
When is infusion therapy used?
- Infusion medications are used to treat various illnesses, including Migraine Headaches, Multiple Sclerosis, Neuropathy, Myasthenia Gravis – to name a few.
- Speak with Dr. Athni about your treatment options, including infusion therapy.
Where are the infusions given?
- We have an Infusion Suite within our facility, with reclining lounge chairs for comfort and ease.
- Our infusion suite is available for infusions during normal business hours.
Who administers the infusions?
- We have 2 infusions nurses – Tracy and Lauren – who are certified in infusion nursing care.
- They will follow the medical directions prescribed by Dr. Athni, including any pre-infusion meds, post-infusion meds, as well as various medications used to treat any infusion related side effects.
VNS – Vagal Nerve Stimulation
What is Vagal Nerve Stimulation?
- Vagal Nerve Stimulation, or VNS, is a therapeutic option available for patients with uncontrolled seizures.
- The procedure is an “adjunct” to seizure medications, not a full replacement for medications.
What is involved with “VNS”?
- If you have a seizure disorder, which is hard to control with medications, then Dr. Athni will assess whether you might qualify for VNS.
- If you are deemed a good candidate for VNS, you will be referred to a local surgeon for VNS implantation.
- The surgeon will implant a small electrode in your neck, as well as a “power generator” in your left chest.
- You will then return to Dr. Athni for programming and management of your VNS.
How is VNS programmed?
- Approximately 1 week after your VNS surgery, Dr. Athni will connect a hand-held computer to your VNS.
- Using the hand-held computer, the VNS is digitally programmed, in an attempt to stop your seizures.
- The programming is done very slowly and methodically. It can take 6-8 weeks to complete the initial programming, requiring weekly visits to our office.
- Additional programming changes will be made beyond the 6-8 weeks as medically necessary.
DBS – Deep Brain Stimulation
What is Deep Brain Stimulation?
- Deep Brain Stimulation, or DBS, is a treatment option used for various types of Movement Disorders.
- The procedure has been very successfully used in patients with Parkinson’s Disease or Essential Tremors.
- The procedure is an “adjunct” to medications, not a full replacement for medications.
What is involved with DBS?
- Dr. Athni will assess you and determine whether you are a good candidate for DBS.
- If you medically qualify for the procedure, you will be referred to a Neurosurgeon for DBS implantation.
- You are fully awake during the surgical procedure.
- The Neurosurgeon will drill a small hole in your skull, and insert an “electrode” into your brain.
- The Neurosurgeon will also implant a “power generator” in your chest.
- You will then return to Dr. Athni for detailed “programming and management” of your DBS.
How is the DBS programmed?
- After you have the DBS inmplanted, Dr. Athni will connect your “generator” to a hand held computer.
- He will then program the leads in the brain to activate certain parts of the brain, in an attempt to reduce and control your movement disorder.
- The full programming may take 3-4 months.
Botox – Botulinum Toxin Injections
What is “Botox”?
- Botulinum toxin (B. toxin) is a “neuro toxin” which paralyzes any muscle it comes in contact with.
- When used as a medication, B. toxin is very powerful, and must be given by specially trained physicians.
- There are a few different companies which manufacture B. toxin, each under different brand names. The most common variety of B. toxin is “Botox”, manufactured by Allergan.
What is Botox used for?
- There are numerous diseases which are associated with “muscle spasms” or “stiffness”. For such conditions, B. toxin is an appropriate medication to “relax” those muscles.
What is the difference between “Cosmetic” and “Therapeutic” Botox?
- The drug is the same, but the use is vastly different.
- With Cosmetic Botox, the drug is injected into various muscles (typically the facial muscles) to eliminate wrinkles.
- Insurance does NOT pay for Cosmetic Botox.
- With Therapeutic Botox, the drug is injected into various muscles of the face, arms, legs, or back to alleviate a problem caused by a specific medical condition.
- Usually, insurance companies will pay for therapeutic Botox treatments.
How much does Botox cost?
- For Cosmetic Botox, it can cost around $13 to $15 per unit, and it is NOT covered by insurance plans.
- A “typical” Cosmetic Botox session can involve injecting 30-100 units, depending on what we are trying to achieve.
- For Therapeutic Botox, if your insurance approves the treatment, your cost will typically be just your co-pay.
- Please speak with our financial / insurance department to get further information about your specific insurance plan.
Diagnostic Testing
Diagnostic Testing
EMG-NCS Test
What is an EMG-NCS test?
- An EMG-NCS, also known as “Electromyography and Nerve Conduction Tests”, is a test of the nerves and muscles of your arms / legs.
- The EMG/NCS study examines the integrity of the peripheral nerves and muscles of the body.
- The study does NOT examine the brain or spinal cord.
- It is important to realize that you can have a nerve or muscle problem, even though you may not “think” you have any nerve or muscle problems.
- This test does NOT measure pain.
- You may have a normal EMG-NCS study, even though you have severe pain.
What are the different parts of the test?
