General Practitioners

• Headaches
• Arthritis
• Medical Weight Loss
  Weight loss and exercise – All patients with sleep apnea who are overweight or obese are advised to lose weight. While this does not often lead to complete resolution of sleep apnea, weight loss has been shown to improve overall health and decrease the severity of sleep apnea.
• Primary Care
  “I am happy to let everyone know how great the Neurology Center/Chevy Chase is. My primary care doctor referred me there because of neuropathy symptoms. He advised that every doctor there is first class, and any will serve me well. I was assigned to Dr. Nabil Altememi, and how fortunate for me. He is brilliant, thorough, experienced, confident and a great communicator. After two appointments now, I am confident in my experience and my judgment. I commend the Neurology Center to you, and I specifically commend Dr. Altememi. Good luck.” –TM
• Sleep Disorders
  Parkinson’s disease related dementia may present with impaired short-term memory, concentration and judgment with additional impairments in visual processing, visual hallucinations, and delusions. People may also develop anxiety, irritability and sleep disturbance such as REM sleep disorder. An estimated 50 to 80 percent of People with Parkinson’s disease eventually develop dementia as their disease progresses, on average within 10 years of their initial diagnosis.
• High Cholesterol
• Constipation
• Erectile Dysfunction
• Infectious Diseases
  Multiple sclerosis mimics can include autoimmune/inflammatory disease such as Systemic Lupus Erythematosus (SLE), Sjogren's syndrome, vasculitis, and sarcoidosis. Other MS mimics include infectious diseases such as Lyme disease, syphilis, HIV, progressive multifocal leukoencephalopathy (PML), and Human T-cell lymphotropic virus-1 (HTLV-1). Finally, genetic disorders, vitamin deficiencies, or brain tumors can also present with similar symptoms, so thorough workup is essential to making a diagnosis.
• Electrocardiogram
  Ozanimod (Zeposia) was approved by the FDA in March 2020 for treatment of relapsing remitting multiple sclerosis (RRMS), secondary progressive multiple sclerosis (SPMS), and clinically isolated syndrome (CIS). It also has a more targeted effect compared to Fingolimod and therefore may lead to less side effects. Its efficacy and safety profile is similar to that of siponimod, and monitoring of cell counts and liver enzymes is recommended. While it does not require first dose cardiac monitoring, a baseline EKG is still recommended to determine if there are pre-existing cardiac conditions.
• Urinary Incontinence
• Diarrhea
• Immunizations
  If you are about to start one of the anti-CD20 monoclonal infusions (Ocrevus and Rituxan), consider getting fully vaccinated at least 2 weeks prior to starting the infusions. If you are already taking Ocrevus or Rituxan, the ideal time for vaccination is approximately 4 weeks before your next scheduled therapy.

Gynecologists

• Pregnancy

Internists

• Internal Medicine
  Dr. Nabil Altememi received his Medical Degree at the Virginia Commonwealth University School of Medicine. He completed his internship in internal medicine at Mount Sinai School of Medicine at Englewood Hospital Medical Center in Englewood, NJ and completed his neurology residency at the Albert Einstein College of Medicine at Beth Israel Medical Center in New York. He then completed a fellowship in clinical neurophysiology at the University of Maryland School of Medicine as well as a fellowship in sleep medicine. In his spare time, he enjoys exercising, playing and watching sports, and spending time with his family and friends.
• Kidney Stones
• Endoscopy
  Hypoglossal nerve stimulator therapy (Inspire) - Hypoglossal nerve stimulation with an implantable neurostimulator device is a treatment strategy that may have a role in selected patients with moderate to severe OSA, who have failed PAP therapy with a body mass index <32 kg/m2, (BMI <35 kg/m2 is used in some centers) and no unfavorable collapse on drug-induced sleep endoscopy (determined by an ENT specialist).

Neurologists

• Neurology
  We, at The Neurology Center, generally think of ourselves as an apolitical organization. Our mission is to treat all who need neurologic care, without regard to race, color, creed, religion, gender identity or sexual orientation.
• Multiple Sclerosis
  Multiple Sclerosis is a neurologic disease associated with autoimmune mediated inflammation in the central nervous system. It results in the breakdown of myelin, the protective insulation surrounding nerve fibers. The exact cause is unknown, but it is likely due to a combination of genetic and environmental factors. Epidemiologic studies indicate that low serum levels of vitamin D, history of smoking, and infection with the Epstein-Barr virus may play a role in disease development. There does seem to be a genetic predisposition to the disease, though it is not directly inherited. It is estimated that nearly 1 million people in the United States have multiple sclerosis. Twice as many women as men are affected. Most people are diagnosed between the ages of 20 and 40, though new diagnoses can sometimes be made in children and older individuals. There have been improvements in diagnostic methods and major advances in medical treatment for multiple sclerosis over the last decade. This means people with multiple sclerosis can be diagnosed and treated earlier in the disease trajectory, leading to improved patient outcomes and reduction in disability.
• Epilepsy
  A seizure is produced when the electrical activity of thousands to millions of brain cells activate in a synchronous fashion. Epilepsy is a disorder defined by the unprovoked tendency to have recurrent seizures.

