An EEG is a recording of the electrical activity of the brain. Fluctuating electrical activity produced by the brain is recorded as wavy lines. The EEG is a totally painless procedure, which takes approximately 45 minutes to 1 hour.
Small metal discs (electrodes) are attached to the patients scalp with an adhesive gel at predetermined locations. You may be required to sleep for a portion of the test. You may be asked to hyperventilate (Breathe through the mouth faster than normal).
A strobe light, flashing at different speeds, hyperventilation and photic stimulation may activate abnormal activity of the brain it is then transmitted through wire to the EEG machine and is recorded on graph paper. Your doctor will interpret the recording and discuss the results with you at your follow-up visit.
This procedure measures the electrical activity of muscle fibers to help diagnose problems with nerves and/or muscles. During the testing, a very thin Teflon-coated probe is inserted into a sampling of muscles. Amplified noises of neuromuscular activity will be heard during the procedure and the computer monitors the muscle’s own natural electrical activity. A muscle controlled by a healthy nerve should be QUIET when it is relaxed. A muscle that is NOISY is controlled by a nerve that is damaged.
NCV Nerve Conduction Velocity
This procedure helps to determine which nerve is causing your symptoms, where on the nerve the problem is originating and whether it is acute or a chronic condition. During the test, the nerves are electrically stimulated to cause a response. The computer times how long it takes these electrical messages to travel. To obtain the velocity, the distance traveled is measured and divided by the time. An example of this type of calculation is miles per hour. If a nerve is damaged, it takes the message longer to travel the measured distance.
EVOKED POTENTIALS Auditory/Visual/Somatosensory
These tests produce graphic recordings of the central nervous system response to sensory stimuli.
Visual Evoked Potential
This test is used to evaluate the visual nervous system. The patients will be shown a TV screen with a rapidly changing geometric pattern. One eye is tested at a time. Electrodes are placed on the patient’s head to measure the brain’s response.
Auditory Evoked Potential
Used to evaluate the auditory system and brain stem. Earphones are placed on the patient and sound such as clicks will be transmitted into the earphones. Only one ear at a time will be tested. Electrodes are placed on the head to measure the brains response.
Somatosensory Evoked Potential
Used to evaluate the electrical activity of the peripheral nervous system. Electrodes are placed on the wrist and/or knee’s to provide a mild electrical stimulation. Electrodes are also placed on the head to measure the brain’s response.
Please come to the test with clean hair that is free from oils, gels, lotions, and no hair spray. Plan to wash your hair after the test.
CUS (Ultrasound of Carotid Arteries)
A CUS is done to evaluate for blockage 0r “hardening” of the carotid and vertebral arteries. The test is performed by placing a transducer on the skin and positioning it to produce an image on an accompanying monitor. A 2-D image of the carotid arteries is produced using ultrasound waves, similar to “sonar”, that are used to image the walls of the artery and any plaque that may be present. The pictures, along with hte measurements of blood flow velocity, tell if there is any blockage and how severe it may be.
Arterial Doppler Studies (Ultrasound of the Lower Extremities)
This ultrasound test is used primarily to diagnose arterial and venous disease, to evaluate blood vessels and its structures for blockages. Ultrasound beams are bounced off moving red blood cells to measure velocity or flow of blood though veins. The returning sound waves from the Doppler transducer are transformed into sounds for the examiner to evaluate. Ultrasound gel is used wherever the transducer is applied to the skin to locate venous or arterial blood flow. With arterial studies, blood pressure cuffs are placed proximal to the transducer and flow is verified as pressure in the blood pressure cuff is released.
This test is done as a baseline, so that we can better monitor your memory and see how or if it is changing from year to year, which will help with an early diagnosis and/or treatment, and determine if it is just regular aging.
Because memory loss is very different for everyone, and there are different medicines, knowing your particluar pattern of deficits, will help find the right treatment. This testing will take from 3 to 4 hours.
