Thank you for considering The Tennessee Valley Neurological Associates for the diagnosis and management of your neurologic health. Our physician staff has well over 15 years experience in diagnosing and treating neurological disorders, and we are dedicated to providing you the utmost care for your specific situation. We appreciate the opportunity to participate in your health care management.
Services
We thank you for selecting our healthcare team! Our goal is to provide the best possible level of neurological care for our patients so that you and your family understand the medical problem and treatment. Our physicians and staff strive to maintain a caring, personal, and respectful atmosphere, whether through our consultation services in our Huntsville and Madison locations or at Huntsville Hospital.
Tennessee Valley Neurological Associates PC offers a full range of in-office and hospital services to our patients, including the following:
At Tennessee Valley Neurological Associates, our practice encompasses diagnosis and treatment of the following issues (as well as many other neurological disorders) in adults:
Alzheimer's Disease (and other memory disorders)
Parkinson's Disease
Epilepsy
Stroke
Multiple Sclerosis
Peripheral Neuropathies
Migraines
Dementia
Vertigo and Dizziness
Syncope
Stroke Team
EMG and Nerve-conduction Studies
Electromyography (EMG) and Nerve Conduction Studies(NCS) are ordered to learn more about the health of the nerves that travel to and from your hands and feet (called peripheral nerves). These tests measure the speed of the nerve's conductivity and the electrical activity of the nerve to establish if a nerve is working properly. In the case of nerve injury or nerve entrapment, the test can often locate the exact site.
EMG and NCS are often done together to provide more complete information. More specifically:
A NCS is used to detect and evaluate damage to the peripheral nervous system and to identify the location of abnormal sensations, such as numbness, tingling, or pain.
An EMG is performed to aid in the diagnosis of conditions that damage muscle tissue, nerves, or the junctions between nerve and muscle (neuromuscular junctions), as well as to evaluate the cause of weakness, paralysis, involuntary muscle twitching, or other symptoms. (Problems in a muscle, the nerves supplying a muscle, the spinal cord, or the area of the brain that controls a muscle can all cause these kinds of symptoms.)
What To Expect
EMG: The muscles are assessed by inserting a tiny Teflon coated pin electrode into the muscle with the computer then recording the muscle potential. The sensation is similar to that of an injection that goes into the muscle as the pin electrode is inserted into the muscle. (That is if sensory awareness is not a problem.) It is important for the patient to lie still to reduce interference and to achieve accurate readings.
NCS: The patient will be asked to lie on an examination table. Electrodes are placed on the skin over the nerve to be studied. These electrodes act as microphones to pick up any electrical signal that goes by them. An electrical stimulator is then placed on the skin near the electrodes and is used to create an electrical current strong enough to fully stimulate the nerve. A computer is used to record responses as various nerves are tested. This allows the physician to measure and calculate how fast the nerve is sending the impulses to the muscle.
A majority of the time spent with the patient is setting up the studies and running the computer; a very small amount of the time involves electrical stimulation or use of the pin electrode.
Discomfort during the tests should be minimal. The electrical stimulation of the nerve conduction study could be compared to a static electricity shock. The pin insertion could be compared to being pinched by someone's fingernails.
No sedation is used during the test, as the patient needs to be awake to follow instructions during the exam.
How To Prepare
Please do not wear any lotion or perfume anywhere on the body.
Wear loose fitting clothes that can be raised to above the knee or above the elbow, depending on the limb that will be tested.
Take all medications regularly, unless given other instructions by your physician.
Following the Exam
For some, there can be minor irritation at the pin insertion sites. However, there are no lasting effects from either the NCS or the EMG.
The examining physician can give you an idea of any obvious abnormalities at the end of the test the same day. However, more detailed interpretation will be done once the results are factored into the patient's health history, symptoms, physical and neurological examinations, and the results of other tests to help establish a diagnosis.
Electroencephalogram (EEG)
An electroencephalogram (EEG) is a test to detect abnormalities in the electrical activity of the brain. At Tennessee Valley Neurological Associates, we are able to perform this test in our facility, as well as for our hospital patients.
An EEG is used to help diagnose the presence and type of seizure disorders, to look for causes of confusion, and to evaluate head injuries, tumors, infections, degenerative diseases, and metabolic disturbances that affect the brain. It is also used to evaluate sleep disorders and to investigate periods of unconsciousness.