Psychiatrists

• Depression
• Insomnia
• Anxiety

Endocrinologist

• Diabetes Care
• Hypothyroidism
  Individuals with sleep apnea may experience problems with snoring, daytime sleepiness, gasping for air at night, morning headaches, difficulty initiating/maintaining sleep, increased irritability, reduced concentration/attention span, and problems with memory. The prevalence of sleep apnea is also increased in patients with certain medical conditions including congestive heart failure, end stage kidney disease, chronic lung disease, stroke, acromegaly, hypothyroidism, polycystic ovarian syndrome, and Parkinson disease. Sleep apnea may also develop in women during pregnancy.
• Thyroid
  There is no single test to diagnose Alzheimer's disease, frontotemporal dementia or vascular dementia. Researchers are identifying biomarkers that may lead to the development of blood tests which can be used to establish a diagnosis. Often brain imaging, such as CT scan or MRI, is performed to evaluate for structural changes associated with dementia such as hydrocephalus, vascular disease, and hippocampal atrophy (decrease in size) of the part of the temporal lobes integral to memory formation). Blood tests are done to rule out reversible causes of dementia such as vitamin deficiencies (thiamine, B12 and folate), metabolic dysfunction (thyroid disease) and infections (Lyme disease, HIV or syphilis). Certain medications such as benzodiazepines, opioid pain medications, and sleep medications can increase risk for development of dementia.

Radiologist

• Ultrasound
  There are also surgical options for treatment including deep brain stimulation and focused ultrasound. Your neurologist will be able to guide you as to which treatment plan is the best to suit your needs.
• MRI
  There is no single test to diagnose Bell's palsy. Other conditions such as injury, stroke and tumor will need to be ruled out clinically and sometimes in atypical cases with an imaging study such as magnetic resonance imaging (MRI) or computerized tomography (CAT) scan. Blood work to look for conditions such as Lyme's disease, B12 deficiency and inflammatory states that may result in weakness of the facial nerve may also be ordered. Risk is increased in people with diabetes.
• X-Rays
• Computed Tomography
• Chemotherapy

Plastic Surgeons

• Botox
  For some migraine patients, a daily preventative medication is required. These medications are typically used in people who have frequent migraines, or long-lasting severe migraines that cause significant disability. These medications include blood pressure medications, anticonvulsants, certain antidepressants, and the newest class of medications which are calcitonin gene-related peptide (CGRP) inhibitors. Botox injections, which are given every 3 to 6 months, can also be very effective for treatment of migraines that are refractory to the standard preventative therapies.

Dermatologists

• Lesions
  There are also other demyelinating disorders that are not multiple sclerosis. Examples include Neuromyelitis optica (NMO) which is characterized by inflammation of the optic nerves (optic neuritis) and long lesions in the spinal cord. Acute disseminated encephalomyelitis (ADEM) is a single inflammatory attack on the CNS that occurs more commonly in children and is typically accompanied by fever and associated with a viral infection.

Physical Therapists

• Sports Medicine
  Motor vehicle or bicycle accidents, physical assaults, falls and sports injuries are common causes of concussion. Motor vehicle accidents account for nearly 50% of all TBI requiring hospitalization. It is estimated that 2.5 million people sustain a TBI every year in the United States, of which more than 75% are considered mild.
• Physical Therapy
  Treatment varies widely depending on the patient’s symptoms, severity of pain, disability and the findings on exam and testing. Physical measures such as posture mechanics, ergonomic workstation optimization, exercises, heat, and physical therapy are often helpful. Anti-inflammatory and analgesic medications may be used for short term acute symptomatic relief but do not reverse underlying structural causes of the pain. Surgery is considered in patients with significant structural compromise of the nervous system or spine which do not respond to other conservative measures.
• Occupational Therapy
  We recommend LSVT-BIG physical and occupational therapy - a program created specifically to tackle the challenges of Parkinson’s. Speech therapy can address speech or voice changes and swallowing issues. We recommend LSVT-LOUD - the most researched voice treatment for people with PD.
• Neck Pain
• Back Pain