An EEG is a test that detects and records electrical impulses in the brain. This test provides important information about the health and functioning of the brain which allows the physician to make a diagnosis or to monitor treatment of various conditions.

Instructions:

• Wash your hair thoroughly with shampoo the night before the test.
• DO NOT use cream rinse, conditioning products or hair spray.
• DO NOT WEAR BRAIDS OR EXTENSIONS.

Unless told otherwise, the patient should sleep no more than 4 hours the night before the test. (We suggest sleeping from 12:00a-4:00a.)
Children should not nap prior to the procedure and not nap in the car on the way to the office. Avoid drinks and foods with excessive amounts of caffeine and sugar from the time you wake up in the am until after the test. Please avoid taking any stimulants or narcotics the morning of the test. You may eat regular meals and take your medications as directed. If you have any questions or need directions, please call the office at 912.354.7676.

Test time may take up to 75 minutes. Please be on time for this test. If you are more than 15 minutes late, this test may have to be rescheduled and wait time for rescheduling for procedure and doctor visit may be over 4 weeks.

NOTE: EEG appointments must be cancelled or rescheduled within 48 hours of the appointment time. You will be charged a $50 fee in order to reschedule the test if we are not given appropriate notice.

Please bring your insurance cards, photo ID, and any paperwork we have sent you. Make sure your paperwork is filled out completely to help avoid an extended wait. We look forward to seeing you at your appointment!

An EMG is a recording of electrical activity in the muscle and this test is used to diagnose diseases and damage of nerves and muscles. Most EMG examinations consist of two necessary but distinct parts- the nerve conduction studies and the needle examination. These are complementary testing procedures that evaluate different aspects of the peripheral neuromuscular system. With the Nerve Conduction Study (NCS), the nerves are simulated with mild electrical impulses to measure their function. During the needle examination (EMG), the doctor inserts a very fine needle under the skin to records the activity in the muscle.

Instructions: You may eat normal meals and take your normal medications. Do NOT take Mestinon. It is ok to continue medications for neuropathic pain such as gabapentin or pregabalin. Bathe or shower on the morning of the exam, making sure to scrub your arms and legs well to remove any body oils. Do NOT use any bath oils, lotion, or creams. Wear loose, comfortable clothing that allows easy access to test area or that can be easily removed if you need to change into a gown

Be sure to tell your physician if you are taking any blood thinners (anti-coagulants), have a pacemaker, a history of hepatitis, or if you have been infected by the AIDS virus. If you have any questions or need directions, please call the office at 912.354.7676.

Test time may take up to an hour or longer. If you are late, this test may have to be rescheduled and wait time for rescheduling may be over 4 weeks.

NOTE: EMG appointments must be canceled or rescheduled at least 48 hours before your appointment time. You will be charged a $50 fee in order to reschedule if we are not given the appropriate notice.

Please bring your insurance cards, photo ID, and any paperwork we have sent you. Make sure your paperwork is filled out completely to help avoid an extended wait. We look forward to seeing you at your appointment.

What is an MRI?

Magnetic Resonance Imaging (MRI) is a non-invasive imaging test that uses powerful magnets and radio waves to create detailed pictures of the inside of your body. It is commonly used in neurology to assess the brain, spine, and nerves.

How to Prepare for Your MRI

Clothing & Jewelry

• Wear comfortable clothing without any metal (zippers, snaps, underwire bras, etc.)
• You will be asked to remove all metal objects, including:
• Jewelry
• Hairpins or clips
• Watches
• Eyeglasses
• Hearing aids
• Dentures or retainers

Before Your MRI

• You can eat and drink normally unless you are instructed otherwise.
• Take medications as prescribed unless told not to by your provider.
• Arrive at least 15-30 minutes early to allow time for check-in and screening.

