Departments

Movement disorders can be caused by diminished or slowed voluntary movements (hypokinetic) or increased involuntary movements (hyperkinetic).Parkinson’s disease is the most common of these hypokinetic degenerative disorders, but we also treat progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and corticobasal ganglionic degeneration. Our expertise in hyperkinetic disorders includes Huntington’s disease, Tourette’s syndrome, essential tremor, and dystonia. We diagnose and treat all movement disorders, whether they are caused by primary nervous system dysfunction or by strokes or medications. Our team has expertise in tremor disorders, primary and secondary ataxias, gait disorders, restless legs syndrome, and stiff-person syndrome.

We are dedicated to delivering expert primary and referral services for all disorders of the peripheral nerves and muscles. Our program is supported by the Muscular Dystrophy Association (MDA). As a tertiary referral site for complex neuromuscular conditions, we serve as consultants to general neurologists, internists, and many other specialists. We specialize in: ALS (amyotrophic lateral sclerosis or Lou Gehrig’s disease) Myasthenia Gravis Myopathy (including polymyositis, dermatomyositis, inclusion body myositis) Neuropathy (CIDP, CMT and other inherited neuropathies, Guillain-Barré, diabetic neuropathy) Muscular Dystrophy (including FSH, Duchene, Becker, Limb-Girdle, Myotonic, Oculopharyngeal) Stiff-Person Syndrome and related disorders Our neurologists have advanced training in neuromuscular disease and electromyography (assessing electrical activity in muscle). They have specialized knowledge in the science, clinical evaluation, or clinical management of disorders that affect cells in the central and peripheral nervous systems, muscles, and the junction between them. They offer greater expertise in the origin, mechanisms, diagnosis, and treatment of these disorders than general neurologists. Our electromyographers have expertise in assessing electrical activity in muscle and nerve conduction studies. We are one of the few programs in the Northeast with several electromyographers, who are expert in a specialized technique called single fiber EMG to test for myasthenia gravis. Our neuromuscular group works together as a team that includes medical assistants, clinical nurse coordinators, an MDA coordinator, resident staff, fellows, and attending physicians. Please bring the following items: A copy of your medical records pertaining to your condition, which should include MRIs, nerve conduction studies, and other testing and/or imaging available A current list of all medications and any allergies to medications Name and address of your primary care physician and any other specialists Your first visit will entail a comprehensive evaluation, and you will be asked for a detailed history of your condition. We will complete a thorough neurological examination, after which we will develop a plan of care. We will inform you if additional testing is needed, make recommendations regarding adjustments to current treatment regimens, or refer you to other physicians or consultants. The term EMG is often used to refer to both electromyography and nerve conduction studies. Electromyography is the technique of assessing the health of muscles. Nerve conduction studies assess the health of nerves. Together these techniques are used to investigate and diagnose the entire spectrum of neuromuscular disorders. Our electomyographers use the latest EMG equipment to perform all available specialized EMG techniques, including Quantitative EMG, Blink Reflex, Single Fiber EMG, and others. We use a specialized type of nerve conduction study, called the Jolly

Yale’s Department of Neurology has been at the forefront of cutting-edge clinical care and scientific discovery since it began in 1952. It was Yale scientists who discovered the genes that cause Multiple Sclerosis. Yale housed one of the first epilepsy monitoring units in the country, and one of the first stroke centers at its partner, the Veterans Affairs (VA) Center in West Haven. Today, our team of experienced doctors are committed to understanding and treating the entire spectrum of nervous system diseases. Expert physicians specialize in brain and nerve health for both children and adults. Specialized care is offered in the following areas: Amyotrophic lateral sclerosis (ALS), myasthenia gravis, peripheral neuropathy, neuromuscular disorders Alzheimer’s disease/cognitive disorders Epilepsy and neurophysiology General neurology, headache, pain Multiple sclerosis and neuroimmunology Neurodegenerative disorders Neurocritical care Neurological infections Neuro-oncology Parkinson’s disease and movement disorders Stroke and vascular neurology