MRI (Magnetic Resonance Imaging)
The MRI provides detailed, two-dimensional “pictures” of soft tissue. The standard MRI is a large, tube-like machine. You will not be able to see out, but the technician will be able to see you and talk with you throughout the test. An MRI with enhancements requires additional imaging, after the enhancement is administered. This preparation is NOT an iodine-containing agent and has an exceedingly low risk of any allergic reactions. During the process of obtaining the pictures, the machine is very noisy; this is normal and not dangerous.
Because the MRI utilizes magnetic fields, it is IMPORTANT to let us know if you have any metal in your body or have worked cutting or grinding metal. This will not necessarily exclude an MRI, but careful screening will be done prior to the test. ALSO, please let us know if you have a problem with claustrophobia, as the machine is very confining.
CT SCAN (Computerized Tomography)
The CT Scan provides two-dimensional “pictures” of bone and soft tissue. CT-scanners are large donut-shaped machines that are positioned around the area of the body to be imaged. A CT Scan ordered with contrast requires additional scanning time after contrast is administered. NOTE: Please let us know if you have any allergies or kidney problems as this may exclude the use of the contrast technique.
SPECT IMAGING (Single Photon Emission Computed Tomography)
SPECT Imaging is done to evaluate the level of activity of various brain regions. The patient is asked to lie down in a quiet environment with eyes closed. An injection of a pharmaceutical agent that gives off slight radioactivity is then given. This is similar to other procedures such as bone and thyroid scans. This particular agent, however, is absorbed only by active nerve cells and their degree of activity. This activity is recorded by a machine and analyzed by a computer that produces “pictures” the doctor uses to evaluate the results. The agent that is used washes out of the nerve cells and body in a short period of time. NOTE: The patient is encouraged to drink plenty of fluids after the test.
MRA (Magnetic Resonance Angiography)
This MRA test is the same as an MRI (see above). This type of test is used to study the blood vessels. This test detects or diagnoses blood vessel disease/abnormalities. Patient preparation is same as MRI.
If the Doctor ordered any of the following, please fast, nothing to eat or drink after midnight, go first thing in the morning:
- Comprehensive Metabolic Profile
- Hemoglobin A1C
- Dilantin/Lamictal/Tegretol/Phenobarbital (make sure you bring your meds to take after blood work).
PET/CT SCAN (Positron Emission Tomography)
This test helps determine the location in the brain for intractable seizures and can also identify and characterize degenerative disease of the brain such as Alzheimer’s. Prior to the test you will be injected with FDG (contains many substances that mimic those in the body i.e.: water, sugar, protein). Once injected you will be led to a private room to sit quietly for one-hour. During the scan, you will be asked to lie still on your back, with your arms above your head. The actual scan takes 45 minutes. After the injection, the tracers are designed to accumulate in the diseased cells, allowing the scanner to identify them by creating an image that highlights abnormal activity, thus helping physicians determine if disease or an abnormality is present.
NO exercise the day before and day of exam / NOTHING to eat 6 hours prior / FOLLOW a low carbohydrate diet the day prior to exam (NO pasta, bread, rice, potatoes, cereal, sugar or chewing gum). You MAY have water and take medications. We also need to know if you’re diabetic. Please bring previous films (CT, MRI and/or PET Scans) for comparison and all pathology reports.
ECHOCARDIOGRAM (Ultrasound of Heart)
This ultrasonic test diagnoses abnormalities in the anatomy and valvular function within the heart. Sound waves are bounced off the heart using a transducer to image the heart in motion as well as its valves and vessels. Ultrasound gel is placed on the chest wall and the transducer is applied to send and receive sound waves. You will hear an occasional loud swishing sound of the heart beating during the test and the room is usually darkened for the tecnician to better see the screen.
AORTA & ILIAC VASCULATURE (Ultrasound of Abdomen)
This ultrasound test diagnoses aorta abnormalities such as aneurysms and arteriosclerotic changes to blood vessels, and abnormal blood flow patterns.
No food or drink 6 hours prior to test.