During your first appointment with a neurologist, they’ll
likely perform a physical exam and a neurological exam. A neurological exam
will test muscle strength, reflexes, and coordination.
Since different disorders can have similar symptoms, your
neurologist may need more testing to make a diagnosis.
Neurologists may recommend a variety of procedures to help
diagnose or treat a condition. These procedures may include:
Your neurologist may use a lumbar puncture to test your
spinal fluid. They may recommend the procedure if they believe your symptoms
are caused by a problem in your nervous system that can be detected in your
spinal fluid.
The procedure involves inserting a needle into the spine
after numbing it and taking a sample of spinal fluid.
This procedure can help your neurologist diagnose myasthenia
gravis. In this test, your doctor injects you with a medicine called Tensilon.
Then they observe how it affects your muscle movements.
An EMG measures electrical activity between your brain or
spinal cord to a peripheral nerve. This nerve is found in your arms and legs,
and is responsible for muscle control during times of movement and rest.
EMGs can help your neurologist diagnose spinal cord disease
as well as general muscle or nerve dysfunction.
During this test, your neurologist-technician inserts small
electrodes into your muscles to help measure activity during periods of
movement and rest. Such activity is recorded by a machine attached to the
electrodes with a series of wires, which may be somewhat uncomfortable.
Oftentimes, a neurologist will order a nerve conduction
velocity (NCV) study in conjunction with an EMG. While an EMG measures muscle
activity, an NCV assesses the ability of your nerves to send the necessary
signals that control these muscles. If your neurologist recommends both tests,
you’ll likely do the EMG first.
During an NCV test, electrodes are taped over the same
muscles that you had EMG electrodes in previously. Two sets of electrodes are
used here — one sends small pulses in an effort to stimulate your nerves, while
the other set measures the results.
In all, the average EMG/NCV combination test may take about
an hour or longer to complete. You’ll want to avoid any stimulants, such as
caffeine and nicotine, several hours before your test, or else these substances
may alter your results.
Your neurologist may also ask that you don’t take any
blood-thinning medications or nonsteroidal anti-inflammatory drugs (NSAIDs) for
24 hours ahead of the EMG.
With electrodes applied to your scalp, an EEG measures
electrical activity in the brain. It’s used to help diagnose conditions of the
brain, including inflammation, tumors, and injuries, as well as seizures and
psychiatric disorders.
Unlike an EMG, an EEG doesn’t usually cause any discomfort.
Before the test, a technician places electrodes around the scalp that look like
small cups. As small charges in the brain are measured through the electrodes,
the technician will create changes in the environment to measure brain signals,
such as different lighting or noises.
Like an EMG, you’ll need to avoid stimulants the day prior
to the test. You can also expect the EEG to take an hour. Sometimes the test is
done while you’re sleeping.
OTHER TESTS
Neurologists may use other types of tests, as well. Although
they may not perform the test, they may order it, review it, and interpret the
results.
To make a diagnosis, a neurologist may use imaging tests
such as:
·
computed tomography, or CT scan
·
magnetic resonance imaging, or MRI scan
·
positron emission tomography, or PET scan
Other diagnostic procedures include sleep studies and
angiography. Angiography determines blockages in the blood vessels going to the
brain.
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