Important to Tell the MRI Technologist if You Have:

• A pacemaker or implantable defibrillator
• Cochlear implants or neurostimulators
• Metal fragments in your eyes or body
• Any type of surgical implant or previous brain/spine surgery
• Kidney disease or allergies (if your MRI will include contrast dye)

What to Expect During the MRI

• The MRI scanner is a large, tunnel-like machine. You will lie on a table that slides into the scanner.
• You must lie very still during the test to ensure clear images.
• You may hear loud tapping or thumping noises during the scan. Earplugs will be provided.
• Most MRI scans take 30 to 60 minutes, depending on the area being examined.

If Your MRI Is Done Outside Our Office

If you have your MRI at a facility outside of our practice:

• We will receive the radiologist's report, but not the images themselves.
• Please bring a copy of the MRI images on a CD to your neurology visit so that your provider can fully review them.
• Without the actual images, we may not be able to complete your full evaluation.

Questions?

If you have any questions about your MRI or need help locating your imaging records, feel free to contact our office: 912-354-7676

What Is Sialorrhea?

Sialorrhea is the medical term for excessive drooling or saliva production. It can be caused by neurological conditions such as:

• Parkinson's disease
• Amyotrophic lateral sclerosis (ALS)
• Stroke
• Cerebral palsy
• Other motor or muscular disorders

It may affect quality of life, cause social embarrassment, and increase the risk of aspiration (saliva inhaled into the lungs).

What Is Botox and How Does It Help?

Botox (botulinum toxin) is a treatment that reduces saliva production by temporarily blocking the nerve signals to the salivary glands. It is injected directly into the glands responsible for most saliva production:

• Parotid glands (near the cheeks)
• Submandibular glands (under the jaw)

Botox has been FDA-approved for treating chronic sialorrhea and is considered safe and effective when administered by trained specialists.

What to Expect During the Procedure

• The procedure is done in the office and takes about 10-20 minutes.
• A small needle is used to inject Botox into the salivary glands.
• Ultrasound guidance may be used to ensure precise placement.
• Discomfort is minimal; anesthesia is not required.
• You can return to normal activities right after the procedure.

When Will I See Results?

• Improvement usually begins within 3-7 days, with maximum effect around 2-4 weeks.
• PBenefits typically last 3-4 months.
• Repeat treatments are recommended every few months as needed.

Possible Side Effects

• Most patients tolerate Botox well. Side effects are rare but may include:
• Dry mouth
• Mild swallowing difficulty
• Local bruising or soreness
• Temporary weakness in nearby facial muscles

If you experience severe difficulty swallowing, breathing, or speaking, contact your provider immediately.

How to Prepare

• You can eat and drink normally before your appointment.
• No sedation or special preparation is required.

Please let us know if:

• You are pregnant or breastfeeding
• You have a neuromuscular condition (e.g., myasthenia gravis)
• You take blood thinners or anticoagulants
• You have had allergic reactions to Botox in the past

After Your Appointment

• You may return to work or normal activity immediately.
• Avoid rubbing or massaging the injection sites for 24 hours.
• Keep track of your symptoms and report any improvement or concerns at your next visit.

Questions or Concerns? Contact us at: 912 354-7676

Cervical dystonia (also known as spasmodic torticollis) is a neurological movement disorder that causes the muscles in your neck to contract involuntarily. This can lead to:

• Abnormal head posture or neck movements
• Muscle pain or tightness
• Tremors or jerking motions of the head

Botulinum toxin is an FDA-approved treatment that can significantly reduce these symptoms.

How Does Botox Work?

Botox is a muscle-relaxing medication made from a purified protein. When injected into overactive muscles, it:

• Blocks the nerve signals causing abnormal muscle contractions
• Reduces muscle spasms and pain
• Improves head position and range of motion

Botox does not cure dystonia, but it helps control symptoms and improve quality of life.

