Great advances have been made in the past 20 years in neurology, the branch of medicine that studies the brain, spinal cord, or the nerves in your body. If you’re diagnosed with a neurologic condition, such as stroke, headaches, seizures, dementia, Parkinson’s disease, and more, our Mid-Atlantic Permanente Medical Group neurologists are amazingly qualified to help guide you.
No matter what health conditions you may face, we believe it should be easy for you to contact your physicians and stay informed. With Kaiser Permanente, you can not only meet with your Permanente physicians face-to-face, but also connect with them by phone, email, or video 1. For example, for patients with Parkinson’s disease, our neurologists can conduct an assessment by video, saving patients from traveling to an appointment. Once you register for kp.org, you can check your provider’s availability, schedule appointments, see past visit notes, check most lab results, or order prescriptions.
At Kaiser Permanente, our integrated system is tailor-made, so our Permanente physicians can support patients who have complicated neurological disorders and diseases with multiple symptoms. Our neurologists have the expertise and access to quickly diagnose and treat neurological disorders and diseases and work seamlessly with Permanente primary care physicians and other Permanente specialists to guide patients’ treatment. For patients with Alzheimer’s and Parkinson’s disease, or those recovering from strokes, we have specialists who can address the wide range of issues patients may encounter from sleep disorders and behavioral health issues to difficulty moving or talking.
If you’re concerned about a potential health problem or a condition that may reoccur, our Permanente physicians have information about treatments and programs that can help you.
What to do about concussions?
The best way to handle concussions is to prevent them. If you or your child has had a concussion or engages in an activity that may lead to one, you can have a frank discussion with your Permanente primary care physician, including whether to seek care from a Permanente neurologist. Together, you can determine the right thing to do with someone who has had, or is at risk of having, head injuries from activities they love.
Steps to try to prevent Alzheimer’s disease
There are steps you can take to try to prevent Alzheimer’s disease or dementia, and our physicians are available to discuss this with you. Most important: Keep your mind and body active. And get enough sleep. Insomnia, sleep apnea, and other sleep disorders might be risk factors for Alzheimer’s disease.
Preventing future strokes
After a stroke, the brain can often heal itself if the patient is kept healthy and other medical issues are addressed. When a person has a stroke, our physicians immediately do several things to prevent a small stroke from becoming a large stroke, or dramatically cut the rate of having another stroke in the future. By helping patients prevent complications that can put them at risk for problems like pneumonia, the most common infection patients are at risk for after a stroke; by making sure they get medications that can speed up the healing process; and by working with them to control high blood pressure, a major risk factor for stroke, physicians can help reduce the chances of a second stoke.
Novel treatment to prevent and reduce headaches
To prevent and decrease the severity of headaches and migraines, some patients will benefit from a new treatment using transcranial magnetic stimulation that our neurologists can prescribe. With this treatment, every morning and evening, patients who have severe headaches can put a magnetic stimulator on the back of their heads and click it three times. The harmless magnetic pulses from the stimulator have led to significantly fewer headaches and decreased use of headache medication for some patients.
Through phone or video consultations (telehealth), our neurologists can check in with patients who have difficulty walking, moving, or driving without making them come in for office visits. Telehealth can be an invaluable tool for patients with headaches, seizures, and chronic neurodegenerative disorders who do not need hands-on examinations on a regular basis. A number of adults and pediatric epilepsy patients also opt for video visits1 and phone calls. For patients with Parkinson’s disease, frequent physician visits are required as part of their treatment plans, but with our telehealth program, these patients are able to have some of their appointments online. Before telehealth was implemented, 25% of patients with tremor had follow-up, in-person visits with their physicians. Beginning in 2016, when video visits became available, almost all of our tremor patients opted for time-saving video visits rather than traveling to a medical center for face-to-face visits. With video visits, a physician can understand the progression of patients’ problems and, if new symptoms arise, guide them further.
Meet Jason Rosenberg, MD, one of our headache specialists, and hear about advances in the treatment of headaches at Kaiser Permanente.
Time is of the essence when neurological problems arise. We have the experts and cutting-edge technology to quickly diagnose neurological conditions and get treatment underway.
Rapid stroke assessment
The sooner physicians can determine that a person is having a stroke, rather than another issue like low blood sugar, the better chance they have to limit or reverse the stroke’s effects. In our Advanced Urgent Care centers, which are open around the clock, patients get the diagnostic testing they require immediately so that physicians can determine right away if they are having a stroke and get them appropriate care. Located throughout our service area, our six Advanced Urgent Care centers are staffed by emergency room physicians who can monitor patients for up to 24 hours in observation units. They have access to pharmacy, lab, and imaging services on-site to help diagnose and treat patients, and they have immediate access to each patient’s full medical history and can coordinate follow-up care with other physicians or specialists, as needed.
Epilepsy monitoring facility to diagnose seizures
The symptoms and causes of seizures vary widely. When patients arrive at a Kaiser Permanente Advanced Urgent Care Center or a hospital emergency room with certain symptoms, physicians must first determine whether the patient is having a seizure or suffers from another underlying issue, such as a behavioral health problem. Our Advanced Urgent Care Center in Gaithersburg, Maryland, has a 24-hour epilepsy-monitoring facility where patients can be given an electroencephalogram — a test to detect electrical activity in the brain. With this information, the physicians can determine if the patient is having a seizure and quickly get them started on the right treatment. Having an electroencephalogram at our Advanced Urgent Care Centers means patients may avoid having to go to a hospital and, in many cases, save time and money.
