Welcome to our Website
Garden State Neurology & Neuro-Oncology, PC
Our aim is to provide the highest quality of care along with the greatest compassion for our patients with any neurologic condition. Our aim is to address all your concerns and provide answers to all your questions. We have the latest technology with a vast array of diagnostic testing and a paperless Electronic Medical Record to help accomplish our goal.
Neurologic Consultation in the Office and Hospitals
Neuro-Oncology Evaluation
Chemotherapy
Intrathecal Chemotherapy
Neurophysiological testing
EMG / Nerve Conduction studies
EEG, Ambulatory EEG
Evoked Potentials - VER, BAER's, SSEP
Lumbar Puncture/Spinal Tap
Dementia Testing
Different Therapeutic Options:
Botulinum toxin (BoTox) injections
Nerve Block
Trigger Point Injections
Patient Registration
Medical History
Financial Policy
Release of Information
Privacy Policy (HIPAA)
The following links take you to patient-friendly information provided by neurologychannel, a physician developed and monitored resource.
Fibromyalgia
Guillain-Barre syndrome
Headaches
Hemifacial spasm
Huntington's disease
Hydrocephalus
Lyme disease
Meningitis
Migraines
Movement disorders
Multiple sclerosis (MS)
Multisystem atrophy
Myasthenia gravis
Myopathies
Nervous system tumors
Neurofibromatosis
Neuropathy
Normal pressure hydrocephalus (NPH)
ADHD
ALS/Lou Gehrig's disease
Alzheimer's disease
Asperger's syndrome
Autism
Back pain
Bell's palsy
Carpal tunnel syndrome
Cephalic disorders
Cerebral palsy
Charcot-Marie-Tooth disease
Chronic pain
Coma
Creutzfeldt-Jakob disease
Degenerative Disc Disease
Dementia
Dystonia
Encephalitis
Epilepsy/seizure disorders
Essential tremor
Parkinson's disease
Restless legs syndrome/periodic limb movement disorder
RSD (reflex sympathetic dystrophy)
Sleep disorders
Spinal cord injury
Stress
Stroke
Tourette's syndrome
Traumatic brain injury
Trigeminal neuralgia
Vertigo/dizziness
Support Organizations
The following links are provided and monitored by Healthcommunities.com, the publisher of neurologychannel:
Attention Deficit Disorder
ADD Resources
Children and Adults with ADD (CHADD)
ALS
ALS Association
Alzheimer's Disease
Alzheimer's Association
Alzheimer's Disease Education and Referral (ADEAR Center)
American Association for Geriatric Psychiatry
American Health Assistance Foundation
Consumer Consortium on Assisted Living
Eldercare Locator
Ethnic Elders Care
Aphasia
National Aphasia Association
Ataxia
National Ataxia Foundation (NFA)
Autism Research Institute
Growing Minds Autism Programs
Interactive Autism Network
The Son-Rise Program...The Autism Treatment Center Of America
Brain Injury
Brain Injury Association Inc.
Cerebral Palsy
BlazeSports®
United Cerebral Palsy
Creutzfeldt-Jakob Disease (CJD)
Creutzfeldt-Jakob Disease Foundation, Inc.
Dystonia Medical Research Foundation (DMRF)
Epilepsy
The Epilepsy Foundation
National Fibromyalgia Association
Guillain-Barre Syndrome
Guillain-Barre Syndrome Foundation International
Headache/Migraine
American Council for Headache Education (ACHE)
National Headache Foundation
World Headache Alliance
Hemifacial Spasm
Hemifacial Spasm Association
Huntington's Disease
Caring For People with Huntington's Disease
Huntington's Disease Society of America
Lyme Disease
American Lyme Disease Foundation
Lyme Disease: A Patients Guide
Lyme Disease Info
Multiple Sclerosis
Multiple Sclerosis Association of America (MSAA)
National Multiple Sclerosis Society
Movement Disorders
WE MOVE
Muscular Dystrophy
Muscular Dystrophy Association
Myasthenia Gravis
Myasthenia Gravis Foundation of America (MGF)
Neurofibromatosis, Inc.