Covering every aspect of health care for adults, Internal Medicine is the largest department in the Yale School of Medicine, and the largest clinical service at Yale New Haven Hospital. We provide comprehensive and specialized services in all areas in a variety of outpatient settings as well as the Veterans Affairs (VA) Connecticut Health Care System campus in West Haven. Our culture of collaboration and research gives patients access to expert opinions from nearly 1,000 doctors, as well as opportunities to get tomorrow’s health care today through more than 100 clinical trials. Most importantly, we attend to our diverse community of patients with compassionate, thorough care. Specialized care is offered in the following areas: Allergy & clinical immunology Cardiovascular medicine Digestive diseases Endocrinology General internal medicine Geriatrics Hematology Infectious diseases Medical oncology Occupational health & environmental medicine Nephrology Pulmonology, critical care & sleep medicine Rheumatology International reputation for work in understanding function, independence, and quality of life in older persons Key research breakthroughs of the past decade that include the development of a protective Lyme bacillus disease vaccine, exploration of the underlying causes of allergic disease, and the discovery of novel inherited immunological diseases Largest interventional cardiology program in Connecticut Major referral center for patients with type 1 and type 2 diabetes, as well as other metabolic conditions Nationally ranked program in kidney diseases and the largest kidney transplant program in New England, with multidisciplinary care clinics One of the largest peripheral vascular programs in the country, with leadership and participation in multiple new percutaneous device trials Once of only a few motility centers in Connecticut to provide all motility procedures and services Unique medical forensic exams for individuals with claims of torture who are seeking asylum in the U.S.

We are internationally known for the care we provide for older people, helping them maintain their independence and quality of life, and manage multiple complex health conditions. Our team of geriatricians, geriatric psychiatrists, nurse case managers, patient care assistants, physical therapists, and neuropsychologists works closely with patients, their families, primary care providers, and other care providers to assess and develop a comprehensive plan for their care. Yale physicians have developed widely used interventions and support families facing such challenges as functional decline, disability, decision-making, and driving problems. The Connecticut Older Adult Collaboration for Health 4M (COACH 4M) grant provides multiple resources for older adults and their caregivers. The new video resource library offers a collection of brief videos for older adults and caregivers by experts in the field touching on a range of topics relating to health, well-being, caregiving, and maintaining creativity in aging. The COACH 4M project is pleased to provide an updated and expanded list of available resources and services for older adults in Connecticut, parts of southeastern New York and southwestern Rhode Island, and hopes you find the Geriatric Resource Directory a helpful guide to assist you in meeting the needs of older adults throughout the region. The new user-friendly version enables you to navigate the content through links in the table of contents and region list or using the Adobe bookmark feature. If you have any questions about the Resource Directory or have corrections to the content, please contact Dana Limone at dana.limone@yale.edu . View the Yale Geriatrics Resource Directory . Disclaimer: COACH 4M does not recommend or endorse the services provided by the organizations and individuals listed in the directory. Inpatient and outpatient geriatric consultations at the VA Connecticut Healthcare System in West Haven Syncope and Falls Assessment Program A prevention initiative for seniors at risk for falls, which has reduced falls and related injuries in many Connecticut The development of the Confusion Assessment Method, used internationally to diagnose delirium An Acute Care for the Elderly Unit at Yale New Haven Hospital, which aids with maintenance of function during acute hospitalization Outpatient consultations at the Dorothy Adler Geriatric Assessment Center Welcome to our video library! Here you will find a collection of brief videos for older adults and caregivers by experts in the field touching on a range of topics relating to health, well-being, caregiving, and maintaining creativity in aging. Each video is 15-30 minutes long and you can view the entire video or come back to it later. We are continuously expanding our offerings, so check in periodically to see new selections and let us know if there are topics you’d like to see addressed in the future. Contact eliza.kiwak@yale.edu with any questions or suggestions. This

Yale Psychiatry is the largest provider of psychiatric services in Connecticut, and the top National Institutes of Health-supported Department of Psychiatry in the United States. We are dedicated to adding to the body of knowledge in the field, and improving treatments for psychiatric disorders that span all ages. This includes helping people cope with major life events or medical illnesses, behavioral problems associated with personality disorder or addiction, mood and psychotic disorders, and dementia. Yale investigators have pioneered new treatments for nearly every psychiatric disorder. Our research programs have produced breakthroughs in areas as diverse as molecular neuroscience, genetics, translational neuroscience, neuroimaging, psychopharmacology, psychotherapy, rehabilitation, health services, forensic psychiatry, epidemiology, and health policy. Today, our clinicians are at the forefront of social, pharmacological, psychological, rehabilitative, and neurostimulation treatments. Through clinical trials, our interventional psychiatry service delivers high-impact treatments, including ECT (electroconvulsive therapy) and ketamine, for patients with treatment-resistant symptoms of depression. Our clinical programs are interwoven with our research efforts. We host programs that specialize in the major mental diseases and substance abuse treatment at three major institutions: Connecticut Mental Health Center, the Veterans Affairs Connecticut Healthcare System, and the Yale New Haven Psychiatric Hospital. We also provide increased psychiatry support for Smilow Cancer Hospital in areas such as smoking cessation.

