Neurology of Central Georgia
175 Water Tower Court, Macon GA 31210 ~~~ Ph (478) 471-6217 ~~~ Fax (478) 471-8663
What is an EMG-NCS test?
- An EMG-NCS, also known as “Electromyography and Nerve Conduction Tests”, is a test of the nerves and muscles of your arms / legs.
- The EMG/NCS study examines the integrity of the peripheral nerves and muscles of the body.
- The study does NOT examine the brain or spinal cord.
- It is important to realize that you can have a nerve or muscle problem, even though you may not “think” you have any nerve or muscle problems.
- This test does NOT measure pain.
- You may have a normal EMG-NCS study, even though you have severe pain.
What are the different parts of the test?
The study is usually done in two parts:
- NCS (i.e. “shocking” test) – which tests the nerve function
- EMG (i.e. “needle” exam) – which tests muscle function
How long is the test?
- Each EMG/NCS study varies from patient to patient, depending on what results are obtained. As such, the study may take as little as 20 minutes, or as much as 2 hours.
What is involved in the Nerve Conduction Study or NCS?
- The NCS examines the nerves in your arms and legs.
- This consists of attaching wires to the surface of your skin, and administering a small “shock” to see how well the nerves react and function. These result are monitored on a computer.
What is involved in the Electromyography or EMG?
- The EMG examines the muscle activity in your body. This study consists of inserting a sterile, individually wrapped, needle into your various muscles and monitoring their activity.
- These results are monitored on a computer. You will probably be stuck 5-7 times per arm or leg. There is NO shocking during the needle exam.
Is the test painful?
- The “shocks” during the NCS are not painful, although they may feel slightly uncomfortable. The needle “sticks” during the EMG feels like a small ant bite, and can sometimes be uncomfortable, but not painful.
How do I prepare for the test?
- Please notify the physician PRIOR to the study if:
- you think you may have AIDS or Hepatitis, or
- if you are taking any blood thinners, such as Coumadin or Aspirin
- Please DO NOT use any Lotion or Creams on the day of the test. Such Lotions or Creams will make it difficult to perform the study.
What type of clothes should I wear for the test?
- Please remove any watches or rings you might be wearing on BOTH your hands / fingers
- Men – if possible, wear shorts and T-shirt.
- Women – if possible, wear a loose dress and T-shirt.
When will I get the results of the test?
- If you are an active patient of our office, then the EMG-NCS results will be discussed with you on your next office visit.
- If you have come to our office only for the EMG-NCS, then the results will be sent to your referring physician within 48 hours.
- Your referring physician will discuss the results with you on your next office visit with them.
Will the doctor advise me of any treatment options?
- If Dr. Athni is actively involved in your care, then he will advise you of your different treatment options after reviewing the results on your follow up visit.
- But, if you have come to our office only for the EMG/NCS, then your referring physician will have to counsel you on your treatment plan.
EEG – Electrencephalogram
What is an Electroencephalogram (EEG)?
- An Electroencephalogram or EEG is a diagnostic test which examines the “brain waves”, using electrodes placed on the scalp. These electrodes are connected to a computer, which records your brain waves.
What is the difference between a “routine” and “ambulatory” EEG?
- Routine EEG
- A “routine” EEG is performed in the office, which takes approximately 30-45 minutes to perform.
- This type of study only records your “brain waves” for about 20 minutes.
- Ambulatory EEG
- For an “ambulatory” EEG, the electrodes are connected to your scalp in the office, but we then send you home with these electrodes, along with a small hand-held computer.
- This will record your brain waves for 3 or 4 full days, while you are leading a “normal life”.
- Such EEGs are more accurate in that they are able to pick up abnormal brain waves while you are at work or while sleeping.
- At the end of the 4 days, you will return the equipment to our office, which will then be analyzed and interpreted by Dr. Athni.
- Please discuss which type of EEG is appropriate for your situation
Which type of EEG is most ideal?
- Each type of EEG is used for different purposes.
- Which EEG is best for you will depend on your individual clinical situation.
- Dr. Athni will discuss these options with you during your office visit.
How is the EEG procedure performed?
- An EEG is a painless procedure, which involves attaching numerous electrodes to your scalp. These electrodes are connected to a computer, which will record your “brain waves’ during the duration of the study.
- These brain wave recordings are reviewed and interpreted by Dr. Athni.
- A certified EEG technician will attach the electrodes and perform the study, while being overseen by Dr. Athni.
Will an EEG always diagnose a seizure?
- A normal EEG does NOT mean there is “nothing wrong with you”.
- It also does NOT absolutely exclude a seizure or any other disease.
- The results of the EEG are used in conjunction with your clinical symptoms and other diagnostic tests, to make a final diagnosis and conclusion.