The Children's Tumor Foundation
Charcot-Marie-Tooth Association
The Neuropathy Association
Pain Management
National Foundation for the Treatment of Pain
American Chronic Pain Association, Inc. (ACPA)
Spine Health
Parkinson's Disease
American Parkinson Disease Association
The Michael J. Fox Foundation for Parkinson's Research
National Parkinson Foundation, Inc.
Parkinson's Disease Foundation
Restless Leg Syndrome
Restless Legs Syndrome Foundation
Spasmodic Dystonia/Torticollis
National Spasmodic Dystonia Association (NSDA)
National Spasmodic Torticollis Association (NSTA)
Stem Cell Information
American Stroke Association
National Institute of Neurological Disorders and Stroke
National Stroke Association
Tourette Syndrome
Tourette Syndrome Association, Inc.
Tremor
International Tremor Foundation
Tremor Action Network
Other Neurological Resources
Aging Parents and Elder Care
The Brain Matters
Christopher and Dana Reeve Paralysis Resource Center
Family Caregiver Alliance
The National Rehabilitation Information Center (NARIC)
General Health Care Resources
OTCsafety.org: Safe & Effective OTC Medicine Use
Safe Medication
Healthcommunities.com, Inc., the publisher of neurologychannel, does not endorse specific organizations. Every effort has been made to ensure the accuracy of the following links, which are provided as a courtesy. If any information requires updating, please contact neurologychannel.
Hotlines
David S. Zocchi Brain Tumor Center
1-877-577-9800
National Child Abuse Hotline
1-800-422-4453 (1-800-4-A-Child)
The National Domestic Violence Hotline
1.800.799.7233 (1-800-799-SAFE)
Poison Control
1.800.222.1222
National Suicide Prevention Lifeline
1.800.273.8255 (1-800-273-TALK)
Hours:
Wed, Thu, Fri
9:00 - 5:00
Mon-Fri
West Long Branch:
100 State Highway 36 East,
Suite 2P, Second Floor,
West Long Branch, NJ 07764
Map
Phone: (732) 229-6200
Fax: 732-229-6201
Toms River:
9 Hospital Drive,
Suite A7
Toms River, NJ 08755 Map
Phone: (732) 341-0200
Dr. Sumul N. Raval completed his neurology residency at UMDNJ- New Jersey Medical School, where he also served as chief resident. After finishing his Neuro-Oncology Fellowship at Memorial Sloan-Kettering Cancer Center in New York, he served as Attending Neuro-Oncologist there.
Dr. Raval has published many peer review papers in many reputed medical journals, written a text book chapter and presented his research in many national and international medical meetings.
Dr. Raval is a Board Certified Neurologist with specialty training in Neuro-Oncology who holds a special interest in treating patients with brain tumors, multiple sclerosis, headaches, and any Neurological problem.
Dr. Elena Ivashina completed her neurology residency at Boston Medical Center, Boston University School of Medicine. She also served as a Chief Resident in her final year. She was awarded a Fellowship in Movement Disorders at Boston Medical Center.
Dr. Ivashina is a Board Certified Neurologist with specialty training in Movement Disorders who holds a special interest in treating patients with disorders including Parkinsons disease, dystonic disorders, tics, gait disorders, and dementia. She is trained to administer botulinum toxin (BOTOX) treatment and managing patients after deep brain stimulation surgery.
Dr. Patel received his medical degree from Upstate Medical University, Syracuse, NY. He continued his training in adult neurology at State University of New York in Stony Brook, NY where he served as a chief resident. He continued his training further with a fellowship in clinical neurophysiology and became proficient in EEG, epilepsy as well as EMG and neuromuscular disorders and finished training in 2007.
Dr. Patel is a Board Certified Neurologist with specialty training in Clinical Neurophysiology who holds a special interest in treating patients with adult and pediatric epilepsy, neuromuscular disorders, movement disorders such as Parkinson's, Alzheimer's dementia, and migraines.
Experimental therapy shrinking brain tumors
Posted by the Asbury Park Press on 10/8/06
BY BOBBI SEIDEL
STAFF WRITER
LONG BRANCH An experimental treatment in use at Monmouth Medical Center one of only two sites in the nation that have been studying the therapy for more than a year has prolonged the life of a Manalapan man diagnosed with a deadly brain tumor and is creating hope for other brain tumor patients.
