The division of Cerebrovascular disease primarily takes care of patients with stroke. Stroke can be of two types. Vast majority of stroke are ischemic stroke, which are result of blockage in blood vessels. This is a medical emergency. The in-patient stroke neurology team is available 24/7 to evaluate these patients and treat them emergently. These treatments may include clot-buster medicines or advanced procedures like “thrombectomy”. The other type of stroke are hemorrhagic strokes which result due to bleeding in the brain. These kind of strokes may need emergent surgery or procedures. For both types of stroke, we work closely with our colleagues in neuroradiology and neurosurgery.

We are the only Joint Commission certified Comprehensive Stroke Center in the state of West Virginia, a certification awarded to centers that can provide the most advanced and complex stroke care. This demonstrates the commitment of the hospital to providing advanced stroke care to the patient in the region.

Symptoms of stroke:

• Face drooping
• Arm weakness
• Speech difficulty
• Time to Call 911

If you are experiencing stroke symptoms, call 911

Other aspect of stroke care is out-patient management of strokes. This could be second opinions and evaluation of stroke. The other aspect of out-patient management of stroke is mainly evaluation and management of post-stroke complications and issues like spasticity, mood issues, balance issues or other social issues. If you want to refer a patient or you are patient who would like a second opinion regarding the management of stroke, please call neurology clinic at 304-293-1795

We are also part of multiple clinical trials and collaborate actively with the basic neuroscience department.

Seizures and Epilepsy

Overview

A seizure consists of a transient discoordinated but simultaneous and excessive electrochemical firing of neurons (brain cells) that alter awareness or cause symptoms such as twitching, migrating numbness, or visual distortions. The vast majority of seizures stop on their own, on average lasting 90 seconds. Occasionally, seizures may recur after the initial one (known as clustering). In rare instances, seizures do not stop and require emergent medical intervention. With the exception of some individuals with epilepsy who have frequent daily or weekly seizures, any new-onset, prolonged, or different seizure constitutes a medical emergency. If you suspect someone is having a seizure, we encourage you to call 911 immediately.

Epilepsy is a condition characterized by two or more unprovoked seizures, which sufficiently raises the risk of suffering recurrent seizures enough to warrant long-term seizure medications. Epilepsy may be inherited (genetic), occur due to trauma at birth or in the developing brain, or arise as a result of injury to the brain later in life (e.g. meningitis, stroke, bleeding, or traumatic brain injury).
Women in general but particularly those who are considering starting a family or are pregnant require special consideration. Seizure medications interact with birth control medications and require careful adjustment until a stable regimen is achieved by both their gynecologist and neurologist. Some seizure medications are associated with birth defects and require transition to safer alternatives prior to conception. Keep in mind that these defects occur in the first trimester and require transition prior to attempting to conceive. During the pregnancy, monitoring levels is recommended as the body changes in how quickly it metabolizes the seizure drugs. Seizures themselves may be harmful to the baby as it may deprive them of oxygen or injure the placenta. As a result, planning and discussion with an epileptologist is critical for those women considering starting a family and a plan should be put in place prior to any attempts to conceive.

Symptoms

Seizures vary in symptoms depending on what area of the brain is involved and how much is involved. Occasionally, individuals have warning signs of an impending seizure such as noxious odors (e.g. burning rubber, chemical smells), déjà vu (a feeling of familiarity), visual distortions (bright colored orbs floating in their vision, hallucinations), or twitching in one body part that expands to involve the entire body. Seizures may be provoked by excessive alcohol use, abruptly cutting down on drinking, sleep deprivation, or certain medications (notably anti-anxiety medications). A seizure may be a symptom of a bigger problem, such as bleeding into the brain, a stroke, or a brain tumor.

