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Neurology Procedures


 

Indiana Neurology and Pain offers a wide variety of treatment options for spinal, musculoskeletal, and neurological injuries. We specialize in three main procedures for diagnosing and treating your neurological conditions, including: Nerve Conduction Study, Electroencephalogram and Vagus Nerve Stimulation.


Nerve Conduction Study

What is a Nerve Conduction Study?

A Nerve Conduction Study (NCS) measures how fast an electrical impulse travels through the nerve and helps identify nerve damage.

During this test, we stimulate a nerve by attaching two electrodes patches on the skin over the nerve. One electrode stimulates the nerve with a very mild electrical impulse, while the other electrode records it. This process is repeated for each nerve being tested.

We measure the time it takes for the electrical impulse to travel between the two electrodes . The speed at which the nerve fires can tell us a lot about the damage to a specific nerve or group of nerves.

We also use a procedure called an electromyography (EMG) to measure the electrical activity in your muscles. Both of these tests can be used together in order to determine the presence, location, and the extent of the disease that has damaged your nerves and muscles.


Electroencephalogram

An Electroencephalogram or EEG, is a test that detects abnormalities in the electrical activity of the brain.

During an EEG, electrodes are placed on the patient’s scalp with paste or a cap is placed on the patient’s head. Electrodes detect tiny electrical charges in the brain that result from activity within the brain cells. These electrical charges are amplified by our monitoring equipment and displayed as a graph on a computer screen for us to read and analyze.

We use the EEG to evaluate several types of brain disorders. For example, Epileptic seizure activity appears as rapid spiking waves on the EEG monitor. Patients with brain tumors, or who have had a stroke, may have unusually slow EEG waves.

The EEG also helps us diagnose disorders that influence brain activity, such as Alzheimer’s disease, certain psychoses, and even some sleep disorders.

How does the procedure work? 

Anterolateral view of male figure with brain and spinal cord with epileptic brain activity ;
SOURCE: Footage from John Hopkins Medicine

  1. For this procedure, we ask that you relax in a reclining chair or lie on a bed.
  2. Next, we place between 16 and 25 electrodes to your scalp with a special paste, or a cap containing the electrodes.
  3. Finally, you will close your eyes, relax, and be still.
  4. Once the recording begins, you will need to remain still throughout the test. The recording may be stopped periodically to let you rest or reposition yourself.
  5. After the initial recording, we test various stimuli to produce brain wave activity that does not show up while you are resting. For example, breathing deeply and rapidly for 3 minutes, or exposing you to a bright flashing lights.
  6. If you are being evaluated for a sleep disorder, the EEG may be done while you are asleep.
  7. If you need to be monitored for a longer period of time, you may also be admitted to the hospital for a prolonged EEG (24-hour EEG) monitoring.
 

Vagus Nerve Stimulation

Vagus Nerve Stimulation (VNS) is designed to prevent epilepsy seizures by sending regular, mild pulses of electrical energy to the brain via the Vagus Nerve. These pulses are generated by a small device implanted under your skin, similar to a pacemaker.

In general, most patients do not feel any of the electrical impulses from the implanted device.

VNS Implantation

The VNS procedure usually takes about 45 – 90 minutes. It is performed on an outpatient basis, with the patient under general anesthesia.

As with all surgeries, there is a small risk of infection. Other surgical risks of VNS include inflammation or pain at the incision site, damage to nearby nerves, and possibly nerve constriction.

During the procedure, two small incisions are made. The first incision is made on the upper left side of the chest where the pulse generator is implanted. The second incision is made horizontally on the left side of the lower neck, along a crease of skin. This is where the thin, flexible wires that connect the pulse generator to the vagus nerve are inserted.

After the implant is complete, the strength and duration of the electrical impulse is programmed into the device. The amount of stimulation varies by case, but typically patients are started at a low level setting and slowly increased to a suitable level. The device runs continuously and is programmed to turn on and shut off for specific periods of time.

To learn more about VNS Therapy – watch the following videos below

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