Neurological Surgery
Your Visit
Scheduling the Visit
Call (212) 305-9606 for an appointment.- X-rays may be needed beforehand.
- Families will be reminded to bring all X-rays, wheelchairs, walkers and/or orthotic devices, for evaluation by the team during the visit.
What to Expect During Your Visit
Families will be asked to fill out:- Medical history
- Insurance information
- Care and Comfort Caregiver Questionnaire, which rates the difficulty of tasks including personal, positioning and comfort
- Consent forms providing parental consent to share information gathered with other caregivers involved in the patient's care, as well as insurance companies
Meeting with the Nurse
The patient and family will meet with the nurse when they arrive for each visit to update the patient's medical record, including information about:- Allergies
- Providers
- Changes in medical care
- Increase or decrease in PT/OT
- Assessment of the patient's pain
- Sleep cycle
- Progress/effectiveness of current management functional assessment from the caregivers
Physical and Occupational Therapy Evaluation
Our physical and occupational therapists will conduct a full evaluation on:- Tone Assessment using the Modified Ashworth, Scale 1-3
- Range of Motion
- Motor Control Scale
- Trunk control
- Gait Analysis
Ashworth Scale:
1 = No increase in muscle tone
2 = Slight increase in tone giving a "catch" when affected part is moved in flexion or extension
3 = More marked increase in tone but affected part is easily flexed
4 = Considerable increase in tone; passive movement difficult
5-Affected part is rigid in flexion or extension
Assessments and Treatment Planning
A neurologist will be present during the physical therapy/occupational therapy evaluation. If indicated, a neurosurgeon, orthopedic surgeon, or orthotist, may also attend to assess the patient and plan the best treatment program to help meet the family's goals.Teaching
Staff will explain the treatment options that are available and exercises that may be done at home to help the patient. If prescribed, families will also be taught about:- Physical Therapy
- Occupational Therapy
- Hippotherapy
- Aquatherapy
- Botox injections
- Surgical option, e.g. Selective Dorsal Rhizotomy, insertion of an Intrathecal Baclofen Pump
Completing the Visit
At the conclusion of your visit, we may:- Order more tests to get a clearer picture of what is neededin preparation for treatments or before a surgical consult
- Schedule follow-up appointments with the Spasticity team
- Make a referral, if indicated to other services, such as a movement disorders specialist, general neurology, or surgical consult, including orthopedics
Case Management
Our nurse will manage the patient's treatment plan throughout. This may include:- Referrals to other services for Botox injections or social work
- Testing
- Rescheduling appointments
- Medication dosing, refills
- Answering questions about treatments
- Programming and refilling the Intrathecal Baclofen Pump
- Summary letters about the visit for referring providers
Making a Referral
Referrals can be made to the Multidisciplinary Spasticity Clinic by calling (212) 305-9606 or faxing the referral to (212) 305-7945, attention: Genevieve Chirelstein, FNPContact
- Spasticity Center
- (212) 305-9606