We evaluate and treat all neurological conditions, and make sure patients are seen by appropriate subspecialists within the Department of Neurology to provide the best possible care. The Yale Headache and Facial Pain Center specializes in the diagnosis and treatment of headaches and facial pain in adolescents and adults. The Lumbar Puncture Clinic provides analysis to physicians for conditions related to spinal fluid abnormalities. We perform routine testing of cerebral spinal fluid, as well as more specialized testing for demyelinating disease, neoplasms, inflammatory conditions, and infections. We also provide large-volume spinal taps for the diagnosis of normal pressure hydrocephalus. The Neurology Urgent Access Clinic provides expedited evaluation of patients seen in the emergency room as well as those referred from physicians requiring an urgent assessment.

Our center is one of the oldest and most comprehensive geriatric assessment centers in the United States. It began in 1981 when a group of Yale physicians, nurses, and social workers established a geriatric clinic in a corner of Yale New Haven Hospital’s Primary Care Center. One of their first patients was a woman named Dorothy Adler. After her death, her sons decided to support an expanded center to evaluate older adults who struggled to take care of themselves. The center was established in Adler’s name in 1987. In 2009, we moved to a freestanding building across the street from the hospital. Today, we draw patients and families from throughout the state, New York, and New England. Our team includes geriatricians, nurse case managers, and ambulatory care associates. We conduct diagnostic assessments on an outpatient basis at our Yale New Haven Hospital-based clinic or at the patient’s preferred site. Family meetings are held at each visit and include a physician, case manager, family/caregivers, and if appropriate, the patient. We also work closely with the patient’s own doctor. The result is a comprehensive plan to help patients optimize function, independence, and quality of life. We help patients and families develop connections to appropriate community services such as home health care agencies, adult daycare centers, and volunteer support groups. Moreover, in conjunction with the patient’s physician, our staff provides ongoing case management and clinical care, as necessary. Finally, our center serves as an important educational site for interns, residents, and fellows in geriatric medicine. We serve as a model for other institutions who are developing geriatric centers, and an important site of patient-oriented research in geriatrics. When a patient brings a loved one to our center for an assessment, he or she will receive: A comprehensive history and medical exam Risk evaluation for falls, mobility, and musculoskeletal complaints of back or joint pain Comprehensive cognitive exam and depression screening A review of medications and an evaluation for polypharmacy A review of patient priorities and goals of care Caregiver counseling An assessment for home-based care needs, as well as for nursing home and assisted living placement

So many of us understand the challenges of caring for a loved one who has a neurodegenerative disease such as Alzheimer’s disease, Parkinson’s disease, or frontotemporal dementia. At our Dorothy Adler Geriatric Assessment Center, our team of experts meets with the patient, family members, or caregivers to determine how medical, psychological, cognitive, or social problems are impeding function or threatening independent living. After assessment, our physicians focus on minimizing the progressive loss of neuron function and repairing neural damage, helping people with these conditions live with as much peace and stability as possible.

We are dedicated to excellence in patient care through the study of the cognitive and behavioral changes that can result from medical and brain injuries. We are experts in identifying a patient’s pattern of cognitive and emotional functioning and how this relates to expected brain function. A neuropsychological evaluation combines tests of cognition, behavior, and emotional functioning. This comprehensive evaluation will help to determine whether cognitive changes are related to symptoms of a medical or neurological illness, a psychological condition, or a normal part of aging. This evaluation is also part of the gold-standard workup for neurosurgery candidates. We provide neuropsychological evaluations for a wide array of medical and neurological disorders, as well as neurosurgery-specific candidacy evaluations. In addition, our bilingual neuropsychologists are able to provide evaluations in Spanish. We have expertise in the following areas. Epilepsy Memory disorders & dementia Multiple Sclerosis Oncology Parkinson’s disease Stroke Traumatic brain injury What to expect at your appointment A neuropsychological evaluation consists of an interview and testing, and lasts approximately three to six hours. During the interview, you will be asked about your cognitive and emotional symptoms, health history and medications, and other important background information. Neuropsychological Testing : Cognitive testing is designed to assess domains of thinking including attention, processing speed, memory, language, visual spatial abilities, and problem solving. Tests include paper-and-pencil as well as computerized methods. Emotional functioning is evaluated during the clinical interview and supplemented with self-report measures. We often request information from a close relation (family member or caregiver) about the individual’s functioning in daily life. The results from testing will aid your providers in diagnosis, treatment planning, and recommendations to improve your overall well-being. The neuropsychological evaluation typically includes administration of standardized tests to determine cognitive functioning in the following areas: General/baseline intellectual ability Attention Processing speed Visuospatial abilities Language Memory Executive functioning (problem solving) Motor skills Behavioral and emotional functioning What to bring to your appointment We are very attentive to our patients’ needs. We work with each patient so that they feel as comfortable as possible. We encourage patents to get a good night’s sleep and eat a good breakfast before the appointment. Please bring the following: Glasses and hearing aids Water and a small snack, if needed Reports from any prior neuropsychological testing previously completed A family member, friend, or caregiver so they can provide insights into your abilities Please call us at 203-785-4085 if you have any questions about your appointment.

