Whatever diagnosis your symptoms and testing reveal, your doctor will provide a personalized plan to improve the quality of your everyday life. Here’s our process, and what you should expect as a new patient.
This is the part of the process where we take the time to understand you and your unique neurologic situation, listen closely to your symptoms, and do a thorough neurological examination. Additional tests may be recommended to aid in diagnosis.
During this phase, we’ll identify the nature of your condition by considering all the information we have collected from your history, examination and test results.
We’ll help you understand your condition, answer any questions, and clearly communicate your path forward.
You’re not on this path alone. Your provider will recommend and guide ongoing treatment to help you improve your life quality immediately.
Autonomic nervous system (ANS) testing evaluates the physiologic responses to various activity and stress related stimuli and assesses the degree of proper function or in the case of various neurologic, endocrine, or cardiac diseases, the improper function of the ANS. The ANS controls several basic functions, including: heart rate, blood pressure, breathing, digestion, blood flow and temperature regulation. The ANS is made up of a central monitoring and control center in the brain as well as the peripheral nerve system that communicates the adjustments needed and provides feedback to the brain.
During the test we will begin by monitoring heart rate and blood pressure with ECG electrodes and automated blood pressure cuffs. While monitoring beat by beat heart rate and blood pressure, you will be instructed to perform deep breathing exercises and Valsalva maneuver (blowing against resistance), tilt table testing to evaluate response to change in blood pressure, and specialized electrode recording of hand, leg and foot sweat response which as a whole evaluates both the central and peripheral ANS ability to keep these vital functions operating smoothly. If you have symptoms of dizziness, nausea, rapid heart rate, cold sweats, or shortness of breath, talk with your primary care physician about neurology consultation for possible ANS dysfunction and ANS testing at our lab if this is indicated. They will likely order basic labs and studies prior to making the appropriate referral.
EMG (electromyography) and NCV (nerve conduction velocity) studies are often done together. During the NCV, electrodes are placed on the skin over a specific nerve or muscle. A mild, brief electrical stimulus is applied to the nerve, and the nerve and muscle response are measured. The speed at which nerves transmit electrical signals and how the muscle responds provides information about the health of the nerve and muscle.
During the EMG, a very fine wire electrode is inserted into one or more muscles to measure the activity of the muscle. It records the electrical activity with the muscles at rest and then during contraction. This test can be helpful in the diagnosis of abnormal nerve function, nerve injury or compression, or muscle diseases.
In our office, the time that the test will take depends on how many areas are being tested. These tests may be somewhat uncomfortable, but are usually very brief. Please let the doctor know before your appointment if you are taking any prescription blood thinners. The results of your test will be provided to your ordering provider who will discuss them with you.
An electroencephalograph helps evaluate the electrical activity of the brain produced by brain cells. The EEG test is painless and harmless. The EEG machine records electrical signals coming from your brain, but it does not put any electricity into your brain or body. You may be advised to have an EEG if you have had symptoms which may be due to a seizure or there is concern about unusual confusion. An EEG test is useful in diagnosing conditions such as epilepsy.
When you have the test, the technician will attach several small patches (electrodes) to your scalp with special paste. Wires from the electrodes are connected to the EEG machine. The machine detects and amplifies the electrical signals and digitally records them. For the duration of the test you may be asked to sit in a chair or lie on a bed. At some point you may be asked to blink lots of times, or to breathe deeply, or there may be flashing lights. The test takes about 20-30 minutes, with the whole process taking about an hour. The electrodes are removed at the end of the test.
The results of your test will be provided to your ordering provider who will discuss them with you.