The study is usually done in two parts:
- NCS (i.e. “shocking” test) – which tests the nerve function
- EMG (i.e. “needle” exam) – which tests muscle function
How long is the test?
- Each EMG/NCS study varies from patient to patient, depending on what results are obtained. As such, the study may take as little as 20 minutes, or as much as 2 hours.
What is involved in the Nerve Conduction Study or NCS?
- The NCS examines the nerves in your arms and legs.
- This consists of attaching wires to the surface of your skin, and administering a small “shock” to see how well the nerves react and function. These result are monitored on a computer.
What is involved in the Electromyography or EMG?
- The EMG examines the muscle activity in your body. This study consists of inserting a sterile, individually wrapped, needle into your various muscles and monitoring their activity.
- These results are monitored on a computer. You will probably be stuck 5-7 times per arm or leg. There is NO shocking during the needle exam.
Is the test painful?
- The “shocks” during the NCS are not painful, although they may feel slightly uncomfortable. The needle “sticks” during the EMG feels like a small ant bite, and can sometimes be uncomfortable, but not painful.
How do I prepare for the test?
- Please notify the physician PRIOR to the study if:
-
- you think you may have AIDS or Hepatitis, or
- if you are taking any blood thinners, such as Coumadin or Aspirin
-
- Please DO NOT use any Lotion or Creams on the day of the test. Such Lotions or Creams will make it difficult to perform the study.
What type of clothes should I wear for the test?
- Please remove any watches or rings you might be wearing on BOTH your hands / fingers
- Men – if possible, wear shorts and T-shirt.
- Women – if possible, wear a loose dress and T-shirt.
When will I get the results of the test?
- If you are an active patient of our office, then the EMG-NCS results will be discussed with you on your next office visit.
- If you have come to our office only for the EMG-NCS, then the results will be sent to your referring physician within 48 hours.
- Your referring physician will discuss the results with you on your next office visit with them.
Will the doctor advise me of any treatment options?
- If Dr. Athni is actively involved in your care, then he will advise you of your different treatment options after reviewing the results on your follow up visit.
- But, if you have come to our office only for the EMG/NCS, then your referring physician will have to counsel you on your treatment plan.
Diagnostic Cardiovascular Ultrasound
Is the office “Accredited”?
- Our office Ultrasound Lab is accredited by the American College of Radiology (ACR).
- Such an accreditation implies that we meet a high standard of proficiency in performing these tests, by qualified and certified technicians.
- Our office is the only Neurology office in Middle Georgia to be fully accredited by the ACR.
What is an “Ultrasound”?
- An Ultrasound test is a non-invasive test used to visualize organs or blood flow inside the body.
- There are no needles involved.
- You will be fully awake and alert during the test.
- Ultrasound tests are NOT painful.
How is an ultrasound test performed?
- An “ultrasound probe” takes “real time” pictures of objects inside your body.
- The probe is moved on the surface of your skin, over the part of the body we are trying to visualize. The other end of the probe is connected to a computer.
- As the probe “sees” the objects inside your body, the computer records these images for later analysis.
Who performs the Ultrasound test?
- Any ultrasound examination done in our office is performed by a Board Certified Ultrasonographer.
- Our lead Ultrasonograher is Mike T, who has been performing ultrasound studies for over 15 years.
What is an Echocardiogram or Echo?
- An Echocardiogram, also called an “Echo”, is an ultrasound test of your heart. It visualizes the beating heart, the pumping blood, and the valves inside your heart.
What is a Carotid Doppler study?
- A Carotid Doppler study is to visualize the blood flow in the major blood vessels going to your brain, including the internal carotid arteries and the vertebral arteries.
Why is an Echo or Carotid Doppler study ordered?
- An Echo and Carotid Doppler tests are typically ordered as part of a “stroke work up”, looking for various causes for strokes.
EEG – Electrencephalogram
What is an Electroencephalogram (EEG)?
- An Electroencephalogram or EEG is a diagnostic test which examines the “brain waves”, using electrodes placed on the scalp. These electrodes are connected to a computer, which records your brain waves.
What is the difference between a “routine” and “ambulatory” EEG?
- Routine EEG
-
- A “routine” EEG is performed in the office, which takes approximately 30-45 minutes to perform.
- This type of study only records your “brain waves” for about 20 minutes.
-
- Ambulatory EEG
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- For an “ambulatory” EEG, the electrodes are connected to your scalp in the office, but we then send you home with these electrodes, along with a small hand-held computer.
- This will record your brain waves for 3 or 4 full days, while you are leading a “normal life”.
- Such EEGs are more accurate in that they are able to pick up abnormal brain waves while you are at work or while sleeping.
- At the end of the 4 days, you will return the equipment to our office, which will then be analyzed and interpreted by Dr. Athni.
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- Please discuss which type of EEG is appropriate for your situation
Which type of EEG is most ideal?
- Each type of EEG is used for different purposes.
- Which EEG is best for you will depend on your individual clinical situation.
- Dr. Athni will discuss these options with you during your office visit.