If you suspect someone is having a seizure, call 911 immediately. If they are standing, help lower them to the ground and clear any objects from around them that may fall or injure them. If they are in water, immediately pull them out of water to prevent drowning. If shaking causes them to hit their head off the ground, you may put a pillow or soft object under their head but do not attempt to pin them to the ground. Many people may vomit during a seizure and it is best to turn them so that they are laying on their side so they do not inhale the vomitus. Whatever you do, DO NOT STICK anything in the patient’s mouth. The notion that an individual will swallow or choke on their tongue is FALSE and it is much more likely if they bite down on the object (or your finger!) they will choke on the fractured object or fracture a tooth. If the patient has any rescue medications (e.g. rectal Diastat or a nasal spray) you may administer them during or immediately after a seizure.

 Evaluation

Although seizures usually stop on their own, they may return (cluster) or be a warning sign of something else going on (medication side effects, stroke, bleeding, or tumor). As such, any seizure requires urgent evaluation by a medical professional. Paramedics may give medication en route to the hospital to stop a seizure. Once they arrive, the patient will be monitored to ensure their vital signs are stable. Any new-onset seizure requires imaging of the head, usually with a CAT scan or MRI. An electroencephalogram, which reads the electrical activity of the brain using wires attached to the head, may also be performed. A neurologist will review these studies to determine the risk of recurrent seizures. Depending on what these studies find, a patient may be started on medications to prevent recurrent seizures.
For those patients referred to our system by an outside physician, we provide many advanced services. These include transitional care for pediatric patients when reaching adulthood. We also provide advanced diagnostic studies to confirm the diagnosis of epilepsy versus other conditions that mimic seizures. These studies include prolonged outpatient electroencephalogram (up to 50 minutes) and ambulatory electroencephalogram—a study where you can go home with a special cap that monitors for seizures over a 24-72 hour period. For those requiring longer studies, we offer an admission to our 6-bed adult Epilepsy Monitoring Unit which is staffed by neurologists, neurology-specific nurses, and other neurology-specific ancillary staff trained to react immediately to seizures when they occur. This is the most advanced method of monitoring that allows for seizure characterization, localization (which part of the brain the seizure comes from), seizure drug adjustment, and advanced imaging techniques (such as ictal SPECT) to further confirm seizure localization. Our epilepsy team also has portable electroencephalogram machines which, when requested, allows us to monitor any patient in the hospital with any brain injury, even when they are not in the Epilepsy Monitoring Unit. In so doing, we identify subtle seizures which may lead to ongoing brain damage and recommend medication adjustment.

It should be noted that per West Virginia Law, any patient diagnosed with seizure should not drive or operate heavy machinery until they are at least six months seizure free. It is also strongly recommended to avoid bodies of water (swimming, bathing in a tub), walking along ledges, or climbing until instructed by a neurologist.

 Treatment

Seizure medications reduce the risk of recurrent seizures, but there is no standardized regimen or drug dose that absolutely guarantees seizure freedom. As such, choosing an appropriate seizure medication regimen involves an ongoing discussion with you and your neurologist. The best seizure regimen minimizes the number of recurrent seizures, the number of seizures medications, the dose and frequency of each medication, and the associated side effects of these medications. Medication adherence (remembering to take your medications as well as being able to afford these medications) is a major barrier to achieving seizure freedom, as missing doses of seizure medications may provoke a seizure.

Up to one third of patients do not achieve seizure-freedom despite reaching appropriate doses of two different seizure medications. These individuals have Medically-Refractory Epilepsy, a condition which the International League Against Epilepsy (ILAE) recommends referral to a specialized Epilepsy Center that sees a large volume of difficult-to-treat cases. Such centers will confirm the diagnosis of Epilepsy (as many other conditions may mimic seizures) and offer advanced therapeutic and, in some cases, surgical options that allow these individuals to achieve seizure freedom.

Finally, for those who suffered an acute brain injury leading to hospitalization, then developed seizures and were started on a seizure medication, and who have not suffered any recurrent seizures since their hospitalization, it is often reasonable to come off these medications—particularly if side-effects or financial concerns exist. Doing so, however, requires careful assessment by a skilled neurologist to avoid seizures when withholding the medications (which in turn, may limit your independence and ability to drive). We offer a special clinic for these patients, staffed by an epileptologist, who can monitor serial electroencephalograms while tapering the medications in order to achieve successful titration down (or even off) the medications.

