Quick Answer
Neurology treatments at CNS are medical rather than surgical, and every one begins with a diagnosis. Five are performed in our own offices: Botox for chronic migraine, CGRP preventive therapy, BPPV canalith repositioning, occipital nerve blocks and nerve blocks for headache. Candidacy for each is decided by a physician, not by a request.
Key Takeaways
- Treatment follows diagnosis here rather than running alongside it. A procedure offered before the condition is confirmed is a procedure looking for a patient.
- Five treatments are performed inside CNS offices. Two more, in-office infusion and injection therapy and disease-modifying therapy for multiple sclerosis, are coordinated with outside providers rather than delivered here.
- Chronic migraine has a specific definition, fifteen or more headache days a month with migraine features on at least eight, and that definition determines candidacy for preventive treatment rather than a patient’s description of severity.
- Nothing on this page promises an outcome. Two patients with the same diagnosis can respond differently, and the honest position is a plan built around your goals with follow-up to adjust it.
- Scope is adults 18 and older, medical and outpatient. There is no surgery, no interventional pain programme and no pediatric service, and each has a proper destination we will point you toward.
01 — OverviewWhy treatment starts with a diagnosis, not a request
Neurology is a diagnostic specialty before it is a treatment specialty, and the order matters more here than on almost any other page of this site. A treatment chosen before the condition is confirmed is a treatment looking for a patient, and in a field where symptoms overlap heavily it is the commonest way for someone to spend a year on the wrong plan. Every treatment described below therefore sits downstream of an examination and, where the examination raised a question, a study. This hub sits within the wider resource on adult neurology care at Clinical Neurology Specialists.
What candidacy actually means
Candidacy is a clinical judgement rather than a preference. For most of these treatments it depends on a specific diagnosis, a documented pattern over time, sometimes a record of what has already been tried, and occasionally a plan requirement. That last point surprises people: several preventive therapies carry insurer criteria that must be documented before coverage applies, and meeting those criteria is part of the clinical work rather than an administrative afterthought. Our team verifies coverage and any prior authorisation before an appointment rather than after, and the detail sits on the insurance page.
What this page will not tell you
It will not tell you which treatment you need, because that cannot be decided from a page. It will not promise a result, because two patients with the same diagnosis can follow different courses and a practice that guarantees an outcome is describing its marketing rather than its medicine. And it will not present a treatment as available here when it is coordinated elsewhere, which is why the second group below is separated out rather than folded into the list.
Neurological treatment is the medical management of a confirmed disorder of the brain, nerves or muscles, using medication, in-office procedures or coordinated therapy, chosen after a diagnosis rather than in place of one.
02In-office neurology treatments performed at CNS
Five treatments are performed inside CNS offices in Las Vegas and Henderson. Each has its own guide covering candidacy, what the appointment involves and what follow-up looks like.
In-office neurology treatments, and what that phrase excludes
In-office neurology treatments are those performed by CNS staff, in a CNS office, on the same day a patient attends for them. That excludes anything requiring a hospital, an operating theatre, an infusion suite or an interventional radiology suite, and it excludes treatments a practice arranges on a patient's behalf. Drawing the line that tightly leaves a shorter list than many practices publish, and it is a list a patient can plan a diary around. Each of the five below is short enough to fit alongside a working day and none requires sedation or a driver.
Botox for migraine Henderson NV and Las Vegas
Onabotulinumtoxin A injections are an established preventive option for chronic migraine, and chronic migraine has a specific definition: fifteen or more headache days a month with migraine features on at least eight. That definition, rather than how severe the headaches feel, is what determines candidacy. Treatment is given as a series of small injections following a fixed pattern across the head and neck, takes a short appointment, and is repeated on a schedule rather than taken as needed. Patients seeking Botox for migraine Henderson NV attend the West Horizon Ridge Parkway office; the same treatment is available at West Flamingo Road. Detail is on the Botox for chronic migraine guide.
CGRP migraine therapy Nevada
Calcitonin gene-related peptide therapies are a newer class of migraine preventives that target a specific pathway involved in migraine attacks. They are considered when migraine frequency justifies prevention rather than acute treatment alone, and the choice between a CGRP therapy and other preventive options depends on the pattern, what has been tried, other medical conditions and plan criteria. CGRP migraine therapy Nevada patients ask about is prescribed and monitored here, with response reviewed over months rather than weeks. Detail is on the CGRP migraine therapy guide.
