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Procedures and Tests

About MRI

Magnetic resonance imaging (MRI) uses a powerful magnetic field to produce detailed images of body structures including tissues, organs, bones, and nerves.

Neurological uses include the diagnosis of brain and spinal cord tumors, inflammation, infection, vascular irregularities and stroke. MRI can also detect and monitor degenerative disorders. It can be used to work up brain injury from trauma.

The equipment houses a hollow tube that is surrounded by a very large cylindrical magnet. The patient, who must remain still during the test, lies on a special table that slides into the tube. The patient will be asked to remove jewelry, eyeglasses, removable dental work, or other items that might interfere with the magnetic imaging. The patient should wear a sweat shirt and sweat pants or other clothing free of metal eyelets or buckles. 

MRI scanning equipment creates a magnetic field around the body strong enough to temporarily realign water molecules in the tissues. Radio waves are then passed through the body to detect the “relaxation” of the molecules back to a random alignment and trigger a resonance signal at different angles within the body. A computer processes this resonance into either a three-dimensional picture or a two-dimensional “slice” of the tissue being scanned, and differentiates between bone, soft tissues and fluid-filled spaces by their water content and structural properties. A contrast dye may be used to enhance visibility of certain areas or tissues. The patient may hear grating or knocking noises when the magnetic field is turned on and off. (Patients may wear special earphones to block out the sounds.)

Please make a follow-up appointment for the results

After your child has taken the MRI, please stop at the front desk to schedule a follow-up appointment to discuss the results with the doctor. If no one is available at the desk, please call to schedule a follow-up appointment.

If you cannot keep your appointment, please be sure to call us.

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About SpringTMS for Migraines

SpringTMS is an advanced migraine treatment