 Information for Providers

WVU Medicine is an Epilepsy Center with the ability to provide longterm video electroencephalogram monitoring for the confirmation of Epilepsy. We also have a staff of fellowship-trained Epilepsy Neurologists who will guide the management of difficult epilepsy patients. For select individuals, a multidisciplinary team of Epileptologists, Neurosurgeons, Neuropsychologists and Neuroradiologists may assist in surgical evaluation. We have the ability to place subdural grids, depth electrodes, stereotactic EEG and advanced imaging to confirm seizure localization prior to surgical intervention. For individuals without a single focus, or a seizure focus overlapping with eloquent cortex, various forms of neuromodulation such responsive neurostimulation, deep brain stimulation and vagus nerve stimulation remain reasonable alternatives.

Surgical Approaches in the Management of Epilepsy

Overview

Seizures arise from the unregulated simultaneous electrochemical discharging of brain cells (neurons) that disrupt normal brain activity. As a result, individuals suffering a seizure may experience transient alterations in the awareness (either loss of consciousness, inability to interact with their environment, or amnesia / memory loss following the event), focal twitching, migrating numbness, or visual distortions/hallucinations. When an individual suffers recurrent seizures (at least two or more not provoked by alcohol, medications, critical illness, or sleep deprivation), they are classified as having epilepsy.
Although two-thirds of patients achieve seizure-freedom with medications and lifestyle modifications alone, up to one third of patients still suffer recurrent seizures despite trials of multiple seizure medications. These individuals are categorized as having Drug Resistant Epilepsy and may benefit from surgical interventions.

Keep in mind that no medical treatment is without risk and all medications, including seizure medications, have sometimes significant side effects. Seizure medications, as a class, may in some individuals cause slowed thinking, sleepiness, and difficulty maintaining focus. When multiple seizure medications are necessary to control seizures, these side effects compound to a point when side effects become just as bad as the intermittent seizures themselves. Surgery provides an alternative method to either remove the dysfunctional region of brain generating the seizures or—when multiple foci exist—modulate the electrical activity and break the circuit via various forms of neurostimulators).

 Symptoms

Those individuals that have recurrent seizures despite adequate trials of at least two seizure medications are classified as having Drug- Reisstant Epilepsy. For a description of what a seizure is and symptoms associated with seizures, please see the web page [Seizures and Epilepsy]. The International League Against Epilepsy (ILAE) recommends evaluation at an Epilepsy Center, such as WVU Medicine, for all patients with Drug Resistant Epilepsy.

 Evaluation

WVU Medicine, as an Epilepsy Center, offers a broad array of options for individuals with Drug-Resistant Epilepsy. Initially, you will see a Neurologist that specializes in Epilepsy to gather an appropriate history, perform a physical exam, and review any studies that you have done in the past. It is important to come prepared to your first visit to gain the most from your time with the Neurologist. It may be beneficial to bring friends or family that have witnessed the episodes or, if possible, a cell phone video of the episode to show to the Neurologist. Please bring an up-to-date list of your current medications, dosages, and frequency you take them. If you can list any seizure medications you have tried in the past, please bring that as well and the highest dose you took of each. If you have ever had any imaging done of your brain, particularly an MRI, requesting the images on CD (not just the report) will allow the Neurologist to review it.
Sometimes it is uncertain whether the episodes of concern are seizures or another condition that mimics seizures. Fainting, migraine auras, tremors, and panic attacks may all mimic seizures and confuse medical providers—sometimes even Neurologists are uncertain until they are captured on an electroencephalogram (EEG). Consequently, the first step in any evaluation for Drug-Resistant Epilepsy is to confirm that a patient does, in fact, have seizures/epilepsy. This requires having an event while being connected to EEG. In such cases, the Neurologist may recommend bringing the patient into the hospital while medications are lowered to provoke a seizure—all while the patient is under the close monitoring of specially-trained nurses and EEG technicians that can respond and treat immediately. This hospitalization may last a few days to a week, depending on when the first seizure occurs. This test, also known as continuous video EEG or long-term EEG, also can give important information on where the seizures arise in the brain.