What to Expect
In an EEG, electrodes (that look like flat metal discs) are placed on the scalp over multiple areas of the brain to record patterns and check for abnormalities in the tiny electrical impulses brain cells used to communicate.
A trained technician will guide you through the process as the test is performed.
The technician will apply between 16 and 25 electrodes with a sticky paste. These electrodes are connected to an amplifier and a computerized recording machine.
The recording machine converts the electrical signals into a series of wavy lines that are digitally recorded on the computer.
You will need to be able to lie on your back on a table for the test.
You will need to lie still with your eyes closed because any movement can alter the results.
You may be asked to do certain things during the recording, if indicated, such as breathe deeply and rapidly for several minutes, or look at a bright flickering light through closed eyes.
This test causes no discomfort. While you may notice the feel of the electrodes on your skin, they only record activity and do not produce any sensation.
How to Prepare
Wash your hair the night before the test, omitting any oils, sprays, or conditioner that you may usually use in your hair.
Take all medications regularly, unless given other instructions by your physician.
Sometimes it is necessary to sleep during the test, so you may be asked to reduce your sleep time the night before the test.
Visual Evoked Response (VER)
Visual evoked responses (VER) evaluate the visual nervous system from the eye to the brain. The test is used to check for optic neuritis, optic tumors, retinal disorders and demyelinating diseases, such as multiple sclerosis.
What to Expect
The test usually takes around 30 minutes.
The head is measured and each electrode is attached with electrode paste and a piece of gauze.
Three or more electrodes are attached to the patient's scalp. The patient is asked to stare at a pattern on a video screen. Each eye is tested separately. A patch is placed over the eye not being tested.
After the test, the electrodes are removed with warm water and a washcloth. The patient's hair and skin remain intact. Normal washing of the hair will remove any leftover residue from the paste.
Preparing for the Test
You will need to be alert and well rested.
Bring any glasses or contact lenses you normally use.
Take all medications regularly, unless given other instructions by their physician.
After the Exam
The patient will learn the test results from either their neurologist or from a copy of the VER report sent to their referring physician.
Brainstem Auditory Evoked Response (BAER)
The brainstem auditory evoked response (BAER) test measures responses in brain waves that are stimulated by a clicking sound to evaluate the central auditory pathways of the brainstem. The test is performed to help diagnose nervous system abnormalities, hearing losses, and to assess neurologic functions.
What to Expect
You will be positioned on a reclining chair or bed and asked to relax and remain still.
Electrodes will be placed on your scalp and on each earlobe.
You will hear clicking noises or tone bursts through earphones, and the electrodes pick up the brain's response and record it on a graph.
There is little, if any, discomfort.
How to Prepare
Please wash your hair the night before the test.
Vagus Nerve Stimulation (VNS)
Vagus nerve stimulation (VNS Therapy®) is designed to prevent seizures by sending regular, mild pulses of electrical energy to the brain via the vagus nerve, which is part of the autonomic nervous system that controls functions of the body that are not under voluntary control. These pulses are supplied by a device something like a pacemaker.
Dr Theodros Mengesha has enjoyed serving the neurological needs of patients in the Huntsville area since 2007. Prior to opening Tennessee Valley Neurological Associates PC in August of 2017, Dr. Mengesha worked with Huntsville Hospital Neurological Associates. He looks forward to continuing to serve Madison County and the greater Tennessee Valley.
He still keeps full privileges at Huntsville Hospital.
Education and Certifications:
Doctor of Medicine, Addis Ababa University Medical Faculty, Addis Ababa, Ethiopia: 1992
Certificate of Residency in Primary Care Internal Medicine, Interfaith Medical Center, Brooklyn, NY
Certificate of Residency in Neurology, University of Kentucky, Lexington, KY
Certificate of Fellowship in Clinical Neurophysiology, Vanderbilt University, Nashville, TN
The Multiple Sclerosis Comprehensive Treatment Training Program, UT Southwestern Medical Center, Dallas, TX
American Board of Psychiatry and Neurology (ABPN) Certification, Board Certified
Our patient portal allows new patients to register themselves into the system and allows all our patients access to communicate securely with our office through their own personalized link.
This is where patients may also fill out information, sign legal documents, fill out forms, view records, and more.
