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Neuro Diagnostic Center

The Neuro Diagnostic Center is responsible for performing and analyzing the results of tests related to neurological function. The Sparrow Neuro Diagnostic Center offers a broad range of services from testing the electricity in the brain to examining your visual system.

Among the tests administered at the Sparrow Neuro Diagnostic center are:

EEG

24-48 Hour Ambulatory EEG

Video EEG

AEP Test

VER Test

SER Test

TCD

EGG (Electroencephalogram)

An EEG is a recording of the electricity (everyone has it) in your brain that is ultimately stored within a computer. The amount of electricity is very small and even small movements will interfere with the recording. This is why relaxation is important.

What do EEG’s show? How does it help the doctor diagnose your problems?

By looking at the shape, frequency and height of the waves, the doctor can tell whether the brain is healthy or not. It can also tell about the possibility of epilepsy.

How long does an EEG take?

An EEG takes about 1 1/2 hours

How to get ready for an EEG:

Wash your hair – apply no sprays, oils, or dressings of any kind. Eat a normal meal within 2 hours of the test. Continue taking prescribed medications unless your doctor instructed you not to.

What happens when you come to the laboratory?

A specially trained technician will be with you throughout the test and give you instructions as needed. The following activities will occur during your visit to the laboratory:

  • The technician will measure your head and put blue marks on your scalp with a soft pencil where the electrodes will go (usually 23 electrodes).
  • Each spot will be scrubbed with a special solution and a cotton tipped applicator.
  • Nothing goes into or under your skin. This is the only part of the test that may feel a little uncomfortable, like cleaning any area of skin thoroughly.
  • Then the technician will check to make sure there is a good electrical connection by testing each electrode on a special meter.
  • The test begins: The recording section of the EEG takes about 30 minutes. You will be asked to get comfortable, close your eyes and relax. At certain times, you will be asked to open and close your eyes (do this only when asked), and to breathe deeply for about 3 minutes. Also, the strobe light will be flashed off and on for a few minutes during one section of the test.
  • The test ends: Electrodes are removed from the head with warm water. You may wash your hair when you get back to your room or home, unless your activities have been restricted.
  • A specialist in reading EEG will interpret the test results and communicate with your private physician.
  • Your doctor will then tell you the results of your test.

24-48 Hr. Ambulatory EEG:

The set up same as regular EEG with the exception that the patient will wear the electrodes home and record activities in a small diary. The EEG data will be collected in a small cassette that is worn around the waist. Instructions and phone number will be given to patient.

The patient is asked to maintain as normal of a day as possible without getting the electrodes wet or changing any clothing over the head.

The patient will be asked to return after 24-48 hr. (depending upon length of time the doctor orders) with diary and have electrodes removed or they may be removed at home and return them.

Data will be reviewed and a report will be sent to your doctor, usually within 1-2 weeks.

Video EEG:

A video EEG consists of recording the electrical activity of the brain plus audio and video recording simultaneously.

A video EEG allows the physician to see brain wave activity along with any movements or sounds made by the patient. The patient may experience unusual movements of their body. Recording these movements along with brain activity helps the physician determine if there is a correlation between movement and abnormal brain activity.

The patient will need to be admitted to Sparrow for observation by the nursing staff along with the video recording.

This set-up is very similar to a regular EEG.

AEP test (Auditory Evoked Potential)

An AEP test is the recording of very small electrical signals from areas of your brain in response to sounds that are not easily seen in a regular EEG. These parts of the brain are called the “brainstem” and “cortex”. The signals are so small that a computer must be used to pick out these special signals for the doctor to see.

A series of clicks are delivered through an earphone to your ear. As the clicks travel from your ear through the various pathways in your brain, they produce electrical signals. These signals are added up by the computer to create the waveforms of your test.

Why do people have AEP’s?

AEP’s check the health of specific pathways in the brain. Some common reasons why patients come for this test are: weakness, nausea, vomiting, unusual ringing of ears, dizziness, hearing loss, vision problems, headaches, numbness, etc. It also is used to search for very subtle tumors affecting the hearing apparatus. It can also be used to help diagnose multiple sclerosis and other neurological diseases.

Does an AEP test hurt?

No, an AEP does not hurt – it is painless. You can even sleep during the test if you are tired.

What do AEP’s show?

By looking at the shapes and heights of the waves, when they occur, and how many there are, the doctor can tell whether or not there may be any problem in various regions of your brain devoted to hearing.

How long does the test take?

The AEP test takes about an hour.

How to get ready for an AEP test:

  1. Wash your hair if possible.
  2. Do not stop taking any prescribed medications unless your doctor tells you to do so.

What happens when you come to the laboratory?

The technician will be with you throughout the test and give you instructions as needed. The following activities will occur during your visit to the laboratory:

  1. First, you will be taken into a room where an audiogram will be performed. The technician will put earphones on your head and sounds will be transmitted from a special machine. The audiogram will help the doctor and technician determine that your outer and middle ears are relatively clear for the AEP test.
  2. You will then be taken into the AEP room where the technician will seat you in a comfortable lounge chair. The technician will glue on three electrodes.
  3. The electrodes will be tested with a special meter to ensure there is a good connection.
  4. Next, the technician will put earphones on your head, lean you back in the chair and ask you to relax and be very still. You may take a nap if you like.
  5. The test begins: A clicking sound will be delivered to one ear at a time. The clicks will be on for a while, off briefly, on again, and off. This will be repeated for several minutes. One ear will be tested at a time. The test may or may not be repeated with louder or faster clicks.
  6. The test ends: The earphones will be removed from your head and the electrodes will be removed with warm water. You may want to wash your hair when you get home or back to your room, unless your activities are restricted.
  7. A neurologist trained in understanding this test will interpret the test and communicate the results to your private physician.
  8. Your doctor will tell you the results of your test.

