EEG Is used to investigate for abnormal electrical signals arising from the brain. The test is oftentimes needed to evaluate symptoms such as fainting or black out spells, seizures and epilepsy.
Procedure Description: EEG Is used to investigate for abnormal electrical signals arising from the brain. The test is oftentimes needed to evaluate symptoms such as fainting or black out spells, seizures and epilepsy.
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Forms: EEG Test Preparation
Electromyography/Nerve Conduction Study (EMG/NCS) is a test used to investigate symptoms such as numbness, tingling, weakness and back/neck/limb pains. The test measures the electricial activity in muscles and nerves, and helps determine if there is damage to these structures. EMG/NCS is usually done if there is a suspicion of carpal tunnel syndrome, a pinched nerve in the neck or back, nerve damage in the feet as in neuropathy, or for muscle damage as in myopathy.
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Forms: EMG Test Preparation
Evoked Potentials (EP)
EP studies are used to study disorders such as multiple sclerosis. The test measures the generation and tansit of electrical impulses along the visual, hearing and sensory pathways in the brain and spinal cord.
TRANSCRANIAL DOPPLERS (TCD) TCD studies utilize ultrasound and Doppler techniques to assess for narrowing or stenosis in the arteries carrying blood to the brain. These tests are usually needed during evaluation of stroke and transient ischemic attacks (TIA).
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Computerized Tomography (CT/CTA)
The test is carried out to study for abnormalities in the head and spine. The technique utilizes small amounts of x-rays to generate three dimensional pictures of the head, including the skull, brain, spine and spinal cord. CT scans are very helpful to exclude sudden or acute problems, such as bleeding in the brain, or fractures of the skull or spine. Sometimes, an iodine-based contrast dye is administered to enhance the ability of detecting abnormalities. The procedure is relatively quick and is typically done in the emergency room.
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Magnetic Resonance (MRI/MRA)
Like CT, MRI is also used to study the brain and spinal cord. However, MRI provides much more detailed information of the intricate structure of these organs. Unlike CT, the technique of MRI utilizes changes in the body’s own magnetic properties to generate remarkable pictures of the inside of the nervous system. There is no radiation or x-ray involved in MRI studies. Sometimes, a special iron-based contrast dye is administered to enhance the ability of detecting abnormalities. Not all MRI machines are the same. The best results are obtained when the procedure is carried out in a high strength (1.5 Tesla or higher) narrow bore machine. Open MRI studies typically utilize less powerful MRI machines and the quality of the pictures are not as detailed as that obtained from high strength machines.
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MRA is carried out to study the blood vessels of the brain. The blood vessels in the neck carrying blood to the brain are called the carotid and vertebral arteries, and the network of arteries inside the brain is referred to as the Circle of Willis. Like MRI, MRA also utilizes changes in the body’s own magnetic properties to generate pictures of the blood vessels. Sometimes, it is necessary to study the blood vessels draining blood from the brain, called veins, using a technique called magnetic resonance venogram (MRV). Typically, MRI and MRA studies are done at the same time.
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Myelogram is a procedure carried out to study for changes in the spine and nerve roots. This procedure is typically done in patients with back and neck pain, and is carried out under fluoroscopy or x-ray control. Under local anesthesia, a needle is inserted in the low back between the spinal bones, the sac containing spinal fluid is entered, and contrast dye placed within the sac. Thereafter, x-rays and CT scans of the spine are taken from different angles.
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Angiography is the gold standard to study the blood vessels supplying the brain. The procedure involves placing a catheter, usually through a small incision in the groin, in the blood vessels leading to the brain. Thereafter, contrast dye is injected into these blood vessels. As the dye flows through the arteries and veins of the brain, sequential x-rays are taken. Typically, this test provides exquisite pictures of the blood vessels going and coming from the brain.
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Lumbar Puncture (Spinal Tap)
The procedure is carried out to obtain a sample of spinal fluid, also called CSF or cerebro-spinal-fluid, for testing. The CSF is produced by specialized blood vessels in the brain, and it functions to help protect and maybe even partially nourish the brain and spinal cord. The fluid is located in a sac that is closely applied to the entire surface the brain and spinal cord, but within the skull and bony spine. Normally, the fluid is constantly circulating between the brain and the spinal canal, and is then released into the draining blood vessels. It is believed that CSF is continuously being produced and removed, such that it is turned around several times daily.
Often times, diseases of the brain and spinal cord, such as infections and multiple sclerosis, cause changes that can be detected in the CSF. Therefore, study of the spinal fluid provides an opportunity to diagnose such conditions without actually having to take a sample of brain tissue. In some other conditions, such as pseudotumor cerebri, there is excessive production of CSF, and its removal may be necessary to provide relief.
The procedure is carried out under local anesthesia. A needle is carefully inserted between the bones in the low back into the sac that contain the spinal fluid. The fluid trickles, drop by drop, and is collected for testing. In order to help replenish the fluid and to help the wound heal, patient’s are advised to lie flat on their back for several hours after the procedure.