Dr. Katz has organized an onsite Infusion Center for treatment of patients with various neurological conditions. Up to six patients can be accommodated at a time. The Infusion Center is staffed with experienced nursing personnel. It is open weekdays between 7:30 AM and 3:30 PM.
Most patients who receive treatment at this facility belong to one of the two groups: patients with neuroimmune conditions (multiple sclerosis, CIDP, MMN) and patients with severe headaches that require aggressive intervention to break, possibly also preventing severe complications such as stroke.
1. Neuroimmune Conditions. A Brief Overview.
Multiple sclerosis (MS) is a disease in which the fatty myelin sheaths around the axons of the brain and spinal cord are damaged, leading to demyelination and scarring as well as a broad spectrum of signs and symptoms. This disease usually occurs in younger adults, and it is more common in women.
MS affects the ability of nerve cells in the brain and spinal cord to communicate with each other. Nerve cells communicate by sending electrical signals along nerve fibers, which are wrapped in an insulating substance called myelin. In MS, the body's own immune system attacks and damages the myelin. When myelin is lost, the axons can no longer effectively conduct signals.
The name multiple sclerosis is somewhat outdated, as it refers to scars (“scleroses”), which are now more commonly known as plaques or lesions, in the white matter of the brain and spinal cord.
The great difficulty in early diagnosis of MS is that almost any neurological symptom can appear and confuse the clinical presentation. This is why specialists in MS have to be excellent at integrative diagnosis and very attentive to the patient. Unfortunately, this disease often progresses to physical and cognitive disability, thus making proper management an absolute necessity.
MS takes several forms, with new symptoms occurring either in discrete attacks (relapsing forms) or slowly accumulating over time (progressive forms). Between attacks, symptoms may go away completely, but permanent neurological problems often occur, especially as the disease advances.
There is no known cure for MS. Treatments attempt to return function after an attack, prevent new attacks, and prevent disability.
Dr. Katz is on the forefront of the clinical approach to MS management. She has developed and implemented a number of state-of-the-art treatment protocols in her Infusion Center.
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an acquired immune-mediated inflammatory disorder of the peripheral nervous system. The disorder is sometimes called chronic relapsing polyneuropathy. CIDP is related to Guillain-Barré syndrome and sometimes considered the chronic counterpart of that acute disease. The pathologic hallmark of the disease is loss of the myelin sheath (the fatty covering that protects nerve fibers) of the peripheral nerves.
Chronic inflammatory demyelinating polyneuropathy presents with numerous symptoms including skin numbness, tingling, pain, progressive muscle weakness, loss of deep tendon reflexes (areflexia), fatigue, and abnormal sensations. The likelihood of progression of the disease is high.
Many specialists believe that, as a result of lack of awareness of CIDP, this disease is under-recognized and under-treated, which is very unfortunate, as early diagnosis and treatment are important in preventing irreversible axonal loss and improving functional recovery.
Dr. Katz’ practice is fully equipped with the necessary electrodiagnostic apparatus, which allows her to accurately and early diagnose this condition. She also provides treatment for CIDP in her Infusion Center according to her proprietary clinical protocols.
Multifocal motor neuropathy (MMN) is a progressive muscle disorder characterized by muscle weakness in the limbs, with differences from one side of the body to the other in the specific muscles involved. It affects men much more than women. Symptoms also include muscle wasting, cramping, and involuntary contractions or twitching of the leg muscles. The disorder is sometimes mistaken for amyotrophic laterial sclerosis (ALS, or Lou Gehrig's disease) but unlike ALS, it is treatable. An early and accurate diagnosis allows patients to recover quickly.
Treatment for multifocal motor neuropathy varies. Some individuals experience only mild, modest symptoms and require no treatment. For others, treatment generally consists of intravenous immunoglobulin (IVIg) or immunosuppressive therapy with cyclophosphamide.
Improvement in muscle strength usually begins within 3 to 6 weeks after treatment is started. Most patients who receive treatment early experience little, if any, disability. However, there is evidence of slow progression over many years.
2. Severe Headaches: When Oral Medication Fails to Help
Migraine is a neurological syndrome characterized by altered bodily perceptions, severe headaches, and nausea. Migraine headaches are more common to women than to men.
The typical migraine headache is unilateral (affecting one half of the head) and pulsating, lasting from 4 to 72 hours; other symptoms include nausea, vomiting, increased sensitivity to light and increased sensitivity to sound. Approximately one-third of people who suffer migraine headache perceive an aura—unusual visual, olfactory, or other sensory experiences that are a sign that the migraine will soon occur. The cause of migraine headache is unknown; the most common theory is a disorder of the serotonergic control system.
Status migrainosus: This term is used to describe a migraine attack that persists for more than 72 hours. Status migrainosus is often an emergency as it often leads to severe complications, from dehydration to, in some cases, stroke.
Cluster headache is a neurological disease with an immense degree of pain. "Cluster" refers to the tendency of these headaches to occur periodically, with active periods interrupted by spontaneous remissions. Men are more commonly affected than women. These are excruciating unilateral headaches of extreme intensity. The duration of the common attack ranges from as short as 15 minutes to three hours or more. The onset of an attack is rapid, and most often without the preliminary signs that are characteristic of a migraine. Experts have suggested that it may be the most painful condition known to medical science. Female patients have reported it as being more severe than childbirth. Analogies frequently used to describe the pain are a red-hot poker inserted into the eye, or a spike penetrating from the top of the head, behind one eye, radiating down to the neck, or sometimes having a leg amputated without any anesthetic.
Dr. Katz has had a keen interest in headaches and migraines throughout her career. She is a pupil of one of the “patriarchs” of the study of headache, Dr. Stephen Silberstein and had successfully treated thousands of patients, utilizing her own protocol that is intended to both break the headache and restore the patient’s quality of life.