How is the EEG procedure performed?
- An EEG is a painless procedure, which involves attaching numerous electrodes to your scalp. These electrodes are connected to a computer, which will record your “brain waves’ during the duration of the study.
- These brain wave recordings are reviewed and interpreted by Dr. Athni.
- A certified EEG technician will attach the electrodes and perform the study, while being overseen by Dr. Athni.
Will an EEG always diagnose a seizure?
- A normal EEG does NOT mean there is “nothing wrong with you”.
- It also does NOT absolutely exclude a seizure or any other disease.
- The results of the EEG are used in conjunction with your clinical symptoms and other diagnostic tests, to make a final diagnosis and conclusion.
How do you prepare for the EEG test?
- For the test, PLEASE do the following:
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- go to bed at 1 AM, and get up at 5 AM
- wash your hair in the morning
- NO hair spray, NO gel, NO mouse, NO oil
- DO NOT style your hair: NO braids, NO ponytails
- Wear a button down shirt or blouse
- NO perfumes or body lotions (you MAY wear deodorant
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- The EEG tech will remind you about your appointment and answer any questions you may during the test.
When will you get the results of the test?
- After the completion of the test, Dr. Athni will review the recorded “brain waves” and put together an analysis or “report”.
- This will be reviewed with you on your next office visit.
eVOX – Quantitative EEG
What is it?
- eVox uses quantitative EEG technology along with various brain health biomarkers to aid in the diagnosis of cognitive disorders.
What is a Head Map?
- Computational EEG head maps are a visual representation of the difference in activity between a patient’s brain and a standardized database.
What are Brain Biomarkers?
- Objective metrics derived from computational EEG data provide insight into how the brain is functioning. Peak Alpha Frequency (PAF) reflects cognitive capacity and physiological aging3,4. Theta/Beta Ratio reflects inattention and is FDA cleared to aid in the diagnosis of various cognitive disorders.
What is an Event Related Potential (ERP)?
- ERPs measure brain processing speed and efficiency7. They are highly sensitive biomarkers that have been shown to reflect functional abnormalities even prior to symptom onset
What is a “Go-No-Go” Task?
- Performance during a go/no-go task reflects a patient’s ability to perform daily tasks effectively. Reaction time, reaction time variability, omission errors, and commission errors give insight to cognitive status and behavioral functioning
How do you prepare for the eVox test?
- For the test, PLEASE do the following:
- wash your hair in the morning
- NO hair spray, NO gel, NO mouse, NO oil
- DO NOT style your hair: NO braids, NO ponytails
- Wear a button down shirt or blouse
- NO perfumes or body lotions (you MAY wear deodorant
- The tech will remind you about your appointment and answer any questions you may during the test.
When will you get the results of the test?
- After the completion of the test, Dr. Athni will review the recorded “brain waves” and the associated Brain Biomarkers, all of which will be put together in the form of a “report”.
- This will be reviewed with you on your next office visit.
NeuroTrax Test
What is a “NeuroTrax” Test?
- A NeuroTrax test is a computerized test to assess whether you have any cognitive impairment caused by your medical / neurological conditions.
- It is an office based NeuroPsychology test.
How is it performed?
- The test is performed on a computer, although you do NOT have to know how to use a computer to take this test.
- The test takes approximately 30-45 minutes to complete.
What will the results reveal?
- The results will tell us what type of cognitive impairment you may have.
- It will give is a “score” which can be tracked over time to look for any worsening or improvement.
How often is the NeuroTrax test performed?
- If abnormal, we typically repeat this test every 6 months to look for any changes.
Autonomic Nervous System test (ANS)
What is the “Autonomic Nervous System” (“ANS”) ?
- Your autonomic nervous system (ANS) is the part of your nervous system that functions to sustain your life by controlling your heart, lungs, digestive system, blood pressure, immune system, certain of your reflexes, fluid balance, pupil diameter, sweating, and sexual function.
- There are two parts (or branches) of your ANS: the sympathetic branch and the parasympathetic branch. Generally, the sympathetic branch is more in control when you are stressed, ill, or injured, while the parasympathetic branch is more in control when you are relaxing, sleeping, or recovering from an illness or injury.
- In fact, most illnesses and injuries cause or result from an imbalance between these two branches. An imbalance in your ANS can tell your doctor many things about how healthy you are, as well as what can be done to keep you as healthy as possible.
What is an ANS Test?
- We perform three (3) independent clinical ANS tests (or studies) designed to determine the ability of both branches of the autonomic nervous system (ANS) to respond to and relax from a challenge.
- The two branches that make up the ANS are the sympathetic and parasympathetic (SNS and PSNS, respectively).
What are the different components of the ANS test?
The ANS test consists of 3 components or challenges.
The challenges are:
- deep breathing to challenge the PSNS,
- valsalva to challenge the SNS, and
- standing from a seated position to challenge both systems
How long does it take?
- A study takes approximately 25 minutes to complete.
What results will be obtained from this test?
