Cigna (all plans, but NOT Cigna Connect network plan)
Carefirst Blue Cross Blue Shield
MEET DR LOUTFI
MD from University if Damascus, Syria, in 2000
Internship in Internal Medicine at University of South Alabama, in 2007
Residency in Neurology at University of Alabama Medical Center, in 2010
Fellowship in Clinical Neurophysiology, with a focus in epilepsy, at Vanderbilt University in Nashville, Tennessee, in 2011
Occipital Nerve Block
An occipital nerve block is an injection of a steroid or other medication around the greater and
lesser occipital nerves that are located on the back of the head just above the neck area.
What is the purpose of an occipital nerve block?
The steroid injected reduces the inflammation and swelling of tissue around the occipital nerves.
This may in turn reduce pain, and other symptoms caused by inflammation or irritation of the
nerves and surrounding structures. Typically, headaches over the back of the head, including
certain types of tension headaches and migraine headaches, may respond to occipital nerve
Botox Injections for Migraines
Botox is an injectable drug made from a toxic bacterium called Clostridium botulinum. When you
eat the toxin produced by this bacterium, it causes a life-threatening form of food poisoning,
known as botulism. But when you inject it into your body, it causes different symptoms. It blocks
certain chemical signals from your nerves, causing temporary paralysis of your muscles.
Vagal Nerve Stimulation (VNS)
VNS Therapy (also called vagus nerve stimulation) has been approved by the U.S. Food and
Drug Administration (FDA) as an add-on therapy for adults and children 4 years and older. It is
approved to treat focal or partial seizures that do not respond to seizure medications. This is
called drug-resistant epilepsy or refractory epilepsy.
Nerve Conduction Studies (NCS)
A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the
function, especially the ability of electrical conduction, of the motor and sensory nerves of the
human body. These tests may be performed by medical specialists such as clinical
neurophysiologists, physical therapists, chiropractors, physiatrists (physical medicine and
rehabilitation physicians), and neurologists who subspecialize in electro diagnostic medicine. In
the United States, neurologists and psychiatrists receive training in electro diagnostic medicine
(performing needle electromyography and NCSs) as part of residency training and in some
cases acquire additional expertise during a fellowship in clinical neurophysiology, electro
diagnostic medicine, or neuromuscular medicine. Outside the US, clinical neurophysiologists
learn needle EMG and NCS testing.
Electromyography (EMG) measures muscle response or electrical activity in response to a
nerve’s stimulation of the muscle. The test is used to help detect neuromuscular abnormalities.
During the test, one or more small needles (also called electrodes) are inserted through the skin
into the muscle. The electrical activity picked up by the electrodes is then displayed on an
oscilloscope (a monitor that displays electrical activity in the form of waves). An audio-amplifier
is used so the activity can be heard. EMG measures the electrical activity of muscle during rest,
slight contraction and forceful contraction. Muscle tissue does not normally produce electrical
signals during rest. When an electrode is inserted, a brief period of activity can be seen on the
oscilloscope, but after that, no signal should be present.