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Neurology

Neurologists are doctors that are concerned with study, treatment and disorders of the nervous system. A neurologist is trained to investigate, diagnose and treat any neurological disorders. Since the nervous system is extremely substantial to our every bodily function, neurology is a big area of study and is very important to the way we function.

Common disorders that neurologists treat include:

  • Attain mental status
  • Behavior/cognitive syndrome
  • Brain injury, spinal cord and peripheral nerves
  • Cerebral palsy
  • Cerebrovascular disease such as stroke or transient ischemic attack (TIA)
  • Multiple sclerosis and other demyelinating diseases
  • Epilepsy
  • Headaches
  • Infections of the brain, brain meninges, and spinal cord
  • Parkinson's disease
  • Tumors of the brain
  • Alzheimer's disease
  • Huntington's disease
  • Sleep disorders
  • Speech and language disorders
  • Traumatic brain surgery

Brainstem Auditory Evoked Potentials (BAEP)

Brainstem auditory evoked potentials, or BAEP, is a diagnostic test performed to evaluate neurological functioning and identify problems with hearing and/or the nervous system. This test may also be performed on patients suffering from brain injury or various speech disorders. Brainstem auditory evoked potentials is safe for all patients, with no associated risks.

While no special preparations are required before undergoing brainstem auditory evoked potentials, you will need to wash your hair the night before, as electrodes will be placed on your scalp during the test. You will remain in a reclined position during the test. The technician places electrodes on your scalp and earlobes. You will hear a series of clicks and tones during brainstem auditory evoked potentials; your brain’s response to each noise is recorded onto the electrodes. Results are available a few days after the test; your doctor will explain them to you at this point.

Nerve Testing: Electromyography (EMG) / Nerve Conduction Velocity (NCV)

Nerve conduction studies are utilized to determine if the patient is suffering from nerve damage or inherent deficiency. This allows the doctor to either rule out or confirm a diagnosis of nervous system issues, instead of musculoskeletal problems that could cause similar symptoms. They can also help determine the source of nerve damage, such as substance abuse, nerve compression or another peripheral neuropathy, as the specific cause can be vital to effective treatment.

Nerve conduction studies are often performed in conjunction with electromyography, which helps to diagnose muscle disease and neuromuscular conditions such as myasthenia gravis and Lou Gehrig’s disease (amyotrophic lateral sclerosis).

The nerves are essentially electrical systems and are thus best observed using an oscilloscope. This device displays signal voltages and charts them along a graph according to time. Electrodes are attached to the skin to deliver mild electrical impulses and then record the body’s response.

This allows the oscilloscope to show exactly how long it takes a nerve to respond to direct stimulation, as well as the magnitude of such response. This vital information is contained within the frequency and amplitude of the resulting graph. In addition, the overall shape of the impulse graph can be also be used for diagnostic purposes.

The electric activity produced by the neural network is inherently variable in all humans due to complicating factors such as height, weight, sex, age, and body temperature. However, the diagnostic value of the nerve conduction study is still effective in determining activation velocities that are outside of the normal range. These abnormal values can help ensure a correct diagnosis.

The test itself is non-invasive and evokes no side effects whatsoever. However, there may be a varying degree of discomfort due to the multiple low-intensity electric pulses sent through the electrodes. Additionally, the paste or gel used to affix the electrodes securely onto the skin may irritate certain people with abnormally sensitive skin.

Somatosensory Evoked Potential (SSEP)

Somatosensory evoked potentials assess the passage of nerves from the arms and legs and their travel through the spinal cord to the brain. This test is done to diagnose spinal cord disorders and neuromuscular diseases. About four hours before their somatosensory evoked potentials, patients shall refrain from drinking caffeinated beverages; no other preparations are necessary for this test.

Somatosensory evoked potentials take about three hours to perform. A technician places electrodes onto your scalp, neck and shoulders. Then, a small electrical current is applied to a nerve near your wrist or ankle; at this point, you may feel a pulsating sensation in your wrist or ankle. This may be slightly uncomfortable for some patients, but the test is otherwise painless. The process is repeated until the electrical current has been applied to each wrist and ankle. At the end of the somatosensory evoked potentials, the electrodes are removed from your scalp, neck and shoulders, and regular activities can be immediately resumed.

Results are usually available immediately after somatosensory evoked potentials. Electrical currents that required an extraordinary amount of time to reach the brain are indicative of spinal cord abnormalities. In such cases, your doctor will discuss these results further with you, and develop a customized treatment plan.

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