- The ANS test will tell us whether your sympathetic and parasympathetic nervous system are “in balance” or “out of balance”.
- These results will help guide Dr. Athni in formulating a treatment plan to try to bring the ANS back “in balance”.
How often is the ANS test performed?
- If your ANS test is “normal”, we will not have to repeat the study at any set interval.
- But, if it is abnormal, we will probably repeat the study in 4-6 months to see if our therapeutic intervention is resulting in any ANS improvement.
Office Policies
Office Policies
New Referrals
- We see patients on a “referral only” basis.
- Once we receive the referral, we will verify your insurance for benefits, and advise you of your expected payment at the time of service
- If you do not have insurance, we will NOT be able to see you as a patient
- At this time, we do NOT see “self-pay” patients without a valid insurance
- If you have seen another Neurologist, we must be forwarded your medical records for review prior to receiving an appointment
- After reviewing your medical records, we might recommend that you see a different Neurologist as our practice may not align with your needs or medical issues
- We require every patient to have an on-going relationship with a primary care physician to handle all of your non-neurological medical needs.
- After your Neurologic Consultation, we will send your consultation report, and any follow-up notes, to your primary care physician
Consent – Who Can Accompany Patient Into Exam Room
- If you are being seen thru Worker’s Comp, we will only allow the patient in the exam room. If a NCM or Adjustor wants to meet with Dr. Athni, they will need to schedule a separate appointment with the front office.
- If you are an adult and are being seen thru your private insurance or Medicare or Tricare, we will allow your spouse into the exam room.
- BUT, for anyone else, we will need a Medical Power-of-Attorney (Medical POA) or a Notorized letter stating the third-party is allowed to be involved in the patient’s care. This would include friends or a parent of a patient or an adult child of a patient.
- This is a standard practice in Psychiatric offices. Although we are not treating Psychiatric illnesses, many of our patients have cognitive issues. To make sure decisions are being made in the best interest of the patient, we require such a POA. Even if you do not have any issues which involve your cognitive abilities, we have one policy for all patients.
- We hope you understand the rationale for this policy. We are merely trying to make sure unauthorized people (who may not have the patient’s best interest) are not involved in medical decisions.
Scheduling Appointments
- We are a “referral only” office. We require a referral from your primary care physician.
- As soon as our office receives your referral, we will first verify your insurance benefits to make sure we are part of your insurance network. (Please look at “Insurance Networks” on the web site to see our network affiliation.)
- We request you forward a copy of your medical records prior to scheduling your initial appointment. We will review your medical records before an appointment is given. We reserve the right to NOT schedule an appointment – after reviewing your medical records, we may decide we will not be able to participate in your medical care.
- Our office staff will then contact you directly to schedule the initial appointment.
- We try to see patients within 2 weeks of receiving the referral.
- We normally see new patients Monday mornings or Thursday afternoons
- We will try to accommodate your personal / work schedule to minimize any inconvenience.
- If the appointment involves a Work-Comp issue, we must obtain a written approval from the WC adjuster prior to scheduling the appointment.
- We request ALL new patients to arrive at the office at least 1 hour BEFORE their scheduled appointment.
- This will ensure that all paperwork issues are completed before your scheduled appointment time. Otherwise, your consultation time will be delayed.
Medication Refills
What medications will be refilled?
- Our office will only refill those medications we have prescribed, AND only if you are an active patient in our practice.
How many refills will be prescribed?
- During your office visit, we will try to prescribe medications with enough refills to last you until your next office visit
- If you cancel your follow up appointment, we will NOT refill your medications until you are re-evaluated by Dr. Athni
- If you choose not to re-schedule your appointment, you should consider obtaining all further refills thru your primary care physician
How are refills processed??
- We normally refill medications during the office visit
- We send all medication refills thru eRx (electronic prescribing system)
- The eRx system minimizes human error, and reduces prescription filling time
- Once we send an eRx prescription, an eRx is typically processed and filled within 1 hour by most pharmacies
“Calling in” prescriptions
- To minimize errors, we will NOT “call in” a refill medications
- If your pharmacy does not accept electronic prescriptions, we will give you a hand-written prescription during your office visit for you to hand-carry
Narcotics Pain Medications and Controlled Medications
- Many pain medications are “controlled” and monitored by the DEA (Drug Enforcement Agency) to minimize fraud and abuse
- We will NOT prescribe or refill any controlled narcotic pain medications
- We WILL prescribed non-narcotic, controlled medications.
- These medications will ONLY prescribed and refilled during a face-to-face office visit
Auto Accident Evaluations
- If your medical issues are related to a recent motor vehicle accident, we will not wait for payment from your auto insurance or from your attorney.
- You will be responsible for full payment of any and all charges incurred at our office.
- You can file the claim with your auto-insurance company.
- We will NOT accept a delayed payment from “3rd party liability” benefits as a result of any auto accidents.
- We will NOT accept any “liens” or “promissory notes” from your attorney.
