Diagnostic Services

Electroencephalography

(EEG)

What is an Electroencephalography or EEG?

Electroencephalography, also called EEG, is a test used to evaluate the electrical activity of the brain. This involves placing several wires on the head and recording the natural electrical impulses the brain is producing.

By examining these impulses, we can determine if someone is prone to seizures or has underlying brain pathology. This study is often used to assist in managing treatment for someone with epilepsy and in evaluating those with recurrent episodes of passing out.

Unlike other tests, EEG does require some preparation.

For a Routine EEG

Please wash your hair the night before or morning of your test.

DO NOT use sprays or hair gels.

NO permanent hair accessories (i.e., weave, corn rolls, toupees, extensions) Some exceptions may apply.

Bring a hat or scarf to wear home as you will have residual gel in your hair that will need to be shampooed out when you get home.

The test takes approximately 1.5 hrs.

For a Sleep Deprived EEG

You may sleep prior to 1:00 am before the test.

Please stay awake after 1 AM.

No sugar, caffeine, soda, tea, coffee etc. before the test.

For Video Ambulatory EEG

You take home a video to record your brain activity for a longer period.

It can be 48 hours or even 72 hours.

The setup is usually about 45 minutes.

Electromyography

(EMG)

What is an Electromyography or EMG?

Electromyography or EMG testing is an electrical test of the nerves and muscles. A physician is here to help diagnose certain nerve and muscle disorders, such as “pinched nerves,” radiculopathy, carpal tunnel syndrome or other nerve injuries.

It is also used to investigate symptoms such as neck pain, low back pain, numbness, tingling sensations muscle weakness, etc. EMG testing can also be helpful in localizing which nerve or nerves are involved in causing a particular problem.

What to Expect

The test can give information about the condition of the nerves and muscles, and whether or not there is damage to them.

The test consists of two parts. The first part of the test is called a “nerve conduction study.’ In this part of the test, electrical stimulation is given to different nerves.

Measurements are made in the hands and/or feet, giving the physician information about how well that nerve is working.

The number of nerves tested depends upon the nature and complexity of the problem and is often determined as the test progresses.

The second part of the test involves the insertion of a small sterile needle into various muscles, just beneath the skin. No electrical stimulation is given in this part of the test, but the needles do measure the electrical activity of the muscle at rest and with activity.

How to Prepare for the EMG Test

No specific instructions need to be followed to prepare for an EMG test.

Please do not to use any lotions, oils, or creams the day of the test.

Please remove all jewelry the day of the test.

The patient may eat and drink normally up to the time of the test.

While parts of the test can be uncomfortable for the patients, most people tolerate the test quite well.

There are no significant risks or dangers from this test, and there are no long-term side effects from it. Normal activities can be resumed immediately after the test has been completed.

Transcranial Doppler Ultrasound (TCD)

What is Transcranial Doppler Ultrasound (TCD)?

Transcranial Doppler ultrasound or TCD is a type of ultrasound that evaluates the blood circulation within the brain.

During the transcranial Doppler ultrasound, sound waves are transmitted through the tissues of the skull. The sound waves allow us to evaluate the speed of the red blood cells moving through the blood vessels within the brain. These are calculated and displayed on a computer screen.

This allows us to determine blood flow to various areas of the brain. The Transcranial Doppler ultrasound allows us to assess for a wide variety of conditions.

What to Expect

The examination is noninvasive. Most patients are very comfortable during the transcranial Doppler. You do not have to change into a gown for this exam.

The technologist we’ll set up the machine while you are relaxing on the examination table. If you have difficulty lying down, then the examination will be carried out in a chair.

Ultrasound gel will be applied to the probe. The probe will be placed on various parts of the head and neck including the eyelids, above the cheekbone, in front of the ear, and on the back of the neck.

The ultrasound gel is water-soluble. It can be easily washed off after the examination. The entire examination may take between 30-45 minutes.

There are no side effects to this examination. The test is extremely safe. There is no use of radiation involved.

Preparation Before the Examination

There is no specific preparation for the examination. Patient’s will typically carry on with their normal routine prior to the examination.

However, if this examination is done in conjunction with other examinations in the office, there may be other specific preparations that need to be done. This will be explained to you by our staff. Please do not hesitate to call.

SUDOSCAN

Testing

What is SUDOSCAN Testing?

Sudoscan testing evaluates the early stages of distal small fiber neuropathy. This is done by evaluating endocrine glands which are responsible for the sweat response.

The sweat glands have a right supply of blood vessels as well as unmyelinated sympathetic C fibers of the autonomic nervous system.

