Neurodiagnostic Exams

EXAM DESCRIPTION:

EEG: 
Clean head of hair. No hairspray, oils, or hairpieces. Patients can take their medications.  Patient should use a minimal amount of caffeine on the day of the test. Bring a list of current medications. A technician performs the test. Measurements are taken of the head, and leads are placed in specific spots with a small amount of cream and tape. There is no discomfort with this exam. The length of time is approximately 1 hour. A neurologist will read this exam and a report will be sent on to the ordering physician.

SLEEP-DEPRIVED EEG:
(16 years and older) Stay awake for 24 hours, unless otherwise directed by physician. Follow instructions for routine EEG above.

(3 -15 years) Keep awake 12 hours before the test, unless otherwise directed by physician.  Follow instructions for routine EEG above. Age two years and younger, keep child awake longer the night before and get them up earlier than normal the day of the test. Keep child awake until the time of the test, so we may attain some sleep during the test.

AMBULATORY EEG: 
Clean head of hair. No hairspray, oils or hairpieces. Wear a button-down shirt, nothing over the head. A technician will take measurements of the head, and place leads on the head with a small amount of glue. The patient then wears the leads home with a recording monitor for either 24, 48, or 72 hours as directed by their physician. The patient then returns on the appropriate day and time assigned by the technician to have all the leads removed. The patient should allow approximately 1 hour for the hook up and a half hour for removal. A neurologist will review this exam and a report sent to the ordering physician. 

VER/BAER/SSER:  (Upper or Lower Ext.) 
All four exams require a clean head, with no hairspray, oils or hairpieces. Each exam takes approximately one half hour. If upper or lower SSERs are ordered, the patient should use no lotion or oils on arms and legs. Leads are placed on the head, and arms and legs when SSERs are ordered. If VERs are ordered, patient should bring their glasses if they wear them. If BAERs are ordered, patient should let the technician know if they have any significant hearing loss from either ear. With SSERs there is some discomfort, but not intolerable. These exams will be performed by a technician, read by a neurologist, and reports will be sent back to the ordering physician.

EXAM DESCRIPTION: 

EMG/NCS:
The EMG is used to detect neuromuscular disorders (nerve and muscle problems). EMG and NCS are important diagnostic tools that can help detect the cause of problems, such as muscle weakness, numbness, spasms, paralysis or pain. They can determine if the problem involves the nerves, muscles, spinal cord or brain. The EMG measures the electrical activity of muscles. The NCS can measure the speed and intensity of electrical signals that travel along the nerves and the time it takes muscles to respond to these signals.

This exam may be ordered on any one extremity, or as many as all four extremities, depending on your physician's request. This procedure may take anywhere from 45 minutes to an hour.  Have no lotions or oils on your body. Frequently the technician will perform the NCS, followed by the EMG, which is performed by a doctor.

NCS:
The technician will take some measurements and apply some electrodes to specific spots on the extremity being tested. The technician then uses a stimulator that sends tiny electrical impulses through the patient's nerves and these responses are recorded. The patient may feel some tingling. This tiny "shock" is unusual, but harmless. 

EMG:
One or more needle electrodes are gently inserted into the muscles being tested. You may feel some pain, a dull ache or pressure as the electrode is inserted. The electrodes may be moved to get readings from different sections of the muscle, you may be asked to slowly flex the muscle. To prevent infection, these needle electrodes are used just once and then discarded.

Tell the technician prior to the EMG study if you are on any blood thinners, bruise easily, diabetic, have any skin infections, or have any allergies to metal or latex.

After the procedure you may experience some tenderness in the areas tested, but this should subside in a few hours. To relieve discomfort, apply ice or a cold pack wrapped in a cloth to the tender area.

A report should be ready for your physician within 24 hours.

PREPARATION:
Clean head of hair. No hairspray, oils or hairpieces. Patient will be confined to bed during this testing.  Special care is needed if video monitoring is ordered; please do not move equipment around or patient will not be videotaped. A technician will hook up 22 electrodes to patient’s head and 2 on their chest. These electrodes do not hurt. It may take 30 minutes for an initial hook-up.

EXAM DESCRIPTION:
This monitoring is used for patients that may have status epilepticus, pseudoseizures, altered mental status, or sub-clinical seizures. This monitoring assists the neurologist in prescribing the correct medications for treatment. This monitoring may last a few hours to several days.

SPECIAL CONSIDERATIONS:
Discontinue monitoring during working hours 7:30am - 4:00pm, Monday through Friday (except holidays). If the test needs to be discontinued at any other time, you may call the Neurodiagnostics Department or follow these instructions:

Using the mouse, locate the yellow circle (this is in between a green and red circle) and click on it. This will pause the recording. Follow the electrodes on the head to the headbox, squeeze on both sides of the cord and pull apart from headbox. If going for an MRI or CT Scan of the head, all electrodes need to be removed. Any staff member may take off the electrodes.

Once the monitoring has ended, a neurologist will review and dictate a report.