Financial Policies
Financial Policies
Insurance Network Contracts:
- We have entered into a contractual agreement with the following insurance companies. The list is NOT exhaustive, as there over 100 different insurance companies. The list only highlights the “major” insurance carriers in this area.
- Since we are not affiliated with the Medical Center, we are not allowed to be part of Secure Health, which is an insurance network owned and managed by the Medical Center of Central Georgia.
- Tri-Care – Military (Standard, Prime, Tricare-for-Life)
- Blue Cross / Blue Choice
- Cigna Insurance
- United HealthCare
- Aetna
- If an insurance company is not listed, please call our office to verify network coverage.
Medicare:
- We are Medicare “Participating Providers”. As such, we accept the Medicare Part-B fee schedule.
- You must show proof of Medicare Part-B coverage before we can accept you as a Medicare patient.
Medi-CAID:
- We are NOT accepting any new MediCAID patients.
Expected Payments
If you are a Work Injury or IME patient – No payment is required at time of office visit
- If you are being seen as an authorized Work Injury patient or as an authorized IME, you will NOT be asked to pay anything. All your bills will be handled through your Worker’s Compensation Insurance Company or your attorney.
What is your payment if you have Medicare?
- If Medicare is your primary insurance, then we expect 20 percent of your “Medicare allowable charges” and any deductible required for the calendar year.
- Per federal regulations, the Medicare deductible for calendar year 2022 is $226.
What is your payment if you have commercial (PPO or HMO) insurance?
- We will typically verify your insurance before you arrive at our office.
- If we are a “participating provider” for your insurance plan, then we will only collect the co-pay (either a set dollar amount or percentage).
- You may also be asked to pay any deductible that may not have been met for the calendar year.
What if we are NOT in your insurance network?
- If we are not in your insurance network, you may be asked to pay your bill in-full.
Please discuss this with our office manager prior to your office visit.
What if you have NO insurance?
- If you are a NEW patient without a valid verifiable insurance, we will NOT be able to see you as a patient
- If you are an existing patient and have lost your insurance or we are no longer in your insurance network, then we expect full payment at the time of service.
Insurance Verification:
- We will verify your insurance PRIOR to your office visit.
- This verification will inform us of your insurance contract stipulations, including any co-pays you are required to pay.
WHEN to Pay:
- We expect payment at the time of service.
TYPE of Payment:
- Our office prefers cash or credit card (MC, Visa, Discover, and Amex).
- You may also pay On-Line thru this web site. We offer a Secure Payment process, powered by Pay-Pal.
- Due to the high number of “bounced checks”, we do NOT accept checks as a form of payment.
Filing Insurance Claims
What insurance claims do we file?
- We will file all Primary insurance claims.
How do we file insurance claims?
- If your insurance company is setup for electronic filing, we will file this claim electronically through our computer system.
When do we file the insurance claims?
- Typically, we file your claim within 7 days after the office visit.
NOTE: Although we may file your claim, it is quite common for insurance companies to “lose” and “not process” the claims. They commonly state that they did “not receive” our claims.
- Hence, it can sometimes take a few months for your claim to be processed properly.
- If we have not received payment within 45 days, we will re-file your claim.
Do we file Secondary insurance claims?
- Although we file all Primary insurance claims, we generally do NOT file Secondary insurance claims.
- Some insurance companies will transfer your claim automatically to the Secondary carrier, in which case it will get processed without any further intervention.
- Else, you will be required to submit the claim to your Secondary carrier after you receive the EOB (Explanation of Benefits) from your Primary insurance company.
Monthly Statements
When do we mail account statements?
- We mail account statements only AFTER the insurance has paid their portion.
- We will wait for payment from your insurance company before we send you a “Payment Due” bill. Sometimes, it may take up to 6 months (or longer) for us to receive the initial payment from your insurance company, so don’t be surprised if you receive a statement from us many months after services are rendered.
- If your insurance does not pay us anything, you will receive a bill for the full amount.
- We normally mail account statements once a month.
What if there is a zero balance?
- If your insurance company pays “in-full”, and there is NO balance due, you will NOT receive a statement.
What if there is a “balance due” on your account?
- If your insurance company only pays us a partial amount, and there is a remaining balance, we will send you a statement during the first week of the month following payment from the insurance company, and each month there-after until the balance is paid.
How many statements are mailed?
- You will receive a total of 3 statements from our office before sending your account over to a Collections Agency.
What if NO payment is made towards an open balance?
- If no payment is made towards your open balance after 3 monthly statements, your account will be sent to a local Collections Agency for further legal action.
- A separate “collections fee” will also be assessed above and beyond your open balance to cover the cost of the collections process.
Methods of Payment
- You may pay all or part of your open balance at any time. As long as there is an open balance, you will receive a monthly statement from our office. You may mail us your payment or stop by the office to pay.
- We accept cash, credit cards (Visa, MC, Discover, Amex), or debit cards.
- You may also pay on-line using our secure payment method powered by Pay-Pal.
On-Line Payment
- If you would like to pay a portion or all of your open balance, please use the form below.