Additional tests may further define the exact focus of a seizure. These include imaging tests such as ictal SPECT, where a technician will inject a very special dye at the onset of a seizure to mark the location in the brain. When a scalp EEG is not sufficient to identify the location of seizure onset, a surgery may be recommended to place electrodes directly onto the surface and/or deep structures of the brain (aka grid or depth electrodes). The purpose of this is to minimize the amount of healthy brain that is ultimately removed, while maximizing the likelihood of removing the actual seizure focus. Keep in mind that not every individual needs to undergo these tests—their indications, risks, and benefits will be thoroughly discussed by your Epileptologist and the Neurosurgeon.

If the seizure focus is near critical structures involved in language, strength, or vision, additional imaging studies (e.g. functional MRI) or additional tests may be recommended. One such study is a Wada test, which temporarily puts a region of the brain to sleep while allowing a Neurologist or a Neuropsychologist to determine which side of the brain language is located. The purpose is to ensure that surgery will not adversely affect language function.

 Treatment

The purpose of surgery is to offer a cure for epilepsy. Many individuals who have recurrent seizures despite maximal drug therapy (with all its associated side effects) may undergo surgery and be cured of the disease—able to come off all of their medications. Even for those individuals whom surgery does not cure, they may still benefit from a reduction in seizure frequency or medication dose—thereby able to return to work or activities of daily life. As a successful surgery requires resection of all seizure foci while minimizing the amount of healthy brain tissue removed, the diagnostic work-up to reach this goal requires on average 3-6 months from start to surgery.
For individuals with a seizure focus, the neurosurgeon will remove the diseased tissue while minimizing damage to the adjacent structures. Following surgery, patients will be monitored in the Neurocritical Care Unit for at least one but possibly several days. They may have an additional hospital stay on a step-down unit while they receive rehabilitation and ensure the incision and brain are healing well. In some patients, rather than a surgical incision, the seizure focus may be destroyed with laser ablation (using multiple lasers focused on a single region of brain tissue to essentially burn away the diseased tissue).

For individuals with multiple seizure localizations or an inaccessible seizure locus, surgery still remains an option but it is typically not wise to resect multiple regions. In these individuals, neuromodulation may allow the patient to come down on the dose of their seizure medications. One exciting intervention, particularly for those with multiple seizure foci, is responsive neurostimulation. Analogous to a cardiac defibrillator, this is an implanted device that both reads brain activity and, if seizure activity is detected, administers and electric field to stop the seizure from developing. As seizures may be detected before the patient has clinical symptoms (i.e. at the time of their aura), this often terminates the seizure before the patient experiences any clinical symptoms.
For those whom surgery is not an option or who wish to pursue other interventions, our clinic is equipped to offer alternative therapies, experimental trials, or supportive interventions for those with chronic epilepsy. Cannabidiol is now an option for select syndromes of drug resistant epilepsy (Lennox Gastaut and Dravet Syndrome). Safety devices are available, such as those used to detect a seizure and notify a caregiver to check on the patient and get help.

 Information for Providers

WVU Medicine is an Epilepsy Center with the ability to provide care and consultation to complex patients with epilepsy. We are happy to provide services to confirm the diagnosis of epilepsy, such as ambulatory EEG monitoring and inpatient EEG monitoring in our 6-bed Epilepsy Monitoring Unit. We also are happy to assist with difficult-to-treat patients, such as those with Medically-Refractory Epilepsy, during transition from pediatric to adulthood, or in female patients—particularly those considering pregnancy. We also encourage groups participating in our Tele-Neurology network to seek consultation, particularly for patients where travel to Morgantown is difficult.
For individuals who have failed adequate trials of at least two seizure medications (i.e. Drug Resistant Epilepsy), it is recommended by the International League Against Epilepsy (ILAE) to refer to an Epilepsy Center such as WVU Medicine. In so doing, we are able to confirm the diagnosis of epilepsy versus mimics with long term EEG monitoring, titrate medications, and initiate work-up for surgical interventions. Our localization capabilities include a 3T MRI (Epilepsy Protocol with thin slices through hippocampi), PET scan, ictal SPECT, and grid or depth electrode placement. To isolate eloquent brain areas, we are able to perform functional MRI, Wada test, and cortical stimulation mapping. If surgery is found appropriate, in addition to surgical resection we offer laser interstitial thermo-ablation. In those where it is not resectable, seizure palliation with vagal nerve stimulation, corpus callosotomy, responsive neurostimulation (Neuropace), and deep brain stimulation (anterior thalamic nucleus) remain viable options.