How do you prepare for the EEG test?
- For the test, PLEASE do the following:
- go to bed at 1 AM, and get up at 5 AM
- wash your hair in the morning
- NO hair spray, NO gel, NO mouse, NO oil
- DO NOT style your hair: NO braids, NO ponytails
- Wear a button down shirt or blouse
- NO perfumes or body lotions (you MAY wear deodorant
- The EEG tech will remind you about your appointment and answer any questions you may during the test.
When will you get the results of the test?
- After the completion of the test, Dr. Athni will review the recorded “brain waves” and put together an analysis or “report”.
- This will be reviewed with you on your next office visit.
Diagnostic Cardiovascular Ultrasound
Is the office “Accredited”?
- Our office Ultrasound Lab is accredited by the American College of Radiology (ACR).
- Such an accreditation implies that we meet a high standard of proficiency in performing these tests, by qualified and certified technicians.
- Our office is the only Neurology office in Middle Georgia to be fully accredited by the ACR.
What is an “Ultrasound”?
- An Ultrasound test is a non-invasive test used to visualize organs or blood flow inside the body.
- There are no needles involved.
- You will be fully awake and alert during the test.
- Ultrasound tests are NOT painful.
How is an ultrasound test performed?
- An “ultrasound probe” takes “real time” pictures of objects inside your body.
- The probe is moved on the surface of your skin, over the part of the body we are trying to visualize. The other end of the probe is connected to a computer.
- As the probe “sees” the objects inside your body, the computer records these images for later analysis.
Who performs the Ultrasound test?
- Any ultrasound examination done in our office is performed by a Board Certified Ultrasonographer.
- Our lead Ultrasonograher is Mike T, who has been performing ultrasound studies for over 15 years.
What is an Echocardiogram or Echo?
- An Echocardiogram, also called an “Echo”, is an ultrasound test of your heart. It visualizes the beating heart, the pumping blood, and the valves inside your heart.
What is a Carotid Doppler study?
- A Carotid Doppler study is to visualize the blood flow in the major blood vessels going to your brain, including the internal carotid arteries and the vertebral arteries.
Why is an Echo or Carotid Doppler study ordered?
- An Echo and Carotid Doppler tests are typically ordered as part of a “stroke work up”, looking for various causes for strokes.
What is a “NeuroTrax” Test?
- A NeuroTrax test is a computerized test to assess whether you have any cognitive impairment caused by your medical / neurological conditions.
- It is an office based NeuroPsychology test.
How is it performed?
- The test is performed on a computer, although you do NOT have to know how to use a computer to take this test.
- The test takes approximately 30-45 minutes to complete.
What will the results reveal?
- The results will tell us what type of cognitive impairment you may have.
- It will give is a “score” which can be tracked over time to look for any worsening or improvement.
How often is the NeuroTrax test performed?
- If abnormal, we typically repeat this test every 6 months to look for any changes.
Autonomic Nervous System test (ANS)
What is the “Autonomic Nervous System” (“ANS”) ?
- Your autonomic nervous system (ANS) is the part of your nervous system that functions to sustain your life by controlling your heart, lungs, digestive system, blood pressure, immune system, certain of your reflexes, fluid balance, pupil diameter, sweating, and sexual function.
- There are two parts (or branches) of your ANS: the sympathetic branch and the parasympathetic branch. Generally, the sympathetic branch is more in control when you are stressed, ill, or injured, while the parasympathetic branch is more in control when you are relaxing, sleeping, or recovering from an illness or injury.
- In fact, most illnesses and injuries cause or result from an imbalance between these two branches. An imbalance in your ANS can tell your doctor many things about how healthy you are, as well as what can be done to keep you as healthy as possible.
What is an ANS Test?
- We perform three (3) independent clinical ANS tests (or studies) designed to determine the ability of both branches of the autonomic nervous system (ANS) to respond to and relax from a challenge.
- The two branches that make up the ANS are the sympathetic and parasympathetic (SNS and PSNS, respectively).
What are the different components of the ANS test?
The ANS test consists of 3 components or challenges.
The challenges are:
- deep breathing to challenge the PSNS,
- valsalva to challenge the SNS, and
- standing from a seated position to challenge both systems
How long does it take?
- A study takes approximately 25 minutes to complete.
What results will be obtained from this test?
- The ANS test will tell us whether your sympathetic and parasympathetic nervous system are “in balance” or “out of balance”.
- These results will help guide Dr. Athni in formulating a treatment plan to try to bring the ANS back “in balance”.
How often is the ANS test performed?
- If your ANS test is “normal”, we will not have to repeat the study at any set interval.
- But, if it is abnormal, we will probably repeat the study in 4-6 months to see if our therapeutic intervention is resulting in any ANS improvement.