Neurology of Central Georgia
175 Water Tower Court, Macon GA 31210 ~~~ Ph (478) 471-6217 ~~~ Fax (478) 471-8663
- Work Injuries
- Records Review
- Concussion Assessment
- Therapeutic Botox
- Deep Brain Stimulation - DBS
- Vagal Nerve Stimulation - VNS
Out-patient, Office Consultations
- Dr. Athni is available for detailed Neurologic Consultations in our office.
- During your initial visit, we will do a detailed Neurologial history and physical exam.
- If a firm diagnosis can be made during the initial visit, we will set forth a treatment plan.
- If additional testing is necessary, we will delineate, schedule and follow thru with a diagnostic testing plan, after which a follow-up visit will be scheduled to discuss the results of the diagnostic tests.
- After the results are discussed, we will set forth a treatment plan as medically appropriate.
- Most diagnostic testing is done in “steps”, starting with the least invasive and slowly progressing to more invasive testing as the need arises.
In-patient, Hospital Consultations
- We are affiliated with the Coliseum Health System, with courtesy privileges at Coliseum Northside Hospital, located in North Macon.
- For in-patient evaluations, we expect you to be admitted under the care of a Hospitalist, your private Internist or Family Practictioner
- If a neurological problem arises which cannot be handled by your admitting physician, he or she will call the Neuro-Hospitalist for a formal hospital consultation
Work Injury – Worker’s Comp
General Work Injury Policies
- We evaluate and treat a full range of work injuries.
- We understand the full breadth of the rules and regulations set forth by the Georgia State Board of Workers’ Compensation (GA – SBWC).
- Prior to each work-injury office visit, we will verify work-comp coverage and obtain a written authorization from the WC insurance adjustor.
- Without a written authorization, we will NOT be able to continue treatment or evaluation.
- If a certain medical symptom or injury or condition has been controverted by the employer or WC insurance company, we will NOT evaluate or discuss or treat that particular problem or issue.
Return to Work
- We will make every attempt to return the injured employee back to work.
- If the patient cannot be returned to work “full duty”, we will try to return them to “light duty” work, and prescribe restrictions or limitations.
- If the patient has maximally recovered, we will delineate a disability rating using the AMA guidelines, and declare the patient as being at “MMI”.
- If an insurance company or attorney is involved in a legal case which requires a Neurological opinion, we will be happy to review the records and answer any pending questions.
- The Medical Records Review will be purely objective, regardless of who is requesting the Records Review.
- After the Records Review, Dr. Athni will be available to discuss the findings with the requesting attorney or insurance company.
- A report of the Records Review will be generated and faxed to the requesting party.
- Depending on the volume of the medical records, the review can take 1-2 weeks after receiving the medical records.
- We expect pre-payment for these services.
- The cost will be based on services requested, such as the volume of medical records, whether any imaging films need to be reviewed, and whether a telephone conference is also being requested.
- Please contact our office to discuss these fees.
IME – Independent Medical Examination
WHAT is an IME?
- An Independent Medical Exam, commonly referred to as an “IME”, is a legal evaluation, usually requested by an insurance company, attorney, or some other involved 3rd party. These evaluations are strictly confidential, and the records are NOT released to any other requesting party.
- As an IME Physician, we fully understand that we are NOT developing any doctor-patient relationship. We will NOT prescribe any medications, and we will NOT make any formal treatment recommendations to the patient.
- Some diagnostic testing may be ordered to properly complete the IME, but these tests are scheduled and performed only with pre-approval from the insurance company or attorney.
HOW to schedule an IME:
- Independent Medical Examinations (IME) must be scheduled by the employer, attorney, or insurance company. Prior to scheduling the appointment, please call our office and talk with the office manager to discuss our IME financial policy. We typically request pre-payment for the IME.
WHEN are IMEs scheduled, and how long does it take?
- IMEs are scheduled at a mutually convenient time, and as quickly as possible.
- A typical IME can take 60 to 90 minutes with the patient. This is followed by an additional 3-4 hours of medical records review and case analysis.
What questions are answered during the IME?
- Typically, the IME-requesting party will ask a series of questions to be answered during the IME. All of these questions will be answered by Dr. Athni.
- If additional testing is necessary to properly answer these questions, we will recommend any necessary diagnostic tests. If approved, we will schedule and coordinate these diagnostic tests.
- Once the IME is completed, and if requested or necessary, Dr. Athni will call the IME-requesting party to discuss the case.
IME records are confidential:
- As noted above, we fully understand the legal implications of an IME, and hence we will release the report only to the IME-requesting party. These records are kept in strict confidence, and will NOT be released to anyone else.
- All cases are handled objectively without being influenced by any outside party. Dr. Athni will “call it like he sees it”.