Memory Health Clinic

View Memory Health Clinic page

What We Do

The WVU Rockefeller Neuroscience Institute Memory Health Center is the only multi-disciplinary specialty clinic in the state of West Virginia that specializes in:

• Specific diagnosis of the type of dementia
• Diagnosis of underlying conditions
• Development of a comprehensive treatment plan for the patient
• Addressing of patient’s caregiver/family’s needs

Please call us if you or a loved one is experiencing any of the following:

• Short-term memory problems
• Forgetting appointments
• Problems with routine daily activities such as preparing meals or paying bills
• Misplacing objects such as car keys, wallet, or purse
• Confusion with time or place
• Withdrawal from work or social activities
• Changes in mood and personality

General Clinic Information

We are located in the WVU Rockefeller Innovation Center (Adjacent to the WVU Cancer Institute) in Morgantown, West Virginia.

33 Medical Center Drive
Morgantown, WV 26506

Office hours: Monday – Friday, 8:00am – 5:00pm

Please call (304) 293-1743 with any questions or concerns.

Referrals and appointment requests

If you need to refer a patient or schedule an appointment, please call 855-WVU-CARE or send an email to RockefellerNeuroscienceInstaapptrequest@wvumedicine.org.

Consultations

If you are a healthcare provider and would like to consult with one of our memory health experts, please call (304) 293-1743 to speak with our memory health coordinator. You may also call our Medical Access Referral System (MARS) at (800) 982-6277.

The term “movement disorders” refers to a group of nervous system (neurological) conditions that cause abnormal increased movements, which may be voluntary or involuntary, or can result in reduced or slowed movements.

 Common types of movement disorders include:

• Ataxia. This movement disorder affects the part of the brain that controls coordinated movement (cerebellum). Ataxia may cause uncoordinated or clumsy balance, speech or limb movements, and other symptoms.
• Cervical dystonia. This condition causes long-lasting contractions (spasms) or intermittent contractions of the neck muscles, causing the neck to turn in different ways.
• Chorea. Chorea is characterized by repetitive, brief, irregular, somewhat rapid, involuntary movements that typically involve the face, mouth, trunk and limbs.
• Dystonia. This condition involves sustained involuntary muscle contractions with twisting, repetitive movements. Dystonia may affect the entire body (generalized dystonia) or one part of the body (focal dystonia).
• Huntington’s disease. This is an inherited progressive, neurodegenerative disorder that causes uncontrolled movements (chorea), impaired cognitive abilities and psychiatric conditions.
• Myoclonus. This condition causes lightning-quick jerks of a muscle or a group of muscles.
• Parkinson’s disease. This slowly progressive, neurodegenerative disorder causes tremor, stiffness (rigidity), slow decreased movement (bradykinesia) or imbalance. It may also cause other nonmovement symptoms.
• Parkinsonism. Parkinsonism describes a group of conditions that has symptoms similar to those of Parkinson’s disease.
• Restless legs syndrome. This movement disorder causes unpleasant, abnormal feelings in the legs while relaxing or lying down, often relieved by movement.
• Tourette syndrome. This is a neurological condition that starts between childhood and teenage years and is associated with repetitive movements (motor tics) and vocal sounds (vocal tics).
• Tremor. This movement disorder causes involuntary rhythmic shaking of parts of the body, such as the hands, head or other parts of the body. The most common type is essential tremor.

What We Do

The WVU Rockefeller Neuroscience Institute Comprehensive Movement Disorders clinic specializes in:

• Specific diagnosis of the type of movement disorder
• Development of a comprehensive treatment plan which can include medications, botox therapy, procedural therapy, and/or surgical therapy depending on the specific disease
• Addressing patient and family/caregiver’s needs and questions
• Providing answers as to not only what is going on, but coming up with a plan to do something about it.

