Neurology

We offer expert diagnosis and treatment for infants, children and adolescents with a wide variety of nervous system disorders including epilepsy, cerebral palsy and muscular dystrophy.Our neurologists regularly work as a team with a child’s pediatrician and with other pediatric specialists to provide ongoing care and support for your child as he or she grows and transitions to adulthood.

Conditions we treat include:

• Routine epilepsy, suspected seizures and new onset seizures
• Neurogenetic disorders
• Neuromuscular disorders, including muscular dystrophy
• Movement disorders, including Tourette’s

Kaiser Permanente’s specialists in Genetics, Neurodevelopmental Disorders, Neurosurgery and Neuro-Oncology also treat neurological-related conditions, such as autism, Down syndrome and tumors.

Diagnosing pediatric conditions

• Electromyogram (EMG)
• Nerve conduction velocity (NCV) testing
• Imaging services (including CT scans, Electroencephalogram (EEG), Sedated Magnetic Resonance (MRI) imaging and brain positron emission tomography (PET)

Treating pediatric conditions

• Botox for spasticity/cerebral palsy
• Inpatient long-term epilepsy monitoring
• Ketogenic diet
• Vagus nerve stimulator management for epilepsy and other seizure disorders
• Neurosurgical procedures for aneurysms, shunts and tumor resections
• Therapeutic hypothermia (whole body or selective head cooling) for brain injury in infants with perinatal hypoxic ischemic encephalopathy (HIE)

We offer neurologic evaluation at all our medical centers. When pediatric patients are referred for a pediatric neurologic evaluation, it will be at the pediatric neurologic location closest to their medical centers.

People with epilepsy have seizures that are caused by sudden bursts of electrical activity in the brain.

Diagnosing epilepsy

Seizures aren’t always a sign of epilepsy. Tests to confirm epilepsy or look for other causes of your symptoms include:

• Electroencephalogram (EEG)
• Long-term inpatient and ambulatory video/EEG surveillance
• Evoked potentials
• Wada studies
• Intra-operative brain mapping

Treating epilepsy

Medicine alone can often control the frequency and severity of seizures in many children and adults. Other treatments include:

• Vagus nerve stimulation
• A special diet which includes more fat and less carbohydrate
• Resective brain surgery to remove the area of the brain causing seizures

Click here for more information about epilepsy.

Sometimes, disorders in the brain and nervous system can change the way we behave, feel or think. Our neuropsychologists specialize in treating the brain and nervous system disorders that can alter behavior and cognitive function.

Symptoms that may call for a referal to a neuropsychologist include:

• Memory difficulties
• Mood disturbances
• Learning difficulties
• Nervous system dysfunction

Diagnosing neuropsychology and cognitive disorders

• Standardized tests to measure many areas of brain function, including memory, cognitive ability and problem-solving skills
• Brain scans, such as CT or MRI

We take a team approach to care for patients with cognitive and behavioral disorders. A patient’s team may include clinical psychologists or psychiatrists to help manage behavior and cognitive issues as well as sleep problems. Our speech language pathologists may help patients cope with memory problems. Physical and occupational therapists may help our patients recapture as much previous function as possible.

A sleep disorder is a medical condition that keeps you from getting a good night’s sleep on a regular basis. We offer consultations with board certified sleep medicine specialists to get to the heart of what’s keeping you up at night.

Conditions we treat include:

• Obstructive sleep apnea
• Insomnia
• Restless leg syndrome
• Narcolepsy
• Circadian rhythm disorders

Diagnosing sleep disorders

• Ambulatory sleep study
• Electroencephalogram (EEG)
• Genetic blood testing (commonly used to diagnose narcolepsy)

Your care team will also examine you to see if you may have a medical condition that’s causing your sleep problems.

Treating sleep disorders

• Insomnia programs, including education, lifestyle modification (such as sleep hygiene, exercise, reducing caffeine) and cognitive behavioral programs
• Breathing devices or surgery for conditions such as obstructive sleep apnea
• Medication for underlying health conditions
• Medication for sleep disorders when necessary

Click here for more information about sleep disorders.

Parkinson’s disease and other movement disorders can affect how you move, function and even talk. We offer complete diagnostic and treatment services for patients with Parkinson’s disease and other movement disorders at all our medical centers. Treatments include Botulinum Toxin injections for dystonia and surgical treatments, like Deep Brain Stimulation for Parkinson disease, tremors and dystonia.

