NeuroMedical Center Clinic Neurodiagnostic Lab
If you are experiencing symptoms that could indicate an illness or condition affecting your brain or spine, a physician may refer you to The NeuroMedical Center Clinic’s Neurodiagnostic Lab for testing. Our state-of-the art technology and neurologists are located on the 4th floor.
Our outstanding Neurodiagnostic Lab provides a comprehensive battery of neurological testing procedures and specialized exams that diagnose, or rule out, central nervous system complications. All tests are administered by neurologists and certified technologists who all specialize in multi-modalities of neurodiagnostic and electrodiagnostic testing. Our team of neurologists interpret results, educate our patients on the findings and formulate customized treatment plans.
The NeuroMedical Center Clinic’s Neurodiagnostic Lab has met some of the most rigorous national standards based on quality and accuracy of tests administered. In 2007, our lab received accreditation by the organization formerly known as the Intersocietal Commission for the Accreditation of Vascular Laboratories. In 2008, we received the same recognition by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories. Both organizations are currently part of one prestigious accrediting body– the Intersocietal Accreditation Commission.
Carotid Ultrasound Studies (CUS) & Transcranial Doppler
A Carotid Ultrasound Study is a test performed inside The NeuroMedical Center Clinic’s Neurodiagnostic Lab that shows the vessels in the neck that provide blood flow to the brain. It also shows us how much blood flows through the vessels and how fast the blood travels through them. Ultrasound waves are used to make an image of the arteries. These images can be used to find out if there is an abnormality or blockage of the carotid artery that could lead to a stroke.
A Transcranial Doppler is a test that evaluates the blood vessels in the skull that supply the brain with blood. Continuous Doppler waves measure how sound waves change in pitch as they encounter blockages or narrowed blood vessels.
Physicians order this test for patients who have had a stroke or who may be at risk for a stroke. Narrowing of the arteries and blood clots can be detected by using this procedure. The conditions can cause problems with the blood flow to the brain and cause a stroke.
What You Can Expect
There is no special preparation required for an ultrasound-please come as you are and eat or drink as you normally do.
Once it is time for your CUS or TCD, you will be kindly escorted to a dimly lit ultrasound room that contains an examination table and an ultrasound machine. The sonographer performing the test will ask you a few questions before starting the test. He or she will ask you to lie flat on your back on the examination table, and once you are comfortable, a special gel will be applied to a handheld device (a transducer) which will receive harmless ultrasound waves. The sonographer will then begin to record images by methodically and precisely moving the transducer around your neck (for CUS) or eyelids and the area around your temples (for TCD).
CUS and TCD tests should take no longer than 30 minutes to complete. Following the recording of your images, the sonographer will wipe off the ultrasound gel from your skin, help you off the examination table and escort you out of the Neurodiagnostic Lab. The ultrasound images will them be submitted to a Neurologist who is specialty-trained in reading vascular ultrasound. Please call your physician’s nurse in two to three days for the results. The sonographer will not provide you with any results at the time of your exam.
An Electroencephalogram is a test performed inside The NeuroMedical Center Clinic’s Neurodiagnostic Lab that painlessly measures and records electrical signals normally generated by the brain. Special sensors (electrodes) are attached to your head and hooked by wires to a computer. The computer records your brain’s electrical activity on the screen or on paper as wavy lines. The test shows areas of the brain that are not functioning correctly either because of too little or too much electrical activity. EEG is commonly used for diagnosing epilepsy and assessing other neurological complications like headaches, vertigo and stroke.
A physician may order an EEG to diagnose epilepsy and see what type of seizures are occurring. It is also used to check for problems with loss of consciousness or dementia. This test is also helpful when diagnosing sleep disorders such as narcolepsy.
What to Expect
Before an EEG test, you will be asked to wash or dry your hair the day before with shampoo only (please do not use conditioner or hair styling products.) Your hair and scalp need to be clean and free of excess oil. If you are on any medications, continue to take them unless told otherwise. Always eat before your test, but refrain from caffeine 24 hours prior to your EEG.
If your physician requests that you sleep during your EEG, you may be asked to stay up all or part of the night before your test. If so, please arrange for a driver to drop you off and pick you up.
During your test, you will be lying down on a bed in a semi-dark room. The EEG technologist will prep and safely apply the electrodes to your scalp with a non-damaging paste in predetermined spots.
You may be asked to do several things including:
- Relax ,open or close your eyes
- Breathe rapidly and deeply for a few minutes
- Watch a flashing light for a short time
- Relax and go to sleep
You may be asked to sleep during the EEG. To help you do this, you may be asked to stay up for an amount of time determined by the physician. Information recorded by the electrodes will be monitored by the certified sleep technologist.
After the EEG, the electrodes will be removed and your scalp cleansed. Once you get home, you are free to wash your hair normally to remove any excess paste that remains in your hair.
A standard EEG takes approximately one hour to complete, but can take longer depending on how long you are asked to sleep.
If your physician requests a 24-Hour Ambulatory EEG, the electrodes will remain attached to your scalp for a 24- hour period. The electrodes will be attached to a small computer-like device you will wear around your waist. You will not be able to shower or bathe while wearing this device. After the 24 hour testing period, you will return to The NeuroMedical Center Clinic where a neurologist will collect data recorded on your device.
Please call your physician’s nurse in two to three days for the results. The technologist will not provide you with any results at the time of your exam.
Electromyography and Nerve Conduction Velocity (EMG/NCV)
Electromyography and Nerve Conduction Velocity are tests performed inside The NeuroMedical Center Clinic’s Neurodiagnostic Lab that measure the health and function of nerves and muscles in your limbs and spine through mild shock stimulation.
A physician may order an EMG to diagnose neuromuscular disorders in patients with symptoms like numbness, tingling, burning and weakness of extremities. NCV is often used to pinpoint the cause of nerve damage or dysfunction.
What to Expect
Before your EMG/NCV you can shower or bathe, but please do not use any powder, lotion or oil on your skin.
You need to inform your technologist if you:
- Are taking any blood-thinning medications such as Coumadin or aspirin
- Have bleeding problems or a cardiac pacemaker or defibrillator
- Are a myasthenia patient on medication
When it is time to perform you EMG/NCV you will be asked to change into a gown and lie down on an exam table.
To perform an EMG, the physician will clean the area to be tested with alcohol. A small needle will be inserted to the selected muscle and may create a pinching sensation. Try to relax. No injection or stimulation is given through the needle. The needle electrodes will transmit a tiny electrical current that feels like a mild electric shock and may cause additional discomfort. The physicians will determine if your muscle is working normally by evaluating the activity seen and heard on the EMG monitor.
To perform an NCV, flat electrodes will be attached to your skin in the area to be tested. A mild electrical stimulation will be given to stimulate a portion of the nerve. The response will be recorded so that the doctor can evaluate and determine if the impulse is conducted normally, at a slow speed, or not transmitting at all. No activity suggests nerve damage.
The time to complete an EMG/NCS varies on how many areas are being evaluated but usually take between 30 minutes-1 hour to complete. Slight limb discomfort and temporary bruising is normal after an EMG.
After an EMG or NCV all electrodes will be removed. You will be able to resume your normal routine. The physician who ordered the study will give you the results of your test. This may take several days.