Centers and Programs - Neurology Residency
This program has been developed as a site for comprehensive care and innovative research into the causes and treatment of M.S. Patient care programs include interdisciplinary cooperation from the specialties of:
- neurology, urology, and neuroradiology
- numerous social and community services
Neurologic rehabilitation, including a supervised exercise program, is offered. The research focus of the center has been both in basic science, specifically neuroimmunology and neurovirology, and in controlled clinical trials.
University of Maryland was the coordinating center for the multicenter clinical trial which lead to the approval of Copaxone as one of the first disease modifying therapies available for Multiple Sclerosis. Recent clinical studies have focused on beta interferons, 4-aminopyridine, glatiramer acetate and several cytokine-based therapies.
As a leader in the region, UMMC's Epilepsy Center is accredited by the National Association of Epilepsy Center as a level 4 epilepsy center. Level 4 epilepsy centers have the professional expertise and facilities to provide the highest level medical and surgical evaluation and treatment for patients with complex epilepsy.
The Maryland Epilepsy Center is a tertiary referral center for evaluation and treatment of seizure disorders in adults and children. Of particular interest are seizures that are either difficult to diagnose or intractable to medical therapy. Outpatient facilities for patient evaluations, EEG, evoked potentials and video-EEG studies are complemented by a state-of-the-art four bed Epilepsy Monitoring Unit and multiple mobile EEG systems that permits long-term inpatient continuous video-EEG monitoring.
An active seizure surgery program includes a multidisciplinary team performing scalp and intracranial EEG recordings, cortical mapping and neuropsychological assessment. Neuroimaging capabilities include routine and thin section MRI, ictal SPECT, and functional MRI.
The Maryland Sleep Disorders Center is also a part of our clinical neurophysiology laboratory.
The research components of the Maryland Epilepsy Center include investigations into:
- cellular mechanisms of neuronal excitation
- multichannel analysis of patterns of seizure onset and propagation
- investigational drug trials
- management of status epilepticus
- treatment of post-traumatic epilepsy
- the epidemiology of seizure disorders
- new anti-epilepsy drug trials
- behavioral issues in epilepsy and seizures
The Neuromuscular Disease Program has an active in-patient and out-patient service covering all aspects of clinical neuromuscular disease. The fully-equipped clinical neurophysiology/electromyography laboratory at UMMC performs a wide range of both general electrodiagnostic studies and specialized studies. Specialized clinics include those in peripheral neuropathy, myasthenia gravis, amyotrophic lateral sclerosis, and muscular dystrophy.
There is an active research program at the University and affiliated laboratories at the Baltimore VA. Muscle and nerve biopsies are processed in the Neuropathology Laboratory and reviewed biweekly. Skin biopsies are performed on patients with suspected small fiber neuropathy. A full course of lectures for trainees covers all aspects of neuromuscular electrophysiology and neuromuscular pathology.
Affiliated staff members have a wide variety of basic and clinical research interests, including:
- Translational and clinical studies of diabetic neuropathy.
- Changes in mitochondrial biology in the peripheral nervous system.
- Autonomic neuropathies and other disorders of the autonomic nervous system.
- Immunologic disorders of the neuromuscular junction and peripheral nerve.
- Effects of exercise in myasthenia gravis.
- Studies on Schwann cell-glial interactions.
- Amyotrophic lateral sclerosis and other motor neuron diseases.
The University of Maryland Medical Center has received Joint Commission certification as a Comprehensive Stroke Center. As such, there are extensive programs throughout the continuum of care for stroke patients, including:
- Brain Attack Team: A 24 hour/7 day a week multispecialty team developed to rapidly evaluate and treat patients with vascular causes of neurologic disorders, including administration of intravenous thrombolysis and intraarterial reperfusion.
- Neurocritical Care Unit: A comprehensive 22 bed unit staffed by neurointensivists
- Interventional Neuroradiology: 24 hour/7 day a week coverage for intraarterial therapy for acute reperfusion to treat ischemic strokes, endovascular therapy for ruptured and unruptured cerebral aneurysms, treatment of arteriovenous malformations and fistulas, among other diagnoses.
- Vascular Neurosurgery: Specializing in evaluation and management of intracerebral, subdural, subarachnoid, and epidural hemorrhage, vascular malformations, and other surgical cerebrovascular issues.
- Carotid Artery Stenosis therapy: Specialized care through the vascular surgery, neurosurgery and interventional neuroradiology groups providing reperfusion via carotid endarterectomy or carotid artery stenting.
- Neurorehabilitation: Comprehensive inpatient and outpatient rehabilitation for stroke and other neurological diagnoses (see below).
- Outpatient evaluation and management of stroke patients: The comprehensive stroke center provides rapid hospital follow-up for patients as well as ongoing care to optimize recovery and secondary stroke prevention. The vascular neurology team also serves as a referral center for outpatient consultation of patients with stroke of unclear or unusual etiology and stroke in young patients.
- The Comprehensive Stroke Center is actively involved in multiple local, national, and international clinical research studies addressing acute stroke care, neurorehabilitation, and primary and secondary prevention strategies.
- The Neurovascular Laboratory performs carotid duplex/color flow Doppler and transcranial Doppler studies to evaluate cerebrovascular blood flow.
The Neurorehabilitation Program
Rehabilitation Medicine is a Division of the Department of Neurology. Inpatient rehabilitation services are provided at three sites: The University of Maryland Medical Center, the R A Cowley Shock Trauma Center, and The University of Maryland Rehabilitation & Orthopaedic Institute.
Stroke, traumatic brain injury, spinal cord injury, neuromuscular disease and multiple sclerosis are the neurologic diseases represented.
The research interests of affiliated faculty members are behavioral neurology, aphasiology, and the functional basis for neurologic recovery. Active research programs include:
- clinical trials
- use of functional MRI to study recovery in stroke
- use of computerized alternative communication systems to support language recovery
- use of partial weight suspension to promote recovery from hemiplegia
- functional electrical stimulation for quadriplegia
- outcome studies on head injury and stroke
- in depth cognitive neurophysiological evaluation and treatment studies
The Maryland Parkinson's Disease and Movement Disorders Center
The center offers comprehensive and expert diagnostic, medical, surgical and rehabilitative services for patients with Parkinson's disease and parkinsonism. We are also members of the Parkinson Study Group, a North American Consortium of Research Neurologists who conduct clinical research studies in Parkinson's disease.
UMMC was among an international group of investigators studying a new noninvasive treatment, MRI-guided focused ultrasound. Recently approved by the U.S. Food and Drug Administration (FDA), the treatment was found to significantly improve tremors and quality of life in patients with essential tremor (ET), the most common movement disorder.
The center is also the site for clinical trials research for Alzheimer's and Parkinson's Disease. NIH- and VA-funded research laboratories of the Department of Neurology utilize molecular and cellular techniques to focus on gene regulation and protein processing in neurodegenerative diseases.
Specialists provide comprehensive diagnosis and management for complex headache disorders including medical management, lifestyle recommendations, and botulinum toxin injection for prevention in patients with chronic headache disorders.