Parkinson’s Care

Parkinson’s Care is just that — a network of specially-trained clinicians at each medical center with one goal in mind — to improve the quality of life for each and every patient with Parkinson’s disease.

But Parkinson’s Care is about much more than us helping our patients, it’s also about us helping our patients help themselves. We encourage our patients to be active partners in their own care. That means speaking up about what you need and want and how we can best serve you. It means taking advantage of our exercise classes, educational resources and online connections to live well and thrive.

Neuroimmunological disorders include a number of diseases in which the immune system becomes overactive and attacks the nervous system. These conditions can cause movement, vision and balance problems.

Conditions we treat include:

• Multiple sclerosis (MS)
• Central nervous system (CNS) vasculitis
• Lupus
• Sjogren’s syndrome
• Acute disseminated encephalomyelitis (ADEM)

We offer diagnosis and treatment for patients with neuroimmunological disorders at all our medical centers. We have MS specialists to manage our more complicated cases and diagnostic challenges (diagnosing MS can take time and and may involve a number of different tests).

Our Neurology Department regularly participates in clinical trials to evaluate new medications and treatments for MS. Visit kp-scalresearch.org to read about our latest neurological research and clinical trials.

Click here for more information about MS.

Neuromuscular diseases affect the nerves that tell your muscles when and how to move. Over time, communication between your muscles and your nervous system breaks down. Muscles weaken and waste away, often causing aches and pains and joint and movement problems.

Conditions we treat include:

• Peripheral neuropathy
• Mononeuropathy
• Mononeuritis multiplex
• Myasthenia gravis
• Lambert-Eaton myasthenic syndrome
• Paraneoplastic peripheral neuropathy
• Acute inflammatory demyelinating polyneuropathy (AIDP)
• Chronic inflammatory demyelinating polyneuropathy (CIDP)
• Acute motor axonal neuropathy (AMAN)
• Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s Disease
• Myopathy
• Muscular dystrophy
• Myositis

Diagnosing neuromuscular disorders

All our medical centers offer electro-diagnostic services to help identify the exact location of your neuromuscular problem.

• Basic electro-diagnostic testing includes nerve conduction velocity (NCV) and electromyography (EMG) studies for disorders such as peripheral neuropathies and myopathies
• Advanced electro-diagnostic testing is offered for more complex disorders such as ALS
• Repetitive Nerve Stimulation (RNS) is offered for disorders of the neuromuscular junction such as myasthenia gravis

Treating neuromuscular disorders

• Immunosuppressive medications
• Anticonvulsants and antidepressants
• Surgery
• Physical, occupational, speech and rehabilitation therapy
• Medications

Our goal is to reduce your symptoms, increase your mobility and enhance your quality of life.

Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s Disease, is a disease that causes nerve cells in the brain and spinal cord to slowly die. Over time, ALS can affect walking, hand use, speech, swallowing and even breathing.

Diagnosing ALS

Muscle weakness or trouble with your speech, swallowing or breathing don’t mean that you have ALS. Tests to confirm ALS or look for other causes of your symptoms include:

• Electromyogram (EMG)
• Magnetic resonance imaging (MRI)
• Nerve conduction studies

Treating ALS

There is no cure for ALS, but we offer many treatments and services to help our patients affected by ALS live their lives as fully as possible.

ALS Clinics at our South Bay, Los Angeles, Riverside and Fontana Medical Centers have been approved and recognized by the ALS Association for their excellent care and service. Our clinical staff is committed to giving people living with ALS and their families comprehensive care and services in a single location, often in a single visit.

Services available include:

• Pulmonary care
• Social Services
• Physical, occupational, speech and respiratory therapy
• Dietary/Nutrition

We work closely with the ALS Association to further expand the support network for our patients, their caregivers, and their families and friends.

Click here for more information about ALS.

Our neuro-oncologists provide state-of-the-art, compassionate care for patients with primary tumors of the brain and spinal cord. We treat all brain and nervous system cancers aggressively by using the latest surgical techniques and drug therapies, as appropriate for each patient.

Conditions we treat include:

• Glioblastoma and other types of glioma
• Primary central nervous system (CNS) lymphoma Medulloblastoma
• Other rarer tumors

We follow patients throughout their treatment and recovery both in person and via video telemedicine visits. We also collaborate with UCLA on clinical trials for malignant glioma which may give eligible patients access to the investigational medications and treatments. We encourage you to talk with your cancer care team about the possibility of participating in a clinical trial.

Our Neuro-Oncology Program is located at our Los Angeles Medical Center.