"The response of malignant brain tumors in the last 50 years to chemotherapy has been very marginal. We used to say, "Nothing works for a brain tumor.' Now we can say something works," says Dr. Sumul N. Raval, study leader. "This research is very, very exciting."
The treatment combines two drugs normally used only for other types of cancer. A year of receiving the treatment has tremendously reduced the brain tumor of Jack Steinberg, 45, of Manalapan, says Raval, medical director of the David S. Zocchi Brain Tumor Center at the Leon Hess Cancer Center at Monmouth Medical.
"I feel positive," says Jack Steinberg's wife, Cheryl, 45, who spoke for the couple while her husband continues recuperating.
"This is not a cure," Raval says. "So far, it is experimental because both drugs are not FDA-approved for brain tumors. But this is a major step. This is going to open up the doors to new treatments.
"All of my patients have responded after the first two cycles of treatment, although not everyone has responded like Jack Steinberg," Raval says. "This is not anecdotal reports. We have this response (to the treatment) continually.
"With more people using it and more literature on it, it will become a new standard of care," Raval says, adding, "I want people to know they can get help."
Steinberg is one of 15 patients in Raval's study. The other study is at Duke University in North Carolina.
"This is a great advance that will help a lot of people," says Dr. Allan Tunkel, chairman of internal medicine at Monmouth Medical of Raval's work. "I think in his role as a neuro-oncologist one of the few in New Jersey and in the country what he's doing is amazing."
Jack Steinberg's treatment began in August 2005, after it was discovered he had a rapidly growing malignant brain tumor a gioblastoma multiforme, or GBM. This is the most common malignant brain tumor, Raval says.
"The prognosis for him was extremely limited," says Raval, a board-certified neurologist and neuro-oncologist affiliated with Monmouth Medical Center for about a year. He previously was at Jersey Shore University Medical Center, Neptune.
The treatment combines Irinotecan, a chemotherapy, and bevacizumab, a monoclonal antibody that blocks receptors that allow blood vessels to grow in the tumor.
"Chemotherapy destroys the rapidly developing cancer cells in the body," says Raval, 37. "Bevacizumab prevents new blood vessels from forming.
"When you have a brain tumor, lots of new blood vessels form, carrying lots of oxygen and nutrition to the tumor cells. The cells, without nutrition, die," he says.
Until now, Irinotecan was used for lung cancer and bevacizumab for colon or rectal cancer.
"When I started using this combination, there was only a small abstract published in The Journal for Neurology in May 2005," Raval says. "Duke decided to do a small study. We also decided to do a study. We did not have information about Duke's study at that time."
Steinberg's case is an example of what the new treatment can do.
In April 2005, Steinberg had undergone surgery in Manhattan to remove an initial tumor, which was diagnosed after he experienced dizziness, blurred vision, headaches and personality changes.
In July 2005, he had a very small tumor remaining, Raval says.
"In August, he grew a massive amount of tumor. That's when we put him on the combination," Raval says.
Treatments were given that August and September, and an MRI was done in mid-September.
"I could not believe my eyes," Raval says of what the MRI showed. "I checked everything 10 times before I broke the news to the family. There was very little of the tumor left. More than 95 percent of the tumor had responded, like it had melted away.
"This was an unreal response for a rapidly progressing brain tumor."
Jack Steinberg remains in remission, Raval says. While recuperating, Steinberg has taken a leave from the auto-parts business he operates with his brother.
Raval's data on the study will be published in the Nov. 16-19 issue of The Journal of Neuro-Oncology.
ON THE WEB: Visit our Web site, http://www.app.com/, and click on this story for a link to Monmouth Medical Center.
Bobbi Seidel: (732) 643-4043 or bobbi_app.com
Copyright © 2006 Asbury Park Press. All rights reserved.
Use of this site signifies your agreement to the Terms of Service and Privacy Policy. (Updated June 7, 2005) Site design by Asbury Park Press / Contact us
Neurologist from Monmouth and Community Medical Centers
Gives Advice about Traumatic Brain Injury
Toms River, March 17, 2006 -- Brain injury is a major cause of death for adults and more U.S. children die of brain injury than any other cause. Each year in the United States, about 1.4 million people sustain a brain injury, according to the Brain Injury Association of America. Of those, 50,000 die; 235,000 are hospitalized; and 1.1 million are treated and released from an emergency department. Currently, there are at least 5.3 million Americans living with a disability because of a brain injury and the cost to society is estimated at $56.3 billion annually.
