A critical mission of the Neurology department at the Ohio State Wexner Medical Center is to provide highly skilled diagnostic services and personalized, comprehensive care for neurological disorders, at a level of expertise typically only available at academic tertiary medical centers. The following list of clinics were developed to support those living with multiple sclerosis and neuroimmunology disorders, and their caregivers.

Aging with Multiple Sclerosis

Goal: To improve quality of life and prevent disability in older adults with MS through multidisciplinary care in geriatric neurology.

We provide comprehensive care for older adults with multiple sclerosis (MS) who are uniquely affected by overlapping symptoms of aging and MS. Our team manages issues related to functional capacity, gait and balance, bladder function, nutrition, cognition, mood, social support and medications. Our multidisciplinary clinic comprises a nurse practitioner, a physical therapist, a pharmacist, a social worker, a dietitian and a neuropsychologist.

Lead Physician: Yinan Zhang, MD
Lead Advanced Practice Provider: Kristi Epstein, APRN-CNP
Additional providers in this clinic: Brooke Gaul, PT, DPT, Margaret Hansen, PharmD, Emily Webster, LISW, Laura Domrose, RDN, CSO, Rochelle O’Neil, PhD

Multiple Sclerosis and Neurology Preconception Planning and Pregnancy Clinic

Goal: To offer pre-pregnancy counseling, monitoring during pregnancy and guidance with symptomatic management during pregnancy and the postpartum period for patients with MS and other underlying neuroimmunological disorders.

This preconception clinic focuses on preparing the patient for pregnancy. This includes a review of current medications and plans for continuation or change in disease-modifying therapy (if indicated). During pregnancy, we monitor for possible relapse and discuss current symptoms and concerns. We discuss breastfeeding goals and medication options available while breastfeeding. In the postpartum clinic, we focus on breastfeeding and symptomatic management following delivery. After the final visit, the patient goes back to their original neurologist for long-term care.

Lead Physician: Allison Jordan, DO

Multiple Sclerosis Psychotherapy Clinic

Goal: To provide evidence-based psychotherapy including cognitive-behavioral therapy, acceptance and commitment therapy, behavioral activation and motivational interviewing for patients with multiple sclerosis.

Patients with MS will receive evidence-based psychotherapy with a clinical neuropsychologist or psychologist to address a wide range of issues, including adjustment to chronic illness/disability, depression/anxiety symptoms and fatigue. Treatment will be individualized to fit each patient’s unique needs and will broadly focus on learning new coping strategies for addressing symptoms and enhancing quality of life. We use evidence-based treatment approaches including cognitive-behavioral therapy, acceptance and commitment therapy, behavioral activation and motivation interviewing.

Lead Physician: Tirisham Gyang, MD
Lead Neuropsychologist: Rochelle O’Neil, PhD
Additional providers in this clinic: Manisha Sawhney, PhD

Neuro-Rheumatology Clinic

Goal: To provide accurate assessment and diagnosis as well as symptom management of neurological manifestations of systemic inflammatory and rheumatologic disorders through a multidisciplinary clinic.

Physicians will provide assessments, diagnoses, and symptom management for patients with neurological manifestations of systemic inflammatory and rheumatologic disorders. A neuroimmunologist works in collaboration with rheumatologists. Disorders we see include neuro-psychiatric lupus, neurologic manifestation of Sjogren’s syndrome, vasculitis and connective tissue disorder.

Lead Physician: Tirisham Gyang, MD

Neurosarcoidosis Clinic

Goal: To provide accurate assessment and diagnosis as well as symptom management of patients diagnosed with neurosarcoidosis.

Our team works together to provide a comprehensive care plan and access to innovative research opportunities to better understand and treat patients with neurosarcoidosis. Our multidisciplinary clinic comprises a neuroimmunologist and pulmonologist.

Lead Physician: Tirisham Gyang, MD

Quality of Life Multiple Sclerosis Clinic

Goal: To develop a comprehensive plan to improve the quality of life for patients with multiple sclerosis.

Patients diagnosed with multiple sclerosis meet with our nurse practitioner who specializes in MS. Patients can address concurrent issues including disease education, disease-modifying therapy education, diet, exercise and supplement education, and are provided referrals to visits with specialists to address associated symptomatic conditions.

Lead Physician: Tirisham Gyang, MD
Lead Advanced Practice Provider: Kristi Epstein, APRN-CNP

Multiple Sclerosis Multidisciplinary Symptom Management Clinic

Goal: To provide accurate assessment and diagnosis of multiple sclerosis, as well as symptom management through evidence-based therapies.

Patients with multiple sclerosis (MS) meet our multidisciplinary team to evaluate and create a treatment plan for a range of MS-related symptoms including fatigue, mood disorders/depression, cognitive and memory issues, spasticity, imbalance and unsteady or labored gait, weakness, incoordination, speech and swallowing difficulties, pain and bladder dysfunction. Our multidisciplinary clinic comprises a neuroimmunologist and nurse practitioners, a registered nurse, a physical therapist, a social worker, a dietitian and a psychotherapist.

Lead Physician: Tirisham Gyang, MD
Lead Advanced Practice Provider: Kristi Epstein, APRN-CNP
Additional providers in this clinic: Vicki Kascsak, RN, Rochelle O’Neil, PhD, Erica Dawson, PhD, Emily Webster, LISW, Margaret Hansen, PharmD, Meredith Puckett, PharmD, Laura Domrose, RDN, CSO

Multiple Sclerosis Fatigue and Sleep Clinic

Goal: To diagnose, treat and manage patients with multiple sclerosis and underlying fatigue and sleep disorders.

This clinic identifies patients who have multiple sclerosis and an underlying sleep disorder. Customized treatment plans are started for each patient, and we assess the need for a polysomnography or further investigational studies. This subspecialty clinic is led by a physician who’s a specialist in both neurological conditions and sleep disorders.

Lead Physician: Tirisham Gyang, MD
Lead Sleep Physician: Meena Khan, MD