- We use a Secure Payment process, powered by Pay-Pal. Please enter your Name and Birth Date so we can credit the correct account with your payment.
- After you click on the “Pay Now” button, you will be taken to a secure PayPal driven web site, where your payment will be processed.
- After the payment process, you will have a chance to enter any “comments or instructions” regarding your payment.
WC - IME - Records Review
Work Injury - IME - Records Review
Work Injury – Worker’s Comp
General Work Injury Policies
- We evaluate and treat a full range of work injuries.
- We understand the full breadth of the rules and regulations set forth by the Georgia State Board of Workers’ Compensation (GA – SBWC).
- Prior to each work-injury office visit, we will verify work-comp coverage and obtain a written authorization from the WC insurance adjustor.
- Without a written authorization, we will NOT be able to continue treatment or evaluation.
- If a certain medical symptom or injury or condition has been controverted by the employer or WC insurance company, we will NOT evaluate or discuss or treat that particular problem or issue.
Return to Work
- We will make every attempt to return the injured employee back to work.
- If the patient cannot be returned to work “full duty”, we will try to return them to “light duty” work, and prescribe restrictions or limitations.
- If the patient has maximally recovered, we will delineate a disability rating using the AMA guidelines, and declare the patient as being at “MMI”.
IME – Independent Medical Examination
WHAT is an IME?
- An Independent Medical Exam, commonly referred to as an “IME”, is a legal evaluation, usually requested by an insurance company, attorney, or some other involved 3rd party. These evaluations are strictly confidential, and the records are NOT released to any other requesting party.
- As an IME Physician, we fully understand that we are NOT developing any doctor-patient relationship. We will NOT prescribe any medications, and we will NOT make any formal treatment recommendations to the patient.
- Some diagnostic testing may be ordered to properly complete the IME, but these tests are scheduled and performed only with pre-approval from the insurance company or attorney.
HOW to schedule an IME:
- Independent Medical Examinations (IME) must be scheduled by the employer, attorney, or insurance company. Prior to scheduling the appointment, please call our office and talk with the office manager to discuss our IME financial policy. We typically request pre-payment for the IME.
WHEN are IMEs scheduled, and how long does it take?
- IMEs are scheduled at a mutually convenient time, and as quickly as possible.
- A typical IME can take 60 to 90 minutes with the patient. This is followed by an additional 3-4 hours of medical records review and case analysis.
What questions are answered during the IME?
- Typically, the IME-requesting party will ask a series of questions to be answered during the IME. All of these questions will be answered by Dr. Athni.
- If additional testing is necessary to properly answer these questions, we will recommend any necessary diagnostic tests. If approved, we will schedule and coordinate these diagnostic tests.
- Once the IME is completed, and if requested or necessary, Dr. Athni will call the IME-requesting party to discuss the case.
IME records are confidential:
- As noted above, we fully understand the legal implications of an IME, and hence we will release the report only to the IME-requesting party. These records are kept in strict confidence, and will NOT be released to anyone else.
Objectivity:
- All cases are handled objectively without being influenced by any outside party. Dr. Athni will “call it like he sees it”.
- For over 25 years, we have regularly seen patients referred by insurance companies (handling life insurance policies, disability insurance policies, workers compensation policies, etc), attorneys (representing both patients and employers), and directly from employers.
Oue experience with IMEs:
- Dr. Athni has been performing IMEs for over 25 years. On average, we complete 10 Independent Medical Evaluations per year.
Questions?
- If there are any questions or concerns regarding IMEs, please call our office and speak with our office manager. If they cannot answer your questions, then Dr. Athni will speak with you directly.
Records Review
- If an insurance company or attorney is involved in a legal case which requires a Neurological opinion, we will be happy to review the records and answer any pending questions.
- The Medical Records Review will be purely objective, regardless of who is requesting the Records Review.
- After the Records Review, Dr. Athni will be available to discuss the findings with the requesting attorney or insurance company.
- A report of the Records Review will be generated and faxed to the requesting party.
- Depending on the volume of the medical records, the review can take 1-2 weeks after receiving the medical records.
- We expect pre-payment for these services.
- The cost will be based on services requested, such as the volume of medical records, whether any imaging films need to be reviewed, and whether a telephone conference is also being requested.
- Please contact our office to discuss these fees.
Concussion Assessment
- Most people are familiar with football related concussions, but they are also quite common after work injuries.
- Concussions occur after a closed head injury, such as can occur after a fall or car accident or some other accident. It is very important to have such head injuries evaluated quickly and aggressively, and as soon as possible after the accident.
- The symptoms associated with a concussion can be quite varied and unusual.
- Some diagnostic tests we perform in the evaluation of a concussion include: an MR brain, EEG, and Neurotrax test.
- Depending on the results of these tests, various treatment options will be discussed and recommended.
Education: Podcasts & Videos
Education: Podcasts and Videos
YouTube Educational Videos
Dr. Athni has created educational videos hosted by YouTube, and have also been posted on this page for convenience. The YouTube channel is called “NeuroEd – Neurology Education Made Easy.”
