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.

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.

eVOX – Quantitative EEG

What is it?

• eVox uses quantitative EEG technology along with various brain health biomarkers to aid in the diagnosis of cognitive disorders.

What is a Head Map?

• Computational EEG head maps are a visual representation of the difference in activity between a patient’s brain and a standardized database.

What are Brain Biomarkers?

• Objective metrics derived from computational EEG data provide insight into how the brain is functioning. Peak Alpha Frequency (PAF) reflects cognitive capacity and physiological aging3,4. Theta/Beta Ratio reflects inattention and is FDA cleared to aid in the diagnosis of various cognitive disorders.

What is an Event Related Potential (ERP)?

• ERPs measure brain processing speed and efficiency7. They are highly sensitive biomarkers that have been shown to reflect functional abnormalities even prior to symptom onset

What is a “Go-No-Go” Task?

• Performance during a go/no-go task reflects a patient’s ability to perform daily tasks effectively. Reaction time, reaction time variability, omission errors, and commission errors give insight to cognitive status and behavioral functioning

How do you prepare for the eVox test?

• For the test, PLEASE do the following:
  • 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 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 the associated Brain Biomarkers, all of which will be put together in the form of a “report”.
• This will be reviewed with you on your next office visit.

NeuroTrax Test

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.