 Please call us if you or a loved one is experiencing any of the following:

• Coordination difficulties
• Balance changes or frequent falls
• Tremor
• Dexterity difficulties, like change in hand writing, buttoning buttons, open bottle caps
• Speech changes
• Extra movements of the head, hands, legs, or torso

 General Clinic Information

We are located in the WVU Rockefeller Innovation Center (Adjacent to the WVU Cancer Institute) in Morgantown, West Virginia.

33 Medical Center Drive
Morgantown, WV 26506

Office hours: Monday – Friday, 8:00am – 5:00pm

Please call (304) 293-1743 with any questions or concerns.

View our page on Multiple sclerosis (MS) other autoimmune disorders

Multiple sclerosis (MS) is an autoimmune disorder, which is a disease in which the body’s immune system targets normal, healthy tissue. The immune system is designed to recognize foreign substances—whether they are bacteria, viruses, parasites, or foreign proteins—and initiate a response to attack and destroy these invaders. The immune system also plays a critical role in preventing cancer, identifying malfunctioning cells and initiating an attack on them before they can grow and spread.

Autoimmune disease occurs when this normal, healthy response is directed against normal proteins on the body’s own cells.  Depending on which organ is affected, a specific syndrome arises. If it is the skin, psoriasis, eczema, or vitiligo may occur.  If it is the internal organs, patients may develop cirrhosis, kidney failure, heart failure, or respiratory failure. There are many autoimmune disorders that affect the brain, nerves, and muscles—the most common of which is multiple sclerosis.

In MS, the immune system attacks myelin, which lines our nerve cells and helps signals transmit quickly from the brain and spinal cord to the rest of our body’s nerves and muscles. When myelin is damaged, the nerve cells begin to malfunction. Sometimes, the nervous system can repair itself from these attacks and symptoms may improve on their own. But even when repair has occurred and symptoms improve, the symptoms can often recur when there is stress on the body such as heat exposure, fatigue, sleep deprivation, or when a patient is ill with the flu or other infection. If multiple sclerosis is left untreated or is particularly active permanent damage can occur. Most of the time, long term treatment is needed to prevent further attacks or progression of the disease.

Patients with neuromuscular disorders present with a myriad of symptoms including weakness, droopy eyelid, twitching muscles, numbness among others. In order to diagnose patients we may need to run several tests such as EMGs, genetic testing, laboratory tests, MRIs and muscle biopsies to make a diagnosis.

Neuromuscular Diseases:

Neuromuscular diseases comprise of several regions and are categorized into the muscular dystrophies, myopathies, ion channel diseases, neuromuscular junction disorders, motor neuron diseases, mitochondrial diseases and neuropathies. We have listed some of the disorders in these categories but this is not a complete list.

Muscular Dystrophies:

• Duchenne muscular dystrophy
• Becker Muscular dystrophy
• Fascioscapular Muscular Dystrophy
• Emery-Driefuss Muscular dystrophy
• Congenital muscular dystrophies
• Limb-girdle muscular dystrophies
• Neuromuscular junction disorders:
• Myasthenia Gravis
• Lambert Eaton Myasthenic Syndrome
• Congenital myasthenic syndromes
• Motor neuron diseases:
• Amyotrophic Lateral Sclerosis
• Spinal Muscular Atrophy
• Primary Lateral Sclerosis.
• Ion channel diseases:
• Myotonia Congenita
• Hypokalemic periodic paralysis
• Hyperkalemic periodic paralysis among others.

Mitochondrial diseases:

• Mitochondrial myopathies
• Friedrich’s ataxia

Neuropathies:

• Charcot Marie Tooth Disease
• Amyloid Neuropathy.

Our Clinics:

We have two dedicated Multidisciplinary clinics for Neuromuscular disease, The ALS Clinic and The MDA Clinic

Our MDA clinic receives funding and support from the Muscular Dystrophy Association (MDA).