These videos are separated into various “playlists” – primarily based on “type of video” and suitable audience. Each playlist is displayed separately on the various tabs on this page.
This list of videos will be slowly expanded over the next few weeks to months. Subscribe to Dr. Athni’s Channel to view the latest videos.
If you have a specific topic that you want Dr. Athni to discuss, please let him know on your next office visit.
“The Brain Doc” – a Podcast series
Dr. Athni is in the process of creating a Podcast series entitled “The Brain Doc”. In the Podcast, Dr. Athni will interview various specialists, medical students, as well as discuss various medical topics.
You can find all the episodes on this website or on your favorite Podcast Player.
For Spotify, search “Brain Doc Athni”
For all other Podcast players, search “Brain Doc”.
If you find the podcast enjoyable and educational, please leave a positive review. Thank you.
The Neuro Axis video-series (8 total videos) will teach you how to “localize the lesion” using a simple approach. Great tool for medical students and residents. If you follow the methodology in this video series, you will markedly improve your clinical neurology skills, improve your Shelf and Step scores. More importantly, you will be a “star” on rounds!
Introduction 00:00 — Disclaimer 00:17 — Start of video 00:56
Subscribe to my channel
Neuro Axis: Overview
Neuro Axis: Muscle Disorder
Neuro Axis: NeuroMuscular Junction Dysfunction
Neuro Axis: Peripheral Nerve Disorders
Neuro Axis: Nerve Root Disorders
Neuro Axis: Spinal Cord Disorders
Neuro Axis: Brainstem Disorders
Neuro Axis: Subcortical & Cortical Disorders
The Medical Student Success video-series aims to give you important tips and tricks to succeed in medical school. During your clinical years, you have to not only get good grades, but you have to also learn how to be a successful clinician. Watch these videos, and learn how to succeed in “the game” and learn how to be a “star” on rounds!
Introduction 00:00 — Disclaimer 00:17 — Start of video 00:56
Education: Students & Residents
Education: Students & Residents
PLEASE READ – IMPORTANT INFORMATION
- Each day starts at 7:45 am — Please arrive on-time
- Please make sure you demonstrate proper time management and professionalism
- Whether you are taking this rotation as an ELECTIVE or as part of your CORE — be prepared to be challenged. This is not a “fluff” rotation.
- Students will be working directly with Dr. Athni – no upper-level, intern, or resident.
- This rotation is not physically challenging, but rather cognitively challenging.
- Get a good nights rest – and be prepared to demonstrate your intellect.
NOCG Education Center
- Prior to the rotation, please log into https://edu.nocg.org which is our online educational portal
- NOTE: You will need to use your school email account to register — this portal ONLY allows .edu email accounts to register
- To gain full access to the resources, you will be provided with an “enrollment key” by Dr. Athni when you make initial contact with him.
- Once “registered” and “enrolled”, you will be able to access a handful of textbooks and various study material.
- You will find a “Pre-Clinic Quiz”, which should be taken without studying.
- The Pre-Clinic Quiz MUSt be completed BEFORE THE ROTATION STARTS – i.e BEFORE MONDAY MORNING
- Starting the rotation without completing the pre-test is NOT the signs of a successful student! A very BAD look!
Clinic Hours
- Your day starts at 7:45 am
- Tuesday and Wednesday are our “late days” – be prepared to stay till around 5:30 pm to 6 pm
- All other days, you should be able to leave office around 4:00 to 4:30 pm
- Consider bringing lunch – we have a kitchen with microwave and fridge.
- Many eateries are within driving distance (Arby’s, Burger King, Fresh Market, Kroger’s, Starbucks, etc)
Attire – STRICT – NO EXCEPTIONS
- Business casual attire or clean scrubs, with your white coat and name tag
- NO visible tattoos – ALL tattoos MUST be covered with clothing (else you will be asked to leave the clinic)
- NO exposed body piercings (this includes NO tongue rings, NO facial piercings, NO gauges, etc)
Other Information
- Park at LEFT side of building, in covered parking area
- Please ONLY use the SIDE DOOR to come in-out of the office
- If you have Orientation, you can use our conference room (remember to ask Dr. Athni for office Wi-Fi password).
- You can also use our conference room to attend your weekly “Academic Day” and “Grand Rounds” meetings.
- After completion of the webinar / meeting, you are expected to return to clinic.
- Wear comfortable shoes
Technology
- Bring your laptop, tablet, iPad, or cell phone with internet browsing capability (we have wifi in the office)
- Please keep cell phone on “vibrate” mode
- DO NOT use your device to play games or “shop” or socialize with your friends while in clinic
- DO NOT use your cell phone or tablet in front of patients – this would be very rude, and disrespectful to the patient
Neuro Tools
- The only tool you would need would be a neuro hammer, but do not buy one.
- Most students & residents purchase the wrong type of hammer. I will show you which one to purchase.
Rotation Expectations
- This is an out-patient rotation, with no call and no weekend responsibilities.