Diagnosing cluster headaches and migraines
Effective treatments for cluster headaches and migraines exist, but the first step is getting an accurate diagnosis. Many people with cluster headaches or migraines have never been properly diagnosed, or they have been diagnosed with sinus headaches, TMJ (temporomandibular joint dysfunction), or neck problems. Our neurologists are well-versed in diagnosing headaches, and we have headache specialists on staff who see patients and are often available for same-day consultations.
Electronic medical record speeds up diagnosis of neurological disorders
Our electronic medical record allows our neurologists to work closely with other specialists in the Mid-Atlantic Permanente Medical Group. When patients with extremely painful headaches or other neurologic symptoms come to an appointment or one of our Advanced Urgent Care Centers, the treating Permanente physician can contact a Permanente neurologist who’s able to review the patients’ electronic medical records and recommend treatment. When needed, the neurologist can often see patients the same day to evaluate them and begin treatment.
Diseases and disorders of the brain and nervous system require state-of-the-art treatment, equipment, and medications, along with the acknowledged experts, that Kaiser Permanente provides.
Cutting-edge treatments for migraines, Parkinson’s disease, and strokes
Our Permanente physicians participate in clinical trials to determine the efficacy of treatments for specific conditions. As a result, they have access to the most current and effective treatments for our patients. Our neurology team participated in an international multicenter trial that showed botulinum toxin (Botox) injections are consistently effective in decreasing the intensity and frequency of migraines. When it is clinically appropriate to treat one of our patients with Botox, the injections are immediately available to that person, without pre-approval.
For another new treatment, our physicians use Botox injections for several patients who have a rare disorder in which they cannot extend their heads. To care for these patients, the physicians have developed multidisciplinary teams in which they integrate radiology, anesthesiology, ENT (ear, nose, and throat), and neurology specialists to deliver the therapy.
Clinicians from the Mid-Atlantic Permanente Medical Group are currently working with the National Institutes of Health (NIH) to find a treatment for glioblastoma, a rare cancer. For this cutting-edge research, clinicians are looking at 70 to 700 genetic markers in the human brain and performing treatments on a small number of patients.
Some patients who have Parkinson’s disease may be candidates for Deep Brain Stimulation (DBS), a very specialized type of therapy. For DBS, specially trained neurosurgeons implant electrodes in the brain, which are connected to a pulse generator on the chest. Specialists can then modulate the generator to send appropriate signals into the deep structures of the brain. These signals dampen the errant signals that cause tremors and other motor symptoms in Parkinson’s disease and allow patients to decrease the amount of medicine they take for the disease. Kaiser Permanente was the first health plan in the Mid-Atlantic region to offer the newest DBS technology for advanced Parkinson’s disease. We are now working on automated programming using artificial intelligence.
About 25% of all people are born with a hole between the two sides of their hearts. In people under age 50 who have an otherwise unexplained stroke, it can be related to this hole. Kaiser Permanente has access to percutaneous (through the skin) closure procedures without having to cut open the entire chest. For instance, the AMPLATZER™ PFO Occluder is a state-of-the-art closure device that can repair the holes in the heart and prevent future strokes in young patients. And for patients who can’t safely use blood thinners but have an irregular heart rhythm that predisposes them to clots that can cause strokes, we use a WATCHMAN device to wall-off the area of the heart that isn’t beating normally.
Integrated care eases diagnosis and expands treatment
Our integrated care model allows Permanente neurologists to see patients within two days and to instantly consult with other Permanente physicians through email, phone, or video when physicians have a patient with neurological symptoms. Even though a patient exhibits neurological symptoms, the problem may be related to other underlying disorders, such as a heart or rheumatologic problem. In these cases, the Permanente neurologist can talk to a Permanente cardiologist or rheumatologist that same day, so those specialists can recommend treatment for the underlying issue. This integrated, cross-specialty approach to care leads to better treatment decisions.
For complicated conditions like Alzheimer’s disease, our physicians not only treat patients and educate them and their caregivers about the disease, but also offer a safety net of resources through our integrated care system. Case managers and social workers are available, as are psychologists and psychiatrists who can help patients with behavioral health issues. Patients with insomnia and other disruptive nighttime behaviors can work with our sleep medicine specialists. We can also assist with transitioning care from the family setting to assisted living and, if needed, a more comprehensive senior living or nursing home center.
For neuromuscular conditions, such as ALS (amyotrophic lateral sclerosis—also known as Lou Gehrig’s disease), we have multidisciplinary clinics with neurology, physical medicine, and rehabilitation physicians. Our physicians lead the Maryland, Northern Virginia, and Washington, DC, chapters of the ALS Association of America. Our neurologists are working on autoimmune conditions nationally using NIH-sponsored studies to figure out treatments for rare conditions.
Neurological issues are complex and can be lifelong. Through our integrated care system, our Permanente specialists provide the care you need over time, no matter how your condition and symptoms evolve.
Improved stroke recovery
Our physicians use the latest medications and treatments available to improve stroke recovery. In addition, our rehabilitation specialists provide integrative rehabilitation therapy by offering therapy both in person and at patients’ homes. They help patients get stiff limbs moving or get those who’d lost the ability to speak talking again. In this way, patients who’d become completely dependent on others for their care eventually become independent once more.
Hear Dr. Rosenberg provide insight on recovering from a stroke.
Watch Dr. Gupta explain how one of her patients benefitted from an out-of-the box line of treatment for her neurologic condition.