If you are new to our practice, Welcome! Please note that you can use our patient portal to complete the new patient information that helps us expedite the process of establishing you as a new patient. However, if you prefer the paper option, please print the New Patient Packet, fill it out, and bring it with you to your first appointment. If you can't print it out, then don't worry! Just be sure to show up 30 minutes before your first appointment to complete the paperwork then.
Also, please bring a list of all current medications and dosage.
If you have not attended our office in the last six months, please print and bring the following forms with you to your next appointment. If you are unable to print the forms, please show up 15 minutes early to complete them in our office.
As a service to our patients, we will complete and submit insurance forms to your insurance carrier. It is imperative that we maintain accurate insurance information. Please notify our staff of any changes in your insurance and personal demographic information to maintain accuracy in our billing, as well as to ensure that we are able to reach you by mail and telephone, if necessary. It is the patient's responsibility to make sure our practice is in-network with their insurance prior to making an appointment.
For patients with the following insurance providers, please contact your insurance company to be sure the correct insurance referral has been submitted (by the patient's referring physician or directly by the patient), or call our office at 256-265-0400 if you have any questions regarding the referral:
Telephones are answered personally by our staff during office hours, with the exception of from 12:00 noon to 1:00 PM Monday - Friday, at which time our answering service takes over during lunch.
Our answering service is available at all times when the office is closed and can contact the physician on call when necessary. As our phone system can be exceptionally busy during peak hours, we provide voicemail boxes to allow you to leave messages for our staff when they are unable to immediately answer your call. Please leave detailed messages as well as a phone number where you can be reached, and our staff will get back with you as soon as possible.
All co-payments, coinsurance and deductibles are due and payable at the time of service, regardless of who brings the patient in for the appointment. Sitters, grandparents, divorced parents, etc., must be prepared to pay at the time of service.
Our offices accept cash, checks, debit cards, Discover, MasterCard, and VISA. We reserve the right to assess a service charge to accounts that require multiple billing for co-payments.
There is a $35 service charge for returned checks. We reserve the right to report returned checks to the Madison County District Attorney's Worthless Check Unit. If we receive two returned checks, we will only accept cash or credit card as payment for future balances.
If you fail to meet financial obligations agreed upon in this financial policy or other payment arrangements made with Tennessee Valley Neurological Associates PC, your outstanding balance will be sent to a collection agency, and you will be required to pay the entire amount plus any collection agency fees before being scheduled for any further appointments.
Over-payments will be refunded after all charges have been processed and paid by your insurance company. A refund check will be written and mailed within 30 days of your written or verbal refund request.
Insurance
Our office participates with a variety of insurance plans. It is your responsibility to
Bring your insurance card to each visit and notify us of any changes.
Know your co-payment amount and be prepared to pay this amount at each visit.
Know your insurance company benefits (physical exam coverage, diagnostic testing co-payment amounts and pre-certification requirements, etc.)
If you are enrolled in a Managed Care Insurance Plan (HMO) it is your responsibility to obtain or ensure a referral is supplied to our office from your primary care physician prior to the time of your appointment. Without this referral, you cannot be seen by our physicians.
If you insurance coverage through a plan that we do not participate with, our office is happy to file the claim for you upon request as a courtesy. However, you are responsible for payment in full at the time of service and you will be reimbursed upon payment being received from your insurance company in the event that the payment is not made directly to you. Also, we file secondary insurance claims as a courtesy. If your secondary insurance has not paid within 60 days of our first filing, you automatically become responsible for the balance of unpaid charges.
Please review our policy on missed appointments and cancellations.
Contact Us
Our answering service is available at all times when the office is closed and can contact the physician on call when necessary. As our phone system can be exceptionally busy during peak hours, we provide voicemail boxes to allow you to leave messages for our staff when they are unable to immediately answer your call. Please leave detailed messages as well as a phone number where you can be reached, and our staff will get back with you as soon as possible.
Huntsville
Address:
Blackwell Medical Tower
201 Sivley Rd, Suite 540
Huntsville, AL 35801
Phone:
256-265-0400
Fax:
256-265-0407
Hours:
Monday-Thursday: 8:00 a.m. -4:30 p.m. (Closed for lunch: 11:30 am to 1:00 pm) Friday: 8:00 a.m. -11:30 a.m. Phones are open from 8:30 am - 4:30 pm