Brain injury is unpredictable in its consequences, says Sumul N. Raval, MD, a Board Certified neurologist and neuro-oncologist on staff at Monmouth and Community Medical Centers. Brain injury affects who we are, the way we think, act, and feel. It can change everything about us in a matter of seconds.
Traumatic brain injury (TBI) can be caused by a blow or a jolt to the head, which causes damage to the brain. TBI occurs when an outside force impacts the head hard enough to cause the brain to move within the skull or if the force causes the skull to break and directly hurts the brain. Injuries can range from a mild concussion to severe injury, coma, and death, Dr. Raval notes.
Not all blows or jolts to the head result in a TBI, he observes. The severity of such an injury may range from mild, i.e., a brief change in mental status or consciousness to severe, i.e., an extended period of unconsciousness after the injury. A TBI can result in short or long-term problems with independent function.
If you have a mild concussion, you may have no long-term side effects. If you have a moderate to severe brain injury, side effects can range from headache and confusion to personality changes and seizures, says Dr. Raval.
TBI can cause a wide range of functional changes affecting thinking, sensation, language, and/or emotions. It can also cause epilepsy.
Half of all brain injuries are due to transportation-related accidents. These can include car, motorcycle, and bicycle accidents, as well as injuries to pedestrians. About 20 percent of brain injuries are due to violence. This can include firearm use and child abuse. For people age 75 and older, brain injuries are most often caused by falls.
Severe brain injuries affect both the injured people and their families. It is a period of great trauma and change, Dr. Raval states.
A brain injury is a true emergency and treatment begins at the time of the accident or incident. Medical personnel try to stabilize the patient and work to prevent further injury. They make sure oxygen gets to the brain, that there is enough blood flow and blood pressure is controlled.
Many of the severely injured people will need surgery. This may be to remove a hematoma, which is bleeding in or around the brain. Some people may need a ventriculostomy, a procedure that drains fluid from the brain.
After the emergency treatment, people may receive care in an intensive care unit in a hospital. Once they are stable, they may move to the sub acute unit of the hospital or to a rehabilitation hospital. At this point, people follow many paths toward recovery.
Fortunately, brain injury is one of the most preventable brain disorders, comments Dr. Raval. Improved use of car safety belts and child car seats has helped reduce the number of brain injuries. So has greater use of helmets in biking and other sports. Efforts to reduce drinking and driving have also helped.
There have been considerable efforts to recognize and prevent brain injuries in sports. Coaches and parents have learned the signs of concussion. They have also learned that student athletes must get quick medical care.
Dr. Raval states that a person with a suspected brain injury should contact a physician immediately, go to the emergency room, or call 911 in the case of an emergency.
The sooner you can get treatment, the greater the chances for a full recover, he says.
For more information about traumatic brain injury or to make an appointment with Dr. Raval, please call his Toms River office at 732-341-0200 or his Long Branch office at 732-229-6200.
Routine EEG:
Ambulatory EEG:
Sleep deprived EEG:
Option 1: Do not go to sleep the night prior to EEG.
Option 2: Go to sleep around 12:00 to 1:00 and wake up at 4:00 to 5:00.
Do not use caffeine or any other stimulants to stay awake.
The patient does not need to do anything special to prepare for this test.
Please plan on being here for approximately one hour.
Please do not bring small children or babies with you, as they cannot be in the testing room during the procedure.
Be sure to inform the physician, however, if you are taking blood-thinning medication such as Coumadin, have hemophilia or a cardiac pacemaker.
Upper Extremities:
Lower Extremities:
Visual Evoked Response (VER)
Brainstem Auditory Evoked Response (BAER)
Somatosensory Evoked Response (SER)
100 State Highway 36 East, Suite 2P, Second Floor, West Long Branch, NJ 07764 Map Phone: (732) 229-6200 Fax: 732-229-6201
9 Hospital Drive, Suite A7, 1st Floor, Toms River, NJ 08755 Map Phone: (732) 341-0200 Fax: 732-229-6201