BPPV treatment Henderson NV: canalith repositioning
Benign paroxysmal positional vertigo is caused by displaced particles in the inner ear, and it is one of the few conditions in neurology with a mechanical treatment. Canalith repositioning, often called the Epley manoeuvre, is a sequence of guided head and body positions performed by a clinician to move those particles out of the affected canal. It is done in the office, takes minutes rather than a session, and is preceded by positional testing to confirm which canal is involved. BPPV treatment Henderson NV patients receive is identical at both offices. Detail is on the BPPV repositioning guide.
Occipital nerve blocks and nerve blocks for headache
An occipital nerve block delivers local anaesthetic, sometimes with a steroid, around the occipital nerve at the back of the head. It is used for occipital neuralgia and for selected headache patterns where the examination localises tenderness to that nerve. Related nerve blocks target other specific sites depending on where the examination points. Both are short in-office procedures performed after a diagnosis, not offered as a first response to headache. Detail is on the occipital nerve block guide and the nerve blocks for headache guide.
| Treatment | Considered for | Appointment length | Both offices |
|---|---|---|---|
| Botox for chronic migraine | Chronic migraine by definition, on a repeating schedule | Short, repeated | Yes |
| CGRP therapy | Migraine frequency justifying prevention | Prescribed and monitored | Yes |
| BPPV canalith repositioning | Confirmed positional vertigo | Minutes | Yes |
| Occipital nerve block | Occipital neuralgia and selected headache patterns | Short | Yes |
| Nerve blocks for headache | Headache localised to a specific nerve on examination | Short | Yes |
Wondering whether you are a candidate?
Candidacy is a clinical judgement. Describe the diagnosis and our team will book the right appointment type.
03Treatments CNS coordinates rather than performs
Two treatments frequently associated with neurology are coordinated with outside providers rather than delivered in a CNS office, and separating them out is deliberate. A practice that lists everything a patient might eventually need, without distinguishing what it does from what it arranges, is making a claim it cannot keep at the appointment.
Infusion and injection therapy
In-office infusion and injection therapy is coordinated with outside facilities. Where a treatment plan requires it, CNS makes the arrangement and remains the practice managing the underlying condition.
Disease-modifying therapy for MS
Disease-modifying therapy for multiple sclerosis is coordinated rather than administered here. MS continuity care is held by the Multiple Sclerosis Certified Nurse working alongside the medical director.
Surgery and interventional pain
Neither is within scope. Where a finding calls for an operation or an interventional pain programme, CNS refers with the accredited report attached rather than leaving you to restart the process.
Why the distinction is worth making explicitly
Patients choose practices partly on the service list, and a list that blurs performed with arranged produces a specific kind of disappointment: the treatment discussed at booking turns out to happen somewhere else, on a different timeline, with a different clinician. Naming the difference in advance costs a practice some apparent breadth and saves the patient a wasted expectation. It also makes the coordinated pathway work better, because a referral planned from the start moves faster than one improvised after a consultation.
04Neurological treatment options Las Vegas patients ask about most
Neurological treatment options Las Vegas patients raise at a first appointment cluster around four questions, and they are worth answering here because the answers shape what the visit can realistically achieve.
Neurological treatment options Las Vegas residents compare
Neurological treatment options Las Vegas residents compare most often are the two migraine preventives, because they occupy the same clinical slot and patients reasonably want to know which is better suited to them. The answer is not general. It depends on headache frequency and pattern, on what has already been tried and for how long, on other medical conditions and medications, on whether a repeating in-office appointment or a prescription fits your life better, and on plan criteria. That is a conversation rather than a comparison table, which is why this page describes what each treatment is instead of ranking them.
Will I leave with a treatment today
Sometimes, and often not. Where the diagnosis is already clear and the treatment is a prescription, a plan can start the same day. Where the diagnosis needs a study first, the visit produces a diagnostic plan rather than a treatment, and that is the right order even when it is not the hoped-for one. BPPV repositioning is the clearest exception: positional testing and the treatment itself can both happen in a single appointment.
