Overview of the departmentWe are responsible for the diagnosis and treatment of patients with diseases involving the central nervovs system(CNS) to peripheral nerves system(PNS), /and muscles. Stroke, neurodegenerative diseases, neuroimmunological diseases, neuro-inflammation, and dementia are included, Patients with frequent symptoms, such as consciousness loss, vertigo, headache, numbness, tremor, gait disturbance, and forgetfulness are actively diagnosed and treated.
Consultation system/therapeutic strategies
In the treatment of patients with stroke, continuous care system for acute to chronic stages was established. We are making efforts to diagnose and treat patients with not only common neurological disorders, including Parkinson’s disease, migraine, epilepsy, and neuropathy but also refractory neurological diseases. A large number of patients with refractory neurological diseases have been referred to our department. Out- and inpatients are treated by 8 board-certified Neurologists, 9 board-certified member or Fellow of Internal Medicine, and 3 Stroke specialists certified by the Japan Stroke Society in cooperation with relevant departments. Specific examinations, such as neurophysiological examinations and ultrasonography are conducted by skilled physicians. Furthermore, diagnostic and therapeutic strategies are discussed at case conference, every morning.
Field of expertise
As our university (hospital) was established to contribute to the region, our medical services involve all fields of neurology. Patients with acute stroke, are treated as emergencies, incliding r-tPA therapy.A large number of patients with Parkinson’s disease, neurodegenerative disease, neuromuscular diseases, neuro-infection, and dementia are also diagnosed and treated. Specific brain functional imagings are performed in cooperation with the Biomedical Imaging Research Center. For the diagnosis and treatment of Hashimoto’s encephalopathy , specific antibody (anti-NAE antibody titer ) is measured. The genetic diagnosis of specific neuromuscular diseases is also conducted.
Advanced medical practice
Thrombolytic therapy for acute-phase stroke (rt-PA is administered to treat stroke within 4.5 hours after onset and achieve better improvement of the symptoms). High-dose intravenous immunoglobulin (IVIg)therapy for neuroloimnumological diseases/plasmapheresis (the symptoms are relieved by reducing a causative proteins or, autoantibodies). Botulinus therapy for blepharospasm/hemi-facial spasm and spasmodic torticollis (the intramuscular injection of attenuated Botulinus toxins is performed to reduce the symptoms). Blood L-Dopa monitoring for refractory Parkinson’s disease (the fine adjustment of L-Dopa is possible). Specific therapy for mitochondrial encephalomyopathy (specific amino acid (L-arginine) treatment for acute and chronic-stage is performed). Diagnosis and treatment of dementia patients is actively performed.
Symptoms/diseases treated in our department
We are responsible for the treatment of patients with diseases that cause various symptoms, such as headache, vertigo, numbness, paralysis, dizziness, forgetfulness, consciousness disorder, tremor, convulsion, and gait disturbances. Diseases treated in our department include stroke, dementia, neuro-degenerative diseases (Parkinson’s disease, amyotrophic lateral sclerosis, and spinocerebellar degeneration), muscular diseases, peripheral neuropathies, neuro-inflammation (meningitis, and encephalitis), epilepsy, migraine, and movement disorders. Furthermore, we are making efforts to investigate the etiology of refractory neurological disorders. Please consult such patients to us.
Primary examinations and explanations
Various diagnostic imaging procedures, such as CT, MRI, MRA, SPECT, carotid ultrasonography, transcephalic Doppler ultrasonography, transesophageal echocardiography, and lower limb vascular ultrasonography are performed to provide the most advanced medical treatment. Neurological diseases are diagnosed using electrophysiological examinations (electroencephalography, nerve conduction study, electromyography, somatosensory evoked potential (SEP), visually evoked potential (VEP), and auditory brain stem response). To examine whether vascular reconstruction for stroke should be performed and help differential diagnosis of neurodegenerative diseases, PET scan is frequently performed. For the differential diagnosis of Parkinson-associated diseases, MIBG myocardial scintigraphy and DAT scan are conducted. For the pathological diagnosis of muscular diseases, such as myositis and muscular dystrophy, and peripheral neuropathy muscle or sural nerve biopsy is performed if necessary. Recently, skin biopsy is performed for the histological diagnosis of Parkinson’s disease.The serological diagnosis of Hashimoto’s encephalopathy showing various CNS symptoms, such as consciousness loss or cerebellar ataxia, as well as the genetic diagnosis of spinocerebellar degeneration and mitochondrial diseases are conducted in our department.