- Over the last 20 years, we have regularly seen patients referred by insurance companies (handling life insurance policies, disability insurance policies, workers compensation policies, etc), attorneys (representing both patients and employers), and directly from employers.
Oue experience with IMEs:
- Dr. Athni has been performing IMEs for the past 20 years. On average, we complete 10 Independent Medical Evaluations per year.
- If there are any questions or concerns regarding IMEs, please call our office and speak with our office manager. If they cannot answer your questions, then Dr. Athni will speak with you directly.
- Most people are familiar with football related concussions, but they are also quite common after work injuries.
- Concussions occur after a closed head injury, such as can occur after a fall or car accident or some other accident. It is very important to have such head injuries evaluated quickly and aggressively, and as soon as possible after the accident.
- The symptoms associated with a concussion can be quite varied and unusual.
- Some diagnostic tests we perform in the evaluation of a concussion include: an MR brain, EEG, and Neurotrax test.
- Depending on the results of these tests, various treatment options will be discussed and recommended.
Botox – Botulinum Toxin Injections
What is “Botox”?
- Botulinum toxin (B. toxin) is a “neuro toxin” which paralyzes any muscle it comes in contact with.
- When used as a medication, B. toxin is very powerful, and must be given by specially trained physicians.
- There are a few different companies which manufacture B. toxin, each under different brand names. The most common variety of B. toxin is “Botox”, manufactured by Allergan.
What is Botox used for?
- There are numerous diseases which are associated with “muscle spasms” or “stiffness”. For such conditions, B. toxin is an appropriate medication to “relax” those muscles.
What is the difference between “Cosmetic” and “Therapeutic” Botox?
- The drug is the same, but the use is vastly different.
- With Cosmetic Botox, the drug is injected into various muscles (typically the facial muscles) to eliminate wrinkles.
- Insurance does NOT pay for Cosmetic Botox.
- With Therapeutic Botox, the drug is injected into various muscles of the face, arms, legs, or back to alleviate a problem caused by a specific medical condition.
- Usually, insurance companies will pay for therapeutic Botox treatments.
How much does Botox cost?
- For Cosmetic Botox, it can cost around $13 to $15 per unit, and it is NOT covered by insurance plans.
- A “typical” Cosmetic Botox session can involve injecting 30-100 units, depending on what we are trying to achieve.
- For Therapeutic Botox, if your insurance approves the treatment, your cost will typically be just your co-pay.
- Please speak with our financial / insurance department to get further information about your specific insurance plan.
DBS – Deep Brain Stimulation
What is Deep Brain Stimulation?
- Deep Brain Stimulation, or DBS, is a treatment option used for various types of Movement Disorders.
- The procedure has been very successfully used in patients with Parkinson’s Disease or Essential Tremors.
- The procedure is an “adjunct” to medications, not a full replacement for medications.
What is involved with DBS?
- Dr. Athni will assess you and determine whether you are a good candidate for DBS.
- If you medically qualify for the procedure, you will be referred to a Neurosurgeon for DBS implantation.
- You are fully awake during the surgical procedure.
- The Neurosurgeon will drill a small hole in your skull, and insert an “electrode” into your brain.
- The Neurosurgeon will also implant a “power generator” in your chest.
- You will then return to Dr. Athni for detailed “programming and management” of your DBS.
How is the DBS programmed?
- After you have the DBS inmplanted, Dr. Athni will connect your “generator” to a hand held computer.
- He will then program the leads in the brain to activate certain parts of the brain, in an attempt to reduce and control your movement disorder.
- The full programming may take 3-4 months.
VNS – Vagal Nerve Stimulation
What is Vagal Nerve Stimulation?
- Vagal Nerve Stimulation, or VNS, is a therapeutic option available for patients with uncontrolled seizures.
- The procedure is an “adjunct” to seizure medications, not a full replacement for medications.
What is involved with “VNS”?
- If you have a seizure disorder, which is hard to control with medications, then Dr. Athni will assess whether you might qualify for VNS.
- If you are deemed a good candidate for VNS, you will be referred to a local surgeon for VNS implantation.
- The surgeon will implant a small electrode in your neck, as well as a “power generator” in your left chest.
- You will then return to Dr. Athni for programming and management of your VNS.
How is VNS programmed?
- Approximately 1 week after your VNS surgery, Dr. Athni will connect a hand-held computer to your VNS.
- Using the hand-held computer, the VNS is digitally programmed, in an attempt to stop your seizures.
- The programming is done very slowly and methodically. It can take 6-8 weeks to complete the initial programming, requiring weekly visits to our office.
- Additional programming changes will be made beyond the 6-8 weeks as medically necessary.