Is medication the only option
No. Several conditions are managed with monitoring rather than medication, because the diagnosis itself changes what a patient does rather than what they take. Others combine medication with the in-office procedures above. And some improve with changes a neurologist can identify but not prescribe, particularly in headache, where sleep, hydration, caffeine and medication overuse are frequently part of the pattern and frequently missed.
How long before we know whether it is working
That depends on the treatment. Preventive migraine therapies are typically assessed over months rather than weeks, because the measure is a change in headache frequency across a period long enough to be meaningful. Repositioning for BPPV is assessed immediately. Nerve blocks are assessed over days. Setting that expectation at the start prevents a treatment being abandoned before it has had the chance to be evaluated fairly.
What happens if it does not work
The plan changes, which is why follow-up is part of the treatment rather than an optional extra. A preventive therapy that has not helped after a fair trial is stopped rather than continued indefinitely, and the alternatives are considered against what the trial revealed. That iterative process is most of what long-term neurological management consists of, and it is the argument for continuity with one practice, described further on the services hub.
05Where treatment fits alongside diagnosis and management
Treatment is the third of three services rather than a standalone offer. It follows a diagnostic consultation and, where needed, the accredited in-office testing described on the diagnostic testing hub. It precedes the long-term management that most neurological conditions require. Reading the three together gives a more accurate picture of what a year of care actually looks like than reading any one alone.
The conditions these treatments belong to
Four of the five in-office treatments sit within headache and facial pain, which is the highest-volume group in adult neurology and the one where the gap between an accurate diagnosis and a generic one is widest. The fifth, canalith repositioning, belongs to the balance group, where objective positional testing separates an inner-ear cause from a central one. The full set of fourteen condition groups the practice manages is indexed on the conditions hub, and most of those are managed with medication and monitoring rather than with a procedure.
Bringing a treatment plan from another practice
Patients transferring care frequently arrive mid-treatment, and the useful thing to bring is the detail rather than the headline. Which preventive, at what dose, started when, and what changed. A treatment that appears to have failed sometimes turns out to have been stopped before a fair trial had elapsed, or given at a dose below the one intended, and that is only visible from the record. Request the full notes rather than a summary through medical records and bring them to the first appointment.
Both offices, same treatments
All five in-office treatments are available at both the West Flamingo Road and West Horizon Ridge Parkway addresses, and the physicians rotate through each. The choice between offices is therefore a commute decision rather than a capability one, with the single exception that a specific provider or a specific procedure day may only be available at one site in a given week. Telling the scheduling team which matters more to you is the fastest way to resolve that.
What is deliberately absent from this page
There are no before-and-after claims, no success percentages and no patient testimonials attached to a procedure. Those are the three devices most often used to sell neurological treatment and the three least defensible on a medical page, because the underlying variability between patients makes any single figure misleading. What replaces them is a clear statement of what each treatment is, who it is considered for, and how response is assessed, which is information a patient can actually use when deciding whether to ask about it.
Explore Every Treatment
7 in-depth guidesThis hub is the parent index for neurology treatments at CNS. The first five guides cover treatments performed inside our own offices. The final two cover treatments coordinated with outside providers, and they are listed separately so the distinction between what the practice performs and what it arranges is never left to inference.
Start Here — Cornerstone Guides
Botox for chronic migraine
Candidacy rests on the chronic migraine definition rather than on how severe the headaches feel.
Read the guide → In-officeCGRP therapy for migraine prevention
A newer preventive class, assessed over months rather than weeks.
Read more → In-officeBPPV canalith repositioning
The one treatment here that is mechanical, and the one assessed immediately.
Read more →Browse by Category
Migraine prevention, in-office
Headache procedures, in-office
Balance, in-office
Coordinated with outside providers
Five board-certified physicians
Leo Germin, M.D., FAANEM, founder and medical director, triple board-certified in Neurology and Vascular Neurology through the ABPN and Neuromuscular Medicine through the ABEM, with subspecialty certification in Neurosonology and Neuroimaging. Anup Panduranga, M.D., fellowship-trained in epilepsy. Eric Gutglueck, M.D., neuromuscular medicine and neuromuscular ultrasound. Jessica A. Knirk, M.D., general adult neurology with Botox for chronic migraine. William Lujan, M.D., broad general adult neurology.