At the Yale New Haven Stroke Center, we offer safe, effective, patient-centered, timely, efficient, and equitable care to patients with strokes. In collaboration with the hospital’s emergency medical service and emergency department teams, we deliver rapid diagnosis and treatment of acute stroke 24 hours each day. Our center is a Joint Commission Primary Stroke Center, a national recognition of our expertise in providing the highest level of care to stroke patients. From prevention to treatment to recovery, we have the most experienced doctors and the latest diagnostic tools, techniques, and treatments. Our patients receive rapid access to treatment by a highly experienced team that includes experts in vascular neurology, endovascular surgical neuroradiology, neurovascular surgery, neurocritical care, physical medicine and rehabilitation, emergency medicine, and other medical subspecialties. Our multidisciplinary team works together to diagnose and determine the most appropriate treatment for our patients. Timely, effective treatment can make a significant difference in quality of life following recovery. We follow best practices to try to preserve brain function and prevent serious injury. Our services include: Dedicated neuro-intensive care unit Stroke consult service with a patient- and family-centered approach to the treatment and rehabilitation of patients with cerebrovascular disease. Specialized stroke clinics for community physician referrals, stroke consults, and for primary and secondary stroke prevention.

We are committed to providing patient-focused, evidence-based care to all of our patients, pairing clinical expertise with the latest advances in technology. We offer a comprehensive range of imaging services, and tailor each exam to meet each patient’s specific needs. Our board-certified doctors are national and international leaders in diagnostic imaging and advanced image-guided therapies, and they are dedicated to maintaining the highest standards of care in patient safety, quality, and satisfaction. We employ a multidisciplinary approach to care, and collaborate with physicians from all medical specialties to make the most accurate diagnosis and determine the best treatment options. Yale patients have access to highly advanced imaging equipment, including an intraoperative MRI/IR/OR suite, and 3D tomosynthesis. Our radiologists conduct advanced research in MRI, MRS, PET, interventional oncology, and image processing. Specialized care is offered in the following areas: Abdominal imaging Breast imaging Cardiovascular imaging Emergency and trauma radiology Neuroradiology Nuclear medicine and molecular imaging (including PET/CT) Pediatric radiology Thoracic imaging Vascular/interventional radiology Rapid, in-house subspecialist imaging interpretations Overnight coverage by three in-house attending radiologists at Yale New Haven Hospital Leader in 3D tomosynthesis mammography imaging and research Leader in screening breast ultrasound Comprehensive multidisciplinary lung cancer screening program with ultra-low-dose CT scanning Cardiac CoreValue planning service, providing a minimally invasive transcatheter aortic valve implantation option for patients with severe aortic stenosis MRI for pacemaker patients Ultrasound contrast and elastography imaging Dedicated peripheral vascular ultrasound Integrated musculoskeletal ultrasound device Subspecialized pediatric interventional radiology expertise Recognized expertise in management of primary and secondary liver cancer Molecular imaging for recurrent prostate cancer and the diagnosis of Alzheimer’s disease Advanced tumor imaging for optimizing best treatment outcomes DaTscan, a diagnostic test for Parkinson’s Disease Portable neuro Intensive Care Unit (ICU) computed tomography (CT) scanning Interventional radiology with state-of-the-art minimally invasive image-guided therapy, including targeted and precision cancer treatments, back pain treatment, and biliary stone laser treatment, among others