Western Multiple Sclerosis Center

Specialty Services

Many specialists assist in the care of patients with MS:

Neuro-imaging - The University of Washington has a comprehensive neuroimaging program. We are capable of performing state-of-the-art CT scans and MRI scans. In addition to our clinical machines, we also have an MRI scanner dedicated to research. The research MRI machine does MR Spectroscopy and other special imaging techniques. Nuclear medicine imaging facilities, angiography and positron emission tomography are also available.

Neurologists - doctors who specialize in the diagnosis and treatment of diseases affecting the nervous system. They oversee diagnostic evaluations of patients suspected of having MS. After a diagnosis is made, they provide treatment for the underlying disease. This includes medications to slow the progression of the disease and treatments to help the symptoms of the disease.

Neuro-ophthalmology - Our ophthalmologists and neuro-ophthalmologists are available for consults. They specialize in the diagnosis and treatment of eye diseases, especially as they relate to neurological diseases.

Neuropsychological testing is used to evaluate areas of cognitive loss. This testing is useful in documenting the extent and areas of cognition affected. This information is often needed for disability documentation and for planning treatment.

Nurse Practitioners (A.R.N.P.) have additional training that qualifies them to diagnose and treat medical conditions with the supervision of a doctor. They are able to order tests, perform physical examinations and assessments, and prescribe most medications. They often assist by following patients after testing or changes in medications, or when a patient notes a change in their condition.

Nurse Specialists (C.R.R.N.) have special training in particular diseases. They assist doctors in educating patients, talking about medical issues with patients, and by following test results. They are a link between the patient and the doctor or nurse practitioner. Most telephone contact with the clinic is through the nurse specialist.

Occupational therapists provide services for those who possess or are at risk for impairments, activity limitations, or participation restrictions from daily living activities including leisure skills, work, and other productive activities due to injury or illness. They use a combination of exercise and practical skills training to improve independence, time management, and the safety and efficiency of performing daily tasks. They also make and recommend equipment and assistive devices. Their programs address training in fine motor skills, use of compensatory techniques and adaptive devices, modifying the work and social environment, protecting joints, and assessments related to daily activities and equipment. Some of these services include:

• Strengthening programs to establish exercise programs to increase arm/hand strength
• Equipment evaluations to find out what equipment is needed in the home to optimize safety. Many of these evaluations are done in the home
• Equipment evaluations for specific tasks to find out what equipment is needed to complete specific tasks such as writing, eating, dressing, etc.
• Driving evaluations for safety and to assess the need for vehicle modifications for patients with disabilities
• Energy conservation methods for patients with weakness or fatigue.

Orthotics - Our prosthetics and orthotics specialists make custom ambulation aids, braces, and special equipment to improve patient function. Our facilities include an Assistive Technology Clinic with a clinical engineer to modify or custom-make equipment as needed.

• Electrodiagnostic Testing These tests are available to assist with diagnosing disease or to document the severity of disease.
• Electromyography (EMG) uses needles inserted into muscles to measure the health of the muscle or to measure the health of the nerve supplying the muscle.
• Nerve conduction studies (NCS) use small electric currents to find out how well peripheral nerves transmit signals. These nerves are those in the limbs (not the brain or spinal cord).
• Somatosensory evoked potentials (SEPs) use small electric currents to measure how well signals are transmitted up the spinal cord and through the brain and helps identify abnormalities due to MS in the spinal cord and brain.
• Visual evoked potentials (VEPs) use a checkerboard pattern on a video screen to measure how well signals are transmitted in the visual system.
• Brainstem evoked potentials (BEPs) use clicking sounds given through headphones to measure how well signals are transmitted through the hearing system.

Physical therapists provide services to those who have impairments, functional limitations, disabilities or changes in physical function and health status from injury, disease, or other causes. Physical therapy uses a combination of exercise and practical skills training to help clients with activities such as walking, transfers, choosing proper equipment, and setting up conditioning programs. The programs address such issues as muscle weakness, limited range of motion, balance and coordination deficits, and impaired sensation. Some of these services include:

• Strengthening programs to establish exercise programs to increase strength
• Stretching and range of motion programs to increase flexibility
• Mobility evaluations to find out the best approach to maintaining mobility including bracing, canes, walkers, wheelchairs, electric wheelchairs or scooters
• Equipment evaluations to find out what equipment is needed in the home to optimize mobility and safety
• Use of physical treatments for muscle stiffness or pain: ultrasound treatments, heat, stretching, or transcutaneous nerve stimulation.

Psychiatrists are specialists in the use of medications to treat the emotional aspects of diseases. This may include anxiety, depression, emotional swings (lability), or behavioral disturbances. They work closely with psychologists and other members of the treatment team.

Psychologists assist in the management of emotional factors linked with diseases. They use testing and counseling techniques such as:

• Psychological counseling to help patients adjust to a disease, learn ways to cope and relax, or to treat depression
• Family counseling to help families and couples adjust to living with a chronic illness.

Rehabilitation (physiatrists) doctors specialize in the management of disability. Physiatrists at the Western MS Center will diagnose and manage problems arising from MS. This includes medications to slow the progression of the disease and treatments to help the symptoms of the disease. The rehabilitation specialist oversees and coordinates a team of professionals to optimize the function of patients with MS.

Rehabilitation Counseling (vocational counselors) offer a range of counseling and consultation services to address complex vocational issues. The counseling staff views each client as a unique individual with a unique set of needs. Services are provided using a team approach or are available separately. Services include:

• Comprehensive vocational assessments to help people remain in the workforce when possible.
• Achievement, aptitude, and interest testing to find out which employment areas are best.
• Counseling for personal, Identification of community resources.
• Rehabilitation case management.

Social workers assist patients in social, educational, vocational, and independent living concerns.