Neurodiagnostic / Testing
At Pinehurst Neurology we offer several different types of neurologic testing which will aid your physician in diagnosing and managing many different neurological diseases. Neurodiagnostic testing can assess both the central (brain and spinal cord) and peripheral (nerve and muscle) nervous system. We strive to perform these studies in the most comfortable and safe environment. The most common neurodiagnostic studies are listed below.
1. Nerve conduction studies (NCS) /electromyogram (EMG): The nerve conduction studies and electromyogram are typically performed together on the same day. Under special circumstances, you may need ONLY one or the other.
These tests are used to evaluate the function of the nerves in the arms and legs as well as the electrical activity of the muscles. Some types of electrical activity are normal while other patterns of electrical activity may suggest a problem with the nerves or muscles. This examination is helpful in patients who complain of numbness, tingling, pain, weakness and fatigue.
Nerve conduction studies will tell how well signals are carried along a nerve. This may tell your doctor the location of a nerve problem as well as the cause of that problem. The test is performed by applying a small electric pulse to a nerve at one site and recording at a different place along the nerve from pads or electrodes taped to the skin of the hands or feet. The shocks are too small to be harmful. The stimulation may cause a small tingling sensation such as the feeling you get from static electricity. You might feel a muscle twitch when the stimulation is delivered. The responses are recorded in a computer and will be reviewed by the neurologist. Depending on the specific problem, several nerves may need to be examined.
There are no specific risks from this test. Most studies would suggest that they are safe even for patients who do have a pacemaker or other stimulator in place.
Electromyography (EMG) measures the electrical activity from individual muscles. This test is often used to evaluate any nerve damage going to a specific muscle (or group of muscles) or problem with the muscles themselves. During this portion of the examination, a thin needle electrode was inserted into the muscle to record the electrical activity. The electrical activity is displayed on an instrument and in addition can be heard through a speaker. This portion of the test is performed by a board-certified neurologist.
There are no serious risks from this test. The needles are very tiny; thinner than the type used to draw blood. When the electrode is inserted into the muscle however, this may be associated with some mild discomfort. The electrodes are used only once and are discarded after each study. There are no after effects of the examination although the muscles may be sore after the examination for a short time.
A board-certified neurologist will interpret the study and prepare a report within a few days.
2. Electroencephalogram (EEG): The electroencephalogram is most often used to help in the diagnosis of seizure disorders. This may also be used to monitor the effectiveness of anti-seizure medications in patients with epilepsy. Other problems which are evaluated with an EEG may include unusual spells, confusion, head injury or other disorders which cause worsening mental impairment or brain dysfunction.
An electroencephalogram (EEG) involves recording of the brain's electrical activity. During the test, you will sit in a comfortable chair and small metal electrodes are applied to the scalp. . A special gel will help the electrodes stay in place and help record your brain waves more efficiently. The electrical activity of the brain is detected and recorded onto a specialized computer. These patterns are typically referred to as "brain waves." The examination typically takes between 30-90 min.
During the course of the evaluation, the technologist may ask you to perform some simple activities such as breathing quickly and deeply and possibly looking at a strobe light. In some cases, you may fall asleep during the study. A video monitor will be attached to the computer as well to record any physical spells or seizures.
In preparation for your EEG, we do ask that the hair being washed the night before the test and that you do not apply oily preparation such as hairspray.
There are no risks to the test. Your neurologist will review the tracings and prepare a report in a few days.
3. A prolonged (or 12 hour) electroencephalogram (EEG) may be performed under certain circumstances. This is similar to the routine EEG described above. This may be requested in circumstances where the nature of certain spells (or seizures) are not clear.
The study is performed in a similar manner to the routine EEG described above. In this case however you will remain in the office for a period of 12 hours while they recording takes place. Our technologist or nurse will be close by should any changes occur. During that time, you may watch TV, read a book or perform other quiet activities. We will be able to provide snacks and drinks during the course of the study.
No special preparation is necessary except as described above. There are no after effects from this type of examination.
4. CNS Vital Signs (R): Patients are often seen with complaints of memory loss, confusion and poor concentration. In addition to routine office testing, your physician may request a computerized neuropsychological assessment.
There is no specific preparation for this testing. It requires NO knowledge of computers. You will be asked a series of questions testing memory, concentration and simple problem solving. The test takes about 25-35 minutes and will be reviewed by your neurologist. This type of examination can provide clarification and grading of impariment in patient's with dementia, Mild Cognitive Impairment (MCI), head injury, etc.
The neurologist will review the results and prepare a report in a few days.
5. Sleep Disorders: Click here to learn more about our certified Sleep Disorders Clinic