In most cases the the primary care physician sees the patient and is referred by the primary care physician for evaluation of a specific neurologic symptom or suspected condition. The neurologist begins by taking a focused subjective history from the patient and his/her family including a detailed description of the complaint, followed by recordation of past medical and family history, and review of symptoms. This is followed by a focused objective medical evaluation and a thorough general examination of the neurological system, including mental status, cranial nerves, reflexes, motor, sensation, and coordination. The neurologist will then make an assessment of the clinical presentation and physical findings. (S)he will develop a plan of action including possible laboratory and imaging studies, or consultations to finalize the diagnosis, and will initiate treatment for improvement of symptomatology. Finally the neurologist will prepare a written report to the referring physician, and staff will make arrangements for studies and a followup. Initial consultations can take anywhere between thirty and forty minutes, depending on the complexity and severity o
This study measures the brain’s natural electrical activity or brain waves. Surface electrodes are applied to the scalp and spontaneous electrical activity is measured and amplified. This is recorded while the patient is awake, asleep, and in response to hyperventilation, and photic stimulation. Important in diagnosis of seizures or epilepsy, head trauma, metabolic, degenerative, infective, and sleep disorders.
EMG stands for Electromyogram which loosely translated means electrical testing of muscles but in fact has come to mean electrical testing of nerves and muscles. It measures natural muscle electrical activity. A small, sterile, disposable electrode is inserted through the skin into the muscle to measure electrical activity associated with muscle activity. It is recorded while the patient is at rest, with mild, and maximal contraction. This test is important in diagnosis of muscle (dystrophic, inflammatory) diseases, ALS, denervating neuropathies, and spinal disorders. By studying specific groups of muscles, patterns of nerve and root damage may be precisely defined.