Our ALS clinic receives support from the Muscular Dystrophy Association (MDA) and ALS Association (ALSA).

Our MDA clinic has a multidisciplinary team which consists of a neuromuscular physician, physical therapist, occupational therapist, Neuropsychologist, Nurse coordinator, social worker and a speech therapist that are available on site. In addition, Cardiologists and Pulmonologists are available as well.

Our ALS clinic has a multidisciplinary team which consists of a neuromuscular physician, nurse coordinator, physical therapist, occupational therapist, Neuropsychologist, social worker, speech therapist, Pulmonologist, respiratory therapist, CT surgeon and dietitian.

Our goals are not only to treat/manage the neuromuscular disease but to also improve the quality of life of our patients.

Please contact us if you would like to be seen in one of our clinics.

Tumors that start in the brain or spinal cord are called primary brain or spinal cord tumors. Some tumors begin in other parts of the body and then spread to the brain or spinal cord. These are called metastatic or secondary brain or spinal cord tumors. Some of the more common subtypes are listed below.

• Glioma (Glioblastoma, Diffuse midline glioma, Gliosarcoma, diffuse astrocytoma). This type of tumor begins in the glial cells and usually takes an aggressive course.
• Oligodendroglioma. This tumor arise in the cells that produce myelin.
• Ependymoma. This tumor develops in the lining of the ventricles.
• Meningioma. Tumor originates from the membrane that surrounds the brain and spinal cord.
• Schwannomas. It is a benign tumor that arise from schwann cells that produce the myelin that protects peripheral nerves.
• Craniopharyngioma. This tumor develop in the region of the pituitary gland near the hypothalamus.
• Primary CNS lymphoma. Rare form of non-Hodgkin lymphoma in which cancer cells develop in the lymph tissue of the brain and/or  spinal cord.
• Metastatic brain cancer (from lung, breast, skin, colon, kidney, thyroid). It is caused by cancer cells to the brain from a different part of the body.
• Leptomeningeal metastases. Rare complication where cancer cells are found in the membranes of the brain/spinal cord or Cerebrospinal fluid.
• Neurofibromatosis. It is a genetic disorder of the nervous system that affects the growth and development of nerve cell tissue.
• Medulloblastoma. Mostly affects children and starts in the lower part of the brain called cerebellum.
• Pineal gland tumor. This tumor forms in the pineal gland that makes a hormone called melatonin that affects sleep-wake cycle.
• Hemangioblastoma. Vascular tumor of the central nervous system.
• Germ cell tumor. This tumor arise from primitive sex cells or germ cells.

Symptoms of brain tumors depend on its size, location and rate of growth:

• Headaches
• Confusion
• Personality changes
• Speech changes
• Nausea/vomiting
• Weakness of arms and/or legs
• Lack of coordination
• Change in vision
• Seizures

Diagnosis of brain tumors:

• Advanced imaging (CT, MRI, functional MRI, MRS, PET-CT)
• Biopsy
• Surgical resection
• Lumbar puncture
• Genotype testing of brain tumor tissue
• Liquid biopsy (blood and CSF)

Treatments we offer:

• Brain and spine surgery
• Chemotherapy
• Clinical trials
• Genotype targeted therapies
• Immunotherapies
• CART cellular therapy
• Intrathecal and intraventricular therapies
• Radiation therapy

General Neurology:

Neurological disorders affect a large number of individuals. Approximately 1 in 6 people have a neurological disorder. While these conditions can greatly impact function and quality of life, there are many great treatments available.

What we do:

Providers in the general neurology clinic see a wide variety of neurological disorders and work with the sub-specialists and other specialty providers to coordinate and deliver the best care for patients and their families. We see the conditions below and many others.

• Headache and facial pain
• Memory dysfunction
• Brain and spine damage
• Pinched nerves in neck and back
• Weakness and tremor
• Numbness, pain, neuropathy, and other nerve issues
• Impaired walking and balance
• Visual changes
• Seizures, syncope, stroke, and other neurological episodes

Please call us if you or a loved one is experiencing any any of the above symptoms or any other neurological symptoms.

