Multiple Sclerosis, or MS, is an immune-mediated disease in which the body’s immune system attacks its central nervous system, including the brain, spinal cord, and optic nerves. This process leaves scar tissue (sclerosis) on the nerve, from which this disease derives its name. As a result of the damaged nerve fiber, nerve impulses traveling through the body are interrupted, which creates a wide variety of symptoms from numbness and walking difficulties, to vision and bladder problems. With over 400,000 people in the U.S. affected by MS, Dr. Royter and his team are committed to combatting this disease by providing access to the latest and best drugs currently on the market.

Epilepsy is a group of disorders categorized by reoccurring seizures. There are many different types of epilepsy and of seizures, therefore, it is important to correctly diagnose a seizure, and to then identify what type of seizure it is. Dr. Royter and his team administer an eletroencephalogram, (or ‘EEG’) which is a test to measure and record the electrical activity of the brain to discover certain conditions, including seizures. These conditions can be detected by changes in the normal pattern of the brain’s electrical activity. Special sensors, or ‘electrodes’, connected to the body allow our machines to record the brain’s electrical activity. An EEG may be done to diagnose epilepsy, to diagnose different types of seizures, to check for problems with loss of consciousness, dementia, or to help find out a person’s chance of recovery after certain traumatic, anoxic, or other brain injuries.

Alzheimer’s disease is a form of dementia, a term used to describe memory loss and the loss of other intellectual abilities that can cause interference in daily life. Alzheimer’s specifically affects memory, thinking, and behavior, with its symptoms worsening over time. Most patients affected by this disease are 65 and older, but it can occur in adults in their 40’s and 50’s. It is important to diagnose Alzheimer’s early on, and one of the ways Dr. Royter and his team do this is with computerized memory testing, a highly sensitive test to detect early declines in memory function. This test accurately measures the most sensitive memory functions that are typically the first indicators of increasing risk of Alzheimer ’s disease. Changes in the brain that affect memory often start 30 years before the diagnosis, so it is beneficial that this test helps monitor changes over time.

Neuropathy and Carpal Tunnel Syndrome are both conditions that affect the peripheral nerves in the body. Neuropathy is a term that encompasses a wide range of nerves including sensory nerves (that control sensation), motor nerves (that allow movement), and autonomic nerves (that control systems of the body, like bladder function or blood pressure). Carpal Tunnel Syndrome is a type of neuropathy that affects motor nerves and causes numbness, tingling and weakness in the hand due to pressure on the median nerve inside the wrist. Dr. Royter and his team use a variety of tests, such as a Nerve Conduction Velocity test (NCV), as well as an Electromyography (EMG) test to diagnose these conditions to better treat them. The NCV is a test to see how fast electrical signals move through a nerve. Surface electrodes are placed over nerves at various locations on the body. Each patch gives off a very mild electrical impulse, which stimulates the nerve. The nerve’s resulting electrical activity is recorded by the other electrodes. The distance between electrodes and the time it takes for electrical impulses to travel between them are used to determine the speed of the nerve signals, information that is used to diagnose neuropathic conditions. Following a NCV is the EMG, during which needles are placed into muscles that then contract. This test is used to diagnose nerve damage or destruction. Occasionally, the test may be used to evaluate diseases of neuromuscular junction or muscle, including myopathy, Lambert-Eaton syndrome, or Myasthenia Gravis.

Syncope, more commonly known as “fainting”, is the loss of consciousness due to temporary, insufficient blood flow to the brain. Usually it is caused by low blood pressure (hypotension), during which the heart pumps less oxygen than usual to the brain. Fainting is caused by a variety of factors including but not limited to, stress, the pooling of blood in certain extremities due to posture, dehydration, overheating, sweating, and exhaustion. Syncope can also be caused by disorders with the heart, lungs, brain and metabolism. Fainting can suggest a serious disorder when it occurs during exercise, when it is accompanied by heart palpitations and irregularities, and when there is an established family history of fainting. Dr. Royter and his team will use the tools at their disposal to identify the seriousness of a syncope, and to work with patients to move past them.