Four advanced practice providers
Fara Tan, APRN, MSCN, a Multiple Sclerosis Certified Nurse through the Multiple Sclerosis Nurses International Certification Board. Lindsey Evans, PA-C, general neurology and electromyography. Terra Fonseca, PA-C, a surgical and vascular background applied to general adult neurology. Alissa Nakamura, PA-C, board-certified through the NCCPA, with three years in pain management that transfer directly to nerve-injury and neuropathy questions.
Spread, not headcount
A referral that lands somewhere without neuromuscular or epilepsy depth often becomes a second referral, and each handoff adds weeks. Here an ambiguous nerve study can be reviewed by a neuromuscular specialist and an ambiguous EEG by a fellowship-trained epileptologist without the patient leaving the practice. Full biographies are on the providers page.
The Bottom Line
Treatment follows diagnosis. Five procedures are performed inside CNS offices, two are coordinated elsewhere, and candidacy for each is a clinical judgement made after an examination rather than a request granted at booking.
Frequently Asked Questions
What treatments does CNS perform in-office?
Five: Botox for chronic migraine, CGRP therapy for migraine prevention, BPPV canalith repositioning, occipital nerve blocks, and nerve blocks for headache. All five are available at both the Las Vegas and Henderson offices.
Which treatments does CNS coordinate rather than perform?
In-office infusion and injection therapy, and disease-modifying therapy for multiple sclerosis. Both are arranged with outside providers while CNS continues to manage the underlying condition. Surgery and interventional pain management sit outside scope entirely.
Am I a candidate for Botox for chronic migraine?
That depends on whether you meet the chronic migraine definition, which is fifteen or more headache days a month with migraine features on at least eight, and on what has already been tried. It is a clinical judgement made after an examination, and plan criteria may also apply.
How is CGRP therapy different from Botox?
They are different classes with different administration. CGRP therapies target a specific pathway involved in migraine attacks and are prescribed and monitored; Botox is given as a series of injections on a repeating schedule. The choice depends on the pattern, prior treatments, other conditions and plan criteria.
How quickly does BPPV repositioning work?
It is assessed immediately rather than over weeks, which makes it unusual among the treatments here. Positional testing confirms which canal is involved, the repositioning sequence is performed in the office, and the effect is evaluated in the same appointment.
Will I get a treatment at my first appointment?
Sometimes. Where the diagnosis is already clear a plan can start the same day, and BPPV testing and repositioning can both happen in one visit. Where a study is needed first, the appointment produces a diagnostic plan instead, which is the correct order.
What happens if a treatment does not help?
The plan changes. A preventive therapy that has not helped after a fair trial is stopped rather than continued, and alternatives are considered against what the trial showed. Follow-up is part of the treatment rather than an optional extra.
Does CNS perform surgery or interventional pain procedures?
No. CNS is a diagnostic and medical neurology practice for adults 18 and older. Where a finding calls for surgery or an interventional pain programme, the practice refers with the accredited report attached.
How this page was sourced
Practice facts here come from Clinical Neurology Specialists directly: which treatments are performed in-office, which are coordinated with outside providers, that all five in-office treatments are available at both addresses, and that surgery and interventional pain management sit outside scope. Clinical context is sourced to the organisations listed below.
The chronic migraine definition quoted, fifteen or more headache days a month with migraine features on at least eight, is a diagnostic criterion rather than a CNS figure. No success rates, before-and-after claims or testimonials appear on this page, because between-patient variability makes any single figure misleading. Scope is adults 18 and older.
References
- American Academy of Neurology — clinical practice guidance for headache and movement disorders.
- National Institute of Neurological Disorders and Stroke — the reference catalogue of nervous-system disorders.
- American Association of Neuromuscular & Electrodiagnostic Medicine — laboratory accreditation for the diagnostic work that precedes treatment.
This page is for general education about adult neurological care and is not medical advice, a diagnosis, or a treatment recommendation. It does not create a physician-patient relationship. Adults 18 and older. For an active stroke, a first-time or prolonged seizure, sudden severe headache, sudden weakness, sudden vision loss, or a head injury with loss of consciousness, call 911 or go to the nearest emergency department. Speak with a qualified clinician about your own circumstances.