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Gilenya Monitoring. Gilenya is an oral medication for multiple sclerosis (MS) that is FDA-approved for relapsing forms of MS.  As part of the protocol dictated by the FDA, a physician must monitor a patient receiving their first dose of Gilenya prior to the patient being prescribed Gilenya.  SCNC offers physician-supervised monitoring of the first dose, for the FDA required six hours in a comfortable patient room with a recliner, DVD player, DVDs, wireless internet, microwave, refrigerator and magazines. The patient’s physician will receive a fax that day, documenting the patient’s response to Gilenya.

Neuropsychological Evaluation. A verbal and written evaluation by a clinical neuropsychologist with specialized training in the science of brain behavior, utilizing multiple standardized assessment measures (paper and pencil tasks, verbally mediated tasks and functional tasks) that are designed to explore the integrity of, or potential compromise of, specific brain structures or systems. The evaluation includes a one-and-a-half hour clinical interview, review of medical records, behavioral observation, administration of assessment tools, written evaluation, feedback session, and a consultation with a patient’s professional and/or medical team regarding the clinical findings.

EEG (electroencephalography) is a painless, non-invasive test that monitors brain activity through the skull.  A series of cup-like electrodes are attached to the patient’s scalp with a special conducting paste.  The electrodes (also called leads) are small devices that are attached to wires and carry the  electrical energy of the brain to a machine for reading.  Patients usually recline in a chair or on a bed during the test, which takes up to an hour.  Testing for certain disorders requires performing an EEG during sleep, which takes 3 hours.

EMG/NCS (Electromyography) records electrical activity from the brain and/or spinal cord to a peripheral nerve root (found in the arms and legs) that controls muscles during contraction and rest.  During an EMG, very fine wire electrodes are inserted into a muscle to assess changes in electrical voltage that occur during movement and when the muscle is at rest.  The electrodes are attached through a series of wires to a recording instrument.  Testing lasts about an hour but may take longer, depending on the number of muscles and nerves to be tested.  Most patients find this test to be somewhat uncomfortable.

Transcranial Doppler is a painless, non-invasive test that does not use contrast agents (iodine dye) and does not expose the patient to ionizing radiation (X-rays).   During a TCD test the patient is asked to lie down on an exam table for 30-45 minutes while the technologist uses an ultrasound transducer to acquire the necessary information. There is no requirement for fasting or other patient preparation for a TCD exam and all daily medicines can be taken in their normal routine.

Evoked Potentials tests are painless and risk free.  Two sets of needle electrodes are used to test for nerve damage.  One set of electrodes, which will be used to measure the patient’s electro physiological response to stimuli, is attached to the patient’s scalp using conducting paste.  The second set of electrodes is attached to the part of the body to be tested.  The physician then records the amount of time it takes for the impulse generated by stimuli to reach the brain. This test usually lasts less than an hour.