Neuropathy

Neuropathy refers to dysfunction of the peripheral nerve. It often presents with progressive pain and/or numbness. The EMG study shows decreased amplitude in the SNAPs (sensory nerve action potentials). This form of neuropathy is usually due to a toxic-metabolic insult such as chemotherapy, diabetes or chronic alcohol use. Sometimes it is the result of connective tissue diseases such as lupus, polyarteritis nodosa or Sjogren’s syndrome. All of these conditions have to be screened for in any evaluation. Sometimes no cause is found and treatment is symptomatic.

There is another very common neuropathic condition seen almost exclusively in the elderly, and it present with progressive imbalance. It is called CIDP (chronic immune demyelinating polyneuropathy) and is an autoimmune condition where there is a loss of myelin in the peripheral nerve. Myelin is the fatty tissue which surrounds every nerve and which enhances conduction. When it is damaged, conduction of electricity in the nerve is slowed. More importantly, different frequencies travel at different velocities (dispersion), the message from the nerve is scrambled, and the brain is no longer sure where the limb is in space. The result is an imbalance. This is a serious condition since it can result in falling, yet it is often highly treatable with intravenous immunoglobulin (ivIg). The EMG signature is slowing of nerve conduction.

CIDP is not usually associated with monoclonal proteins but sometimes it is. These must be screened for with a blood test known as immune protein electrophoresis since a monoclonal spike in the blood could represent a more malignant underlying condition such as multiple myeloma or lymphoma. If the spike is of the IgG type, then a bone marrow aspiration is mandatory. Usually, this is negative for malignancy and most of these neuropathies are treatable. If it is IgM then it is usually benign but is usually less responsive to ivIg.

Michael Hutchinson, MD

Neurologist located in New York, NY

Michael Hutchinson MD, PhD is a neurologist at New York Core Neuroscience serving patients in New York, New York. A graduate of the highly competitive PhD-to-MD program at the University of Miami, Dr. Hutchinson received his medical degree in 1988. During his residency training at the University of Washington, he developed a method of treating status epilepticus (the most lethal form of epilepsy) that is now the standard of care in the US. In addition to extensive training in multiple sclerosis, Dr. Hutchinson completed a two-year fellowship in neuroimaging at UCLA. He is currently Senior Faculty  at the Icahn School of Medicine at Mount Sinai, New York.

Dr. Hutchinson is board certified in both neurology and neuroimaging and is President of the American Society of Neuroimaging. He holds a PhD in molecular physics in addition to his medical degree. A medical pioneer, Dr. Hutchinson proposed a novel treatment for status epilepticus in 1990, now the standard of care. He was the first to use cholinesterase inhibitors for the dementia of Parkinson’s disease (1995) and developed a novel approach to treating acute relapses in multiple sclerosis (2002). He is the inventor of the parallel MRI (1987), which is now the world standard for magnetic resonance imaging.

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New York Core Neuroscience

Michael Hutchinson MD, PhD is a neurologist at New York Core Neuroscience serving patients in New York, New York. A graduate of the highly competitive PhD-to-MD program at the University of Miami, Dr. Hutchinson received his medical degree in 1988. During his residency training at the University of Washington, he developed a method of treating status epilepticus (the most lethal form of epilepsy) that is now the standard of care in the US. In addition to extensive training in multiple sclerosis, Dr. Hutchinson completed a two-year fellowship in neuroimaging at UCLA. He is currently Senior Faculty  at the Icahn School of Medicine at Mount Sinai, New York.

Dr. Hutchinson is board certified in both neurology and neuroimaging and is President of the American Society of Neuroimaging. He holds a PhD in molecular physics in addition to his medical degree. A medical pioneer, Dr. Hutchinson proposed a novel treatment for status epilepticus in 1990, now the standard of care. He was the first to use cholinesterase inhibitors for the dementia of Parkinson’s disease (1995) and developed a novel approach to treating acute relapses in multiple sclerosis (2002). He is the inventor of the parallel MRI (1987), which is now the world standard for magnetic resonance imaging.


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Our medical practice works closely with numerous insurance carriers to ensure that our patients get the care that they need and deserve. If you have any questions or do not see your insurance carrier listed, please contact our office directly. We now accept Oscar Commercial Insurance, and effective as of October 1st, Dr. Hutchinson is in-network with HIP Medicare Advantage and HIP commercial plans.

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    "Finding Dr. Hutchinson has saved my life from migraines that I have suffered from all my life. I love him! I highly recommend him to anyone who needs a neurologist."

    Lisa M.
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    "Dr. Hutchinson is a great physician. He takes time with his patients and really listens to his patients - which is a rarity today in health care!"

    Christine S.
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Michael Hutchinson, MD
345 East 37th Street
Suite 320
New York, NY 10016