What to Expect During the Procedure

• Duration: The treatment takes about 15-30 minutes.
• Injections: A small needle is used to inject Botox directly into the affected neck and shoulder muscles.
• Your provider may use EMG (electromyography) or ultrasound guidance to ensure precise targeting of overactive muscles.
• You may feel a quick pinch or slight burning during each injection.

After the Injection

• You can go home immediately and return to your usual activities.
• Avoid strenuous neck or shoulder exercise for 24 hours.
• You may experience:
• Mild soreness or bruising at injection sites
• Temporary neck weakness
• Flu-like symptoms (rare)

These side effects are usually mild and resolve within a few days.

When Will You Notice Results?

• YImprovements typically begin 3-7 days after treatment.
• Full effect is usually reached by 2-3 weeks.
• Benefits last around 12 weeks, after which symptoms gradually return.

How Often Will I Need Injections?

• Botox treatments are typically repeated every 12 weeks.
• Your response will be monitored, and dosage may be adjusted over time for optimal results.

Is Botox Safe for Cervical Dystonia?

Yes. Botox has been safely used for decades to treat muscle disorders like cervical dystonia. Rare but serious side effects may include:

• Difficulty swallowing or speaking
• Generalized weakness

Questions or Concerns?

If you have questions before or after your treatment, or if you experience any unexpected symptoms, please call our office at 912-354-7676

Hemifacial spasm is a neurological condition that causes involuntary twitching or contractions of the muscles on one side of the face. It often begins around the eye and can spread to the cheek, mouth, or neck.

It can be caused by irritation or compression of the facial nerve (cranial nerve VII), often from a blood vessel or other structural issue but can also occur spontaneously.

What is Botulinum Toxin?

Botulinum toxin is a purified protein used to relax overactive muscles. It works by blocking nerve signals that cause muscle contractions.

For hemifacial spasm, Botox is considered a safe and effective treatment to reduce or eliminate facial twitching.

How is the Treatment Done?

• The procedure is performed in the office and takes about 10-15 minutes.
• Botox is injected into specific facial muscles involved in the spasm (e.g., eyelid, cheek, jawline).
• A very fine needle is used, and the injections are usually well-tolerated.

What to Expect After Treatment

• You can return to normal activities immediately after the procedure.
• Improvement usually begins within 3-7 days.
• Peak effect occurs around 2 weeks, and benefits typically last 3 to 4 months.
• Regular follow-up injections may be needed every 3 months to maintain relief.

Possible Side Effects

Most side effects are mild and temporary. These may include:

• Mild swelling or bruising at the injection site
• Drooping of the eyelid (temporary)
• Dry eye or excessive tearing
• Weakness in surrounding facial muscles

Serious side effects are rare. Notify the clinic if you experience difficulty swallowing, breathing, or speaking.

Before Your Appointment

Eat normally and take medications as prescribed

Inform the provider if you are:

• Pregnant or breastfeeding
• Using blood thinners or have a bleeding disorder
• Diagnosed with a neuromuscular condition (e.g., myasthenia gravis)

Tips for Best Results

• Keep a symptom diary to track changes between treatments
• Avoid rubbing or massaging the injection areas for at least 4 hours
• Report any new or worsening symptoms at your follow-up visit

When to Call the Office

Call us at 912-354-7676 if you experience:

• Unusual facial weakness
• Vision changes
• Trouble swallowing or speaking
• Side effects that worsen or last more than a few days

Botulinum toxin is a medication derived from a purified protein that temporarily blocks nerve signals to muscles. It is FDA-approved to help prevent chronic migraine - defined as 15 or more headache days per month, lasting 4 or more hours each day.

How Does It Work for Migraine?

Botox is thought to reduce migraine frequency by:

• Relaxing overactive muscles in the head and neck
• Blocking pain transmission pathways
• PReducing inflammation around nerve endings
• Patients often experience fewer and less severe migraines over time.