View the WVU Headache Center page

For those who are among the 50 million Americans who suffer from chronic or severe headaches, the WVU Headache Center provides personalized, empathetic care and a commitment to improving quality of life.

The WVU Headache Center has always excelled at pioneering new approaches to headache treatment and is part of several multi-center clinical trials for novel treatment of headache disorders. With three fellowship-trained and certified headache specialists, the WVU Headache Center is the only comprehensive headache program in West Virginia.

Physicians in the Headache Center work closely with specialists in neurosurgery, ophthalmology, otolaryngology, psychiatry, pain medicine and radiology to help treat headache disorders through medications, procedural interventions, changes in behavior and nutrition, and other approaches. In addition, our doctors provide patients the means to deal with acute headaches, such as migraine, so future occurrences can be relieved quickly.

Treatments

The various types of treatments provided at the WVU Headache Center include:

• Oral and injectable medications
• Infusion therapies
• Botulinum toxin therapy
• Nerve blocks
• Trigger-point injections
• Neuromodulation

When your child is suffering from a condition affecting their neurologic functioning or their growth and development, you want answers. Our team of experts can help you find them. As the state’s flagship Children’s Hospital, our specialists are trained in treating a broad range of pediatric neurological disorders. However, we do not stop there. We are home to expert care in highly specialized areas of child neurology as well, including neurodevelopmental disabilities, epilepsy, neuromuscular disorders, cerebral palsy, neuroimmunology, headaches, and neurocutaneous syndromes. We have assembled a comprehensive team to evaluate your child’s concerns and work together to create a unique treatment plan to meet your child’s needs, because no two children are exactly alike.

Conditions We Treat:

We treat infants, children, and teens with neurological disorders. We guide them through every phase of care from initial diagnostic investigation to adjustments of ongoing treatment plans based on changing personal and family needs. Just a few of the conditions that our team cares for:

• Cerebral palsy
• Demyelinating disorders, including multiple sclerosis
• Epilepsy
• Headaches
• Movement disorders
• Neonatal neurologic disorders
• Neurocutaneous syndromes
• Neurodevelopmental disorders, including Autism Spectrum Disorder
• Neuroimmunologic and neuroinflammatory disorders
• Neuromuscular disorders, including muscular dystrophy
• Spasticity

Our Multispecialty Clinics and Providers:
We take a team approach to providing complete care for your child. We continue to provide the most up-to-date treatments for complex neurologic disorders and partner with the Rockefeller Neuroscience Institute to pioneer novel approaches and treatments for some of these disorders. Our teams include but are not limited to:

• Pediatric neurologists, including subspecialty care with pediatric epileptologists, neurodevelopmental disabilities specialists, and pediatric neuroimmunologist
• Pediatric neuropsychologists
• Pediatric psychologists
• Pediatric neurosurgeons
• Pediatric orthopedists
• Pediatric physical medicine and rehabilitation physicians
• Complex care physicians
• Pediatric pulmonologists
• Pediatric hematology and oncology specialists
• Rehabilitation specialists, including pediatric specific physical, occupational, and speech and language therapists
• Applied Behavioral Analysis providers
• Nurse practitioners
• Social workers and care coordinators

Referral Information:
We welcome all new patient evaluations for patients up to and including the age of 17 years and younger. Referral from a physician is required. Please call 304-598-4835 with any questions.

Click on the link below to access the WVU Medicine Children’s Hospital Neurology homepage.
https://childrens.wvumedicine.org/services/specialty-care/neurology

Sleep realated disorders we idenify and treat:

• Sleep apnea
• Narcolepsy, excessive daytime sleepiness
• Restless leg syndrome
• Parasomnias
• Insomnia
• Circadian rhythm disorders

Through our comprehensive WVU Sleep evaluation center a variety of overnight and daytime sleep testing could be performed in addition to the convenience of performing unattended sleep testing at home for a lot of appropriate individuals who prefer to do so.

Adult and pediatric patients can be tested at the WVU comprehensive sleep center.

We take pride in not just diagnosing sleep related disorders but in monitoring and following up on all of our patients to assure satisfaction and proper response to our different treatment modalities.