Primary Stroke Centers

All Kaiser Permanente Southern California medical centers have been certified as primary stroke centers by The Joint Commission. Research shows that patients receiving care at primary stroke centers have a higher incidence of survival and recovery than those treated in hospitals without this type of specialized care.

Our comprehensive stroke services include:

• Evaluation of cerebrovascular diseases such as stroke and transient ischemic attack
• Physical, occupational and speech therapy
• Dietary/lifestyle modification
• Comprehensive medical management
• Neurovascular intervention, such as thrombectomy

Our Neurology Department regularly participates in clinical trials to evaluate new medications and treatments for stroke. Visit kp-scalresearch.org to read about our latest neurological research and clinical trials.

Tele-Stroke Program

Our Tele-Stroke Program puts video to the best possible use — to save lives. This video system allows emergency physicians to contact and consult with a stroke neurologist in real time, often before a patient reaches the ER via ambulance. In a very real sense, this system brings a stroke care specialist to the patient’s bedside via video, to shave precious minutes off diagnostic and treatment time.

We offer complete Physical Medicine & Rehabilitation (PM&R) services to help our patients with neurological disorders and musculoskeletal dysfunction achieve the highest possible pediatric neurologic level of function, independence and quality of life possible.

Rehabilitation may help restore functions that have been affected by:

• Neck and back problems
• Stroke
• Spinal injuries and disorders
• Multiple Sclerosis
• Parkinson’s disease
• Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s Disease

Your care team includes board certified PM&R physicians (also known as physiatrists), pain medicine specialists, and physical, occupational and speech therapists. Their shared goal is to help you recover some of what you’ve lost to live a healthier, more fulfilling life.

Click here to find the Physical Medicine & Rehabilitation services nearest you.

Our neuro-ophthalmologists specialize in caring for patients with vision problems related to diseases or injuries to the brain or to the optic nerves which send visual signals from the eyes to the brain.

Neuro-ophthalmologists work very closely with the other neurology specialists who are also caring for you, so that your vision care is integrated into your total care plan.

Conditions we treat include:

• Vision loss due to a brain tumor, stroke, multiple sclerosis, Parkinson’s disease, brain injury or myasthenia gravis
• Double vision
• Eye movement disorders
• Optic nerve disorders
• Thyroid eye disease
• Visual field defects
• Abnormal contraction of the eyelid muscles
• Idiopathic intracranial hypertension

Treating vision conditions

Treatment will depend on your diagnosis but could include medical therapies or surgery. Many surgical procedures can be done in an outpatient setting, without an overnight stay in the hospital.

Our neuro-opthalmology services are located at our Los Angeles, Anaheim, Irvine, and San Diego Medical Centers.

Our neurotologists specialize in providing advanced care for patients with neurological disorders of the ear. Treatment will depend on your diagnosis but could include medical therapies or surgery.

Conditions we treat include:

• Complex balance disorders, such as Ménière’s disease
• Tumors of the ear, hearing nerve and skull base
• Facial nerve disorders, including facial nerve paralysis
• Hearing loss and tinnitus
• Dizziness
• Infectious and inflammatory diseases of the ear
• Congenital malformations of the ear

We have two board certified neurotologists at our San Diego Medical Center. Physicians with neurotology fellowship training are located at our Orange County and Riverside Medical Centers.

Most neurological conditions are not inherited, but some, like stroke, epilepsy and Parkinson’s disease, may run in families.

Genetic counseling and testing may be appropriate if you have a family history of:

• Alzheimer’s disease
• Huntington’s disease
• Epilepsy
• Parkinson’s disease
• Stroke
• Inherited Neuromuscular disease (muscular dystrophy, spinal muscular atrophy, etc)

Genetic counselors are located at all our medical centers. Please ask your doctor if a referral is right for you.

Can I or my family refuse medical care for religious or cultural reasons?

Who decides what treatment I will have?

What if my family and I disagree about my treatment plan?

These are just some of the ethical questions that patients and their families may face following the diagnosis of a neurological disease. We understand and we’re here to help.

Every medical center has a Bioethics Program to help patients, their families and friends, and their health care team come together to talk about and resolve difficult medical issues.

We are committed to:

• Ensure the rights of our patients
• Promote shared decision making between patients and their doctors
• Help patients and their families make decisions when ethical questions or conflicts arise
• Identify and make clear the values and beliefs of everyone involved
• Clarify what decisions need to be made
• Get to the root of any disagreements to seek moral understanding

Our goal is to help patients and their families reach decisions that are best for them, based on their values, wishes, and what is medically possible.