What to Expect During the Procedure

• The procedure takes about 10-15 minutes.
• Small amounts of Botox are injected with a fine needle into specific areas: forehead, temples, back of the head, neck, and shoulders.
• Typically, 29-31 injections are given per session.
• It is performed in the outpatient clinic - no anesthesia or sedation is required.

After the Injection

• You may return to normal activities right after the procedure.
• Avoid strenuous exercise, wearing a hat, massaging the injection sites, or lying flat for 4 hours after treatment.
• Mild side effects like bruising, neck stiffness, or headache can occur and usually resolve within a few days.

When Will It Start Working?

• Botox takes about 1-2 weeks to start working.
• Maximum benefit is usually seen after 2-3 sessions (each session is spaced 12 weeks apart).
• For best results, consistency is key—ongoing treatments every 3 months are typically recommended.

Common Side Effects

Most side effects are mild and temporary:

• Neck pain or stiffness
• Headache at injection site
• Temporary eyelid droop (rare)
• Flu-like symptoms

Serious side effects are very rare. Contact your provider if you experience difficulty breathing, swallowing, or speaking.

Who Should Not Receive Botox?

Let your provider know if you:

• Are pregnant or breastfeeding
• Have a history of neuromuscular disorders (e.g., myasthenia gravis)
• Are allergic to any botulinum toxin products

Tracking Your Progress

We encourage patients to keep a headache diary to track:

• Frequency and severity of migraines
• Days of missed work or activities
• Any changes in medication use

This helps assess how well Botox is working for you.

Have Questions?

If you have any questions or concerns before or after your injection, please call us at 912-354-7676

Spasticity is a condition in which certain muscles are continuously contracted. This can cause:

• Muscle stiffness or tightness
• Involuntary muscle spasms
• Pain or discomfort
• Difficulty with movement, walking, or function

Spasticity often occurs after neurological injuries or conditions such as:

• Stroke
• Multiple sclerosis (MS)
• Cerebral palsy
• Spinal cord injury
• Traumatic brain injury

How Does Botox Help?

Botox (onabotulinumtoxinA) is a muscle relaxant that works by blocking signals between nerves and overactive muscles. When injected into specific muscles:

• It reduces tightness and stiffness
• Improves comfort, mobility, and function
• Can make it easier to perform stretching, therapy, or daily activities

Botox is not a cure for spasticity but can significantly improve symptoms.

What to Expect During the Appointment

• Procedure Time: About 15-30 minutes, depending on the number of muscles treated.
• Injections: Botox is injected directly into the affected muscles using a small needle.
• DO NOT eat, drink, or smoke 2 - 4 hours prior to the test. If you are diabetic or hypoglycemic, eat a light snack instead of skipping meals.
• Your provider may use EMG (electromyography) or ultrasound guidance to identify the most affected muscles.

You may feel a quick pinch or mild discomfort with each injection, but the procedure is generally well tolerated.

After the Procedure

• You may resume normal activity right away unless instructed otherwise.
• Some mild bruising, soreness, or muscle weakness can occur near injection sites.
• Avoid intense physical activity in the injected area for 24-48 hours.
• It is important to continue any recommended physical or occupational therapy to get the best results.

When Will I See Results?

• Effects typically begin within 3 to 7 days after injection.
• Maximum benefit is usually seen in 2 to 6 weeks.
• Results typically last 3 to 4 months, and repeat treatments are needed to maintain benefit.

How Often Are Injections Needed?

• Botox can be safely repeated every 12 weeks or as recommended by your provider.
• Your response to treatment will be monitored and adjusted to best meet your needs.

Is Botox Safe?

Botox has been used safely for spasticity for many years. Side effects are usually mild and temporary. Rare side effects include:

• Temporary weakness in nearby muscles
• Flu-like symptoms
• Difficulty swallowing (if neck/throat muscles are injected)

Notify your provider if you experience any unusual symptoms.

Have Questions?

If you have any questions or concerns before or after your injection, please call us at 912-354-7676