VER test (Visual Evoked Response)

This is a test of your visual system to see how well it is working. It specifically evaluates your optic nerves with signals going down the visual pathway. The computer adds them up and creates a wave for your doctor to view. To get these signals you have to watch a TV screen with a special checkerboard pattern on it that is moving.

Why do people have VER’s?

Some common symptoms patients have when they come for this test are: double vision, blurred vision, eye injuries, head injuries, weakness of eyes, arms, legs, and decreasing vision, etc.

Does a VER test hurt?

No, the test is not painful. All you do is watch a T.V. with reversing checkerboards during the test.

Can you sleep during a VER?

No. It is very important that you be wide-awake and alert for this test. Even drowsiness can affect your test results, making them appear abnormal when they may actually be very normal.

What do VER’s show?

VER’s tell us about the health of your visual system and if there is any damage or problems that might be the cause of your symptoms. The VER is part of an “internal” check of the visual system. This is the part that is located in the brain. Your eye doctor checks the “external” factors of your vision.

The wave form, shape, size and when it happens are what the doctor looks at to determine whether or not there is a problem in your visual system.

How long does a VER take?

The VER test takes about 45 minutes.

How to get ready for a VER?

Wash your hair if possible – no sprays or oils.
Continue taking prescribed medications unless your doctor tells you not to.
Bring ALL of your glasses to the lab, regardless of the reason you wear them.
Be well rested and as wide-awake as possible.

What happens when you come to the laboratory?

The technician will first check your vision with an eye chart so we will have a basic idea how well you will be seeing during the test. Don’t forget your glasses! Your head will be measured so we know where the seven electrodes will be applied. Each spot is then scrubbed with a special solution and gauze. Electrodes go on with paste. Nothing goes in or under your skin. The technician ensures there is a good electrical connection by testing each electrode on a special meter.

The test begins: You will be seated in a lounge chair, reclined to a certain distance from a T.V. screen, and asked to relax. First you will close both eyes for about a minute while the technician runs a bit of EEG; then a patch will be placed over your left eye for the first part of the test. A total of six different tests or “trials” will be done, each lasting only two minutes. During each trial, all you have to do is to stare at a little red dot on the T.V. screen and be as still as possible. Your eyes are patched alternately until each has been tested twice and both eyes are tested together twice.

The test ends: The technician will remove the electrodes with warm water. You might want to wash your hair afterwards, unless your activities have been restricted.

Your doctor will tell you the results of your test.

SER test (Somatosensory Evoked Response)

The SER test checks the pathway from the nerves in your limbs to your brain. A stimulating electrode that generates an electrical signal is placed on your arm or leg. Recording electrodes are placed on your head and/or spine. The information received can help diagnose your problem.

Why do people have SER tests?

SER tests are performed on people who are experiencing muscle weakness, numbness anywhere, spinal injuries, loss of vibration and position sense, and diseases of the spinal cord.

Does an SER test hurt?

No – the first touch is a surprise, like a little tiny shock, but after that it is like a “pulse” sensation.

Can you sleep during an SER?

Yes, if you want to and if the technician does not need your help.

What does an SER show?

If it occurs, the shape and height of a waveform can tell the doctor where there may be a problem in your nervous system.

How long does an SER take?

The test takes about an hour.

How to get ready for an SER?

There are no preparations for the SER test, other than general cleanliness. Do not stop taking any prescribed medications unless your doctor told you to do so.

What happens when you come to the laboratory?

The technician will be with you throughout the test and give you instructions as needed. The following activities will occur during your visit to the laboratory:

Most likely, you will be lying down and the technician will determine where to place the electrodes.
The electrodes will be put on with paste, and possibly taped.
The skin under each electrode will be rubbed slightly and checked on a special meter to make sure there is good contact.
Then the “pulse” will start and you will be asked to lie very still for a couple of minutes at a time until the test is completed.
It may surprise you the first time the “pulse” is turned on for each area. After it begins, it will be a repetitive pulse sensation over the area that is being tested. Your muscles may twitch slightly, but the test does not hurt.
After the test is completed, the electrodes will be removed with warm water and you may return to your room or home.
Your doctor will tell you the results of your test.

TCD (Transcranial Doppler)

TCD is used to identify the flow of intracranial blood vessels.

Transtemporal (side of the head)
Transorbital (over the eye)
Transoccipital (back of the head)
Vessels are identified by depth, direction of flow, traceability and spatial relationships.

This is a painless procedure using a small Doppler instrument and usually takes approximately 30 minutes to 1 ½ hours. Patient should be quiet and comfortable. Vessels are identified and compared to reported normal values.

The TCD can be used for:

  • Stroke and stroke prevention
  • Vasospasm (narrowing of the arteries)
  • Surgery – carotid endarectomy and cardiac
  • CHI – post traumatic (CHI means closed head injury)
  • Brain death determination
  • Carotid artery disease

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