The human nervous system is an intricate and complex network of fibers that impenetrates the entire body and functions in complicated and often mysterious ways. Sophisticated imaging and laboratory tests do not always provide sufficient information about how the nerves are functioning -- or not functioning, as the case may be. The neurological examination is a series of simple questions and tests that provide crucial information about the nervous system. It is an inexpensive, noninvasive way to determine what might be wrong. The neurological examination is divided into several components, each focusing on a different part of the nervous system such as, mental status, cranial nerves, motor system, sensory system, the deep tendon reflexes, coordination and the cerebellum, gait. The exam requires skill, patience, and intelligence on the part of the physician, and cooperation from the patient. Incomplete or inaccurate exams can lead to incorrect diagnoses.

A sleep study is a recording that includes measurements used to identify different sleep stages, breathing pattern, blood oxygen level, muscle activity and heart rhythm. The recording is done by using small metal discs (called electrodes) applied to head and skin with an adhesive. Flexible elastic belts around the chest and abdomen measure breathing. Blood oxygen saturation is measured by a clip on index finger or earlobe. None of these devices are associated with pain and all are designed to be as comfortable as possible. The recording generally takes between 6 and 8 hours at night and is performed in a comfortable and quite private room.

An electroencephalogram (EEG) is a test to detect abnormalities in the electrical activity of the brain. In an EEG, electrodes are placed on the scalp over multiple areas of the brain to detect and record patterns of electrical activity and check for abnormalities. The test is performed by an EEG technician in our office. You will be asked to lie on your back on a table or in a reclining chair. The technician will apply between 16 and 25 flat metal discs (electrodes) in different positions on your scalp. The discs are held in place with a sticky paste. The electrodes are connected by wires to an amplifier and a recording machine. The recording machine converts the electrical signals into a series of wavy lines that are drawn onto a moving piece of graph paper. You will need to lie still with your eyes closed because any movement can alter the results. You may be asked to do certain things during the recording, such as breathe deeply and rapidly for several minutes or look at a bright flickering light.

Electromyography is a test that assesses the health of the muscles and the nerves controlling the muscles. For an EMG, a needle electrode is inserted through the skin into the muscle. The electrical activity detected by this electrode is displayed on an oscilloscope, and may be heard through a speaker. After placement of the electrodes, you may be asked to contract the muscle (for example, by bending your arm). The presence, size, and shape of the wave form -- the action potential -- produced on the oscilloscope provide information about the ability of the muscle to respond when the nerves are stimulated. A nerve conduction velocity test is usually performed in conjunction with an EMG.

Nerve conduction velocity (NCV) is a test of the speed of conduction of impulses through a nerve. The nerve is stimulated, usually with surface electrodes, which are patch-like electrodes (similar to those used for ECG) placed on the skin over the nerve at various locations. One electrode stimulates the nerve with a very mild electrical impulse. The resulting electrical activity is recorded by the other electrodes. The distance between electrodes and the time it takes for electrical impulses to travel between electrodes are used to calculate the nerve conduction velocity. Electromyography is often done at the same time as the NCV test.

A trigger point is a portion of the muscle that has become a source of pain and dysfunction. Injecting a trigger point can help to eliminate it. While the trigger point is being injected, you may briefly experience the same pain has been previouslt aching. Two to three days after your injection, you should notice a decrease in your pain along with increased freedome of movement.

Botox injections are approved for treatment of cervical dystonia in adults to decrease the severity of abnormal head position and associated neck pain. It is also indicated for the treatment of strabismus and blepharospasm. Botox therapy blocks the nerve from releasing acetylcholine. As a result, the muscle spasms stop or are greatly reduced, providing relief from symptoms.

A polysomnograph is a test of sleep cycles and stages through the use of continuous recordings of brain waves (EEG), electrical activity of muscles, eye movement (electrooculogram), breathing rate, blood pressure, blood oxygen saturation, and heart rhythm and direct observation of the person during sleep. You will lie on a bed in the test center. The test may be carried out during the night so that normal sleep patterns can be reproduced. Electrodes are placed on the chin, the scalp, and the outer edge of the eyelids in preparation for the test. Characteristic patterns from the electrodes are recorded while you are awake with your eyes closed and during sleep. The time taken to fall asleep is measured as well as the time to enter REM sleep. Sometimes the movements of a person during sleep are recorded by video camera.

If you are visiting us with a "General Appointment" then the procedure/appointment descrition varies! If you would like more information about your appointment and what to expect during it, give us a call!

Neuropsychological Testing is a series of tests that test your cognitive functioning, attention span, visual-spatial skills, auditory processing-skills, concentration, etc. They are used to measure the type and amount of cognitive deficits that you have in order to help tailor the type of rehabilitation that would most benefit you.