- This is not a physically-challenging rotation (no sleep deprivation, no excessive walking, no after hours, etc).
- If you have a lecture commitment, just let me know, and you can break away for the lecture and return when you are done.
- We have a conference room where you can watch your lectures and grand rounds.
- I will assign reading and “homework” during the rotation – you are an adult, so I expect you to keep up with these assignments.
- Your typical workweek in the clinic will be around 30-35 hours.
- Since this is not a very time-demanding or physically demanding rotation, I EXPECT you to read and learn Neurology when not in clinic.
- There should be absolutely no excuses for not reading neuro related material during the rotation.
- You will be working with Dr. Athni, directly – so please leave any “laziness” at home.
- REMEMBER: You will get out of this rotation what you put into it.
- This might be your only exposure to Neuro, so take advantage of the rotation.
- The more you learn, the more you demonstrate an interest to learn, the more you ask, the more I will teach.
How to Assess Progress
- You will be required to take a “Neurology Pre-Clinic Quiz” PRIOR to the first day of the rotation (available on the NOCG Education portal).
- Try taking this test without studying to assess your baseline neuro knowledge.
- I do NOT expect you to “ace” this test. Rather, it will assess your level of Neurology knowledge at the beginning of the rotation.
- You will be required to take another “Quiz” at the end of the rotation.
- Part of your “clinic” grade and assessment will be based on how you have progressed during your Neurology rotation.
- These quizzes are NOT meant to be stressful. Rather, they are meant to demonstrate your academic growth and help build your confidence in clinical Neurology.
Teaching and Learning Process
- Many students and residents are “afraid” of Neuroscience and Neurology.
- One of the best ways to learn Neurology is to understand the pathology and pathophysiology, instead of memorizing random facts.
- To accomplish this, I use the Socratic method of teaching – so, be prepared to be challenged academically.
- You will quickly realize, and hopefully appreciate, the importance of critical analysis and reasoning (remember CARS on the MCAT?).
- Come with an open mind, and you will quickly find that Neurology is a lot of fun.
- Don’t stress over this rotation.
- Bring your “A” game, and you will learn more than enough to earn an “A” on your shelf exam, while also becoming well prepared for the Neurology component of the Step 1 and Step 2 exams.
Things to Study – BEFORE Rotation Starts
- Since you only have 3 to 4 weeks on the neurology rotation, I have found that most students / residents lose a lot of time trying to “re-learn” the fundamentals of neurology (information that should have been learned during basic sciences).
- Review basic neuro-anatomy (cortical lobes, detailed anatomy of brainstem and spinal cord, etc).
- Review the sensory and motor pathways.
- We will review this information during the rotation. But, without this basic knowledge, your experience in neurology will be limited and constrained.
- SIDE NOTE: Chapters 5 (Weakness) and chapter 6 (Sensory system) of Blueprints has a nice overview of the above information. Pay special attention to how to properly “localize the lesion.”
Educational Videos – Watch BEFORE Rotation Starts
- All students and residents rotating through our office are expected to watch the “How To Localize The Lesion” video series (i.e. NeuroAxis) BEFORE starting the rotation.
- No excuses. Without a clear understanding of the information provided in this video-series, you will find your first few days of neurology to be very painful!
- Also listen to the “FDA” podcast
- The Videos and Podcasts are located on the https://nocg.org web site
NOTE: “BEFORE STARTING THE ROTATION” means BEFORE THE FIRST MONDAY OF THE ROTATION
Topics to study DURING the rotation
- There are a handful of topics which are very common in Neurology – very frequently appearing on your various exams (Shelf, Step, Specialty Boards)
- I encourage you to study and try to understand the clinical relevance of these topics, not just memorize the core information
- We will be discussing these topics at random times during the month.
Difficult Topics – Learn Big Concepts
- Synucleinopathies
- Epilepsy classification and treatment (including status)
- Multiple Sclerosis
- Myasthenia Gravis
- Concussion vs. TBI vs. Closed Head Injury vs. Post-concussive Syndrome
- How to analyze CSF results
- Stroke Management – acute vs. long term .. surgical vs. non-surgical … etc
- Spinal cord compression
- Classification of peripheral neuropathy
- “AIDP” vs. “CIDP”
Not So Difficult – Quickies – Easy To Learn
- Different types of hydrocephalus
- Bell’s Palsy
- Trigeminal Neuralgia
- Scheduling of medications
- Types of headaches
- Chronic pain vs. acute pain
- Aphasia vs. Dementia vs. Delirium
- Intracranial bleeds (5 types !!)
- Side effects of common medications
Try To Learn, Else Just Memorize
- Visual field defects
- Muscular Dystrophies
- Metabolic Syndromes
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Office Hours
Mon: 8:30 am to 4:30 pm
Tues: 8:30 am to 4:30 pm
Wed: 8:30 am to 4:30 pm
Thurs: 8:30 am to 4:30 pm
Fri: 8:30 am to 12 Noon
Weekends & Holidays – Closed