In this regard, the test can also evaluate for autonomic dysfunction. Autonomic dysfunction can be seen in conditions such as diabetes mellitus, Parkinson’s disease, amyloidosis, and a wide variety of other conditions.

What to Expect

Prior to the examination hands and feet are cleaned. They must be dry prior to the start of the test. The patient may sit or stand for the scan.

The examination itself involves putting one’s hands and feet onto metallic plates which measure the galvanic skin response from sweat glands. The entire examination takes approximately 2-3 minutes. The examination is non-invasive.

What Does It Test?

The examination can be used to evaluate individuals who have the early stages of neuropathy as well as those individuals who complain of dizziness and lightheadedness which may be presenting symptoms of autonomic dysfunction.

The examination can also be utilized in assessing diabetic patients and glycemic control.

This examination is different from electromyography (EMG) and nerve conduction studies in that it measures different nerve fibers.

Therefore, an EMG/NCV may not pick up the above issues, particularly at an early stage. A sudoscan may be done in conjunction with an EMG for a more in-depth assessment.

At times, the examination may need to be repeated in order to assess the severity of once condition or to assess treatment. This will typically be done after 3-6 months from the initial scan.

Polysomnogram

(Sleep Study)

What is a Polysomnogram?

A Polysomnogram or sleep study is used to diagnose sleep disorders. A sleep study records brain waves, oxygen levels in your blood as well as your heart rate, breathing, and leg movements.

Sleep studies are typically done at outpatient sleep centers. Most patients will come at nighttime to assess sleep patterns. However, there are times where sleep studies will be done during the day to assess disorder such as shift work disorder and narcolepsy.

Not only are sleep studies done to assess various sleep disorders, they are also done to provide a treatment plan for those individuals who are already diagnosed with sleep disorders.

Polysomnography assesses various sleep stages and patterns and assess why they become disrupted.

What Can It Assess?

Sleep disordered breathing - This is typically identified as obstructive sleep apnea and central sleep apnea. In this condition patients stop breathing during sleep.

Periodic limb movement disorder - During sleep, legs rhythmically move and disrupt sleep. This can also be associated with restless leg syndrome.

Parasomnias - These include abnormal behaviors that occur during sleep. This may include walking, acting out dreams etc.

Narcolepsy - This is characterized by excessive daytime sleepiness

There are no major risks involved with this sleep study as this is a noninvasive examination.

Preparation Before the Sleep Study

You will be asked to arrive at the sleep center in the evening for an overnight stay.

You will change into your nighttime clothes and will then be set up by the technician. This typically involves several electrodes to monitor your breathing, your leg movements, your heart rate, and brain waves.

A video camera will also be utilized to assess behavioral patterns. All the electrodes will be hooked up to a machine that will provide data for the recording.

You will be monitored throughout the night by the technician. If you are having a CPAP study, CPAP mask will be placed in addition to the above.

We don’t expect you to fall asleep as easily as you what home; however, we do expect to obtain a reasonable snapshot of your sleep.

The recording will then be scored by the technician and interpreted by the physician.

Video

Nystagmography

What is a Video Nystagmography?

Your doctor has requested vestibular testing for dizziness. The test, a video nystagmography is performed to differentiate whether the source of dizziness is from the inner ear or brain. It is most useful in leading to recommendations regarding treatment.

The test takes about 45 minutes. Goggles are placed over the eyes. In the first round of testing, one eye is uncovered so that you can follow certain targets on a computer screen while an infrared camera inside the goggles records the movements of the covered eye.

In the second round of the test both eyes are covered. You will be asked to sit and to lie in different positions with your eyes open in the dark. You may experience some dizziness.

In the third round while the goggles still cover both eyes, cool air and then warm air gently run into each ear.

What to Expect

Prior to the examination hands and feet are cleaned. They must be dry prior to the start of the test. The patient may sit or stand for the scan.

The examination itself involves putting one’s hands and feet onto metallic plates which measure the galvanic skin response from sweat glands. The entire examination takes approximately 2-3 minutes. The examination is non-invasive.

How To Prepare

Please do not wear any makeup. Make sure your face is clean and free of any lotions or creams.

If you wear contact lenses, come prepared to remove them.

Do not take any alcohol, tranquilizers, sleeping pills, other antihistamines, or other medication for the control of dizziness for 48 hours prior to the test.

After testing you will be able to reinsert your contacts and apply makeup.

Please make sure ears are free of wax build up.

If you have any questions about your procedure:

Links

Hours

Monday – Friday

9:00 am – 5:00 pm

Location

16 Pocono Road Suite 205

Denville, NJ 07834

16 Pocono Rd Suite 205, Denville, NJ 07834, USA

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