Referring a patient to Dr. Cajigas.
Dr. Iahn Cajigas, MD, PhD, sees patients on the Functional & Stereotactic Service of Penn Neurosurgery, based at Pennsylvania Hospital. This page covers who benefits from a surgical evaluation, how to send the referral, what records make the consultation most useful, and what happens after. For the patient-facing version of this information, see For Patients & Families.
Who to refer
- Movement disorders — Parkinson's disease, essential tremor, or dystonia with motor symptoms not adequately controlled on optimized medication. Evaluations cover DBS (including imaging-guided directional DBS), MR-guided focused ultrasound, Gamma Knife, and LITT.
- Drug-resistant epilepsy — patients who have failed two or more appropriately chosen anti-seizure medications. Evaluations cover resection, LITT, stereo-EEG workup, RNS, and VNS, coordinated with the Penn Comprehensive Epilepsy Center.
- Facial pain and refractory pain — trigeminal neuralgia (microvascular decompression, Gamma Knife, percutaneous options), occipital neuralgia, and chronic pain syndromes being considered for spinal cord stimulation, DRG, or peripheral nerve stimulation.
- Post-stroke upper-extremity impairment — patients at least six months out from ischemic stroke with persistent moderate-to-severe arm impairment despite rehabilitation, for paired vagus nerve stimulation evaluation.
If you are unsure whether a patient is a candidate, email a brief case summary — it is often faster than a formal referral for borderline questions.
How to send the referral
- Referral order: direct the referral to Penn Neurosurgery — Functional & Stereotactic Service (Dr. Iahn Cajigas), Pennsylvania Hospital.
- By phone: Penn Medicine's appointment line at 800-789-7366, or the Pennsylvania Hospital neurosurgery clinic directly at 215-829-6700.
- Case questions: iahn.cajigas@pennmedicine.upenn.edu · Penn Medicine provider profile
Video visits are available for patients in Pennsylvania, New Jersey, and Delaware where the type of evaluation allows. Most major insurance plans are accepted, including Medicare and Medicaid (PA & NJ).
What to send with the referral
The consultation is most useful when these arrive ahead of the visit:
- Recent brain MRI (images, not just the report — disc or electronic transfer)
- Current medication list with doses, and prior medication trials with reasons for discontinuation
- Relevant clinic notes (neurology, pain management, or rehabilitation)
- For epilepsy: EEG and video-EEG reports, and neuropsychological testing if done
- For movement disorders: documentation of levodopa response where available
What happens after the referral
- Records review. The team reviews the records to confirm a surgical evaluation is appropriate at this stage and schedules the right combination of specialists.
- Team visit. For movement disorders and epilepsy this is a team evaluation by design — the patient usually meets a neurologist and a neurosurgeon together, sometimes the same day. First visits run 45–60 minutes and end with a discussion of options, not a surgical decision.
- Condition-specific workup. Imaging, neuropsychology, video-EEG, or levodopa challenge as indicated, followed by presentation at the relevant multidisciplinary conference (movement disorders, epilepsy surgery, or pain).
- Recommendation. Patients receive the team's recommendation with alternatives and risks, and a written summary of recommendations that can be shared with you and used for second opinions. Your patient remains under your care throughout — surgical evaluation does not transfer their neurology or primary care.
Some surgical patients are eligible for intraoperative research studies conducted during their clinically planned procedure (see Clinical Trials). Research participation is optional, separately consented, IRB-reviewed, and never changes the clinical plan — declining has no effect on care. Referring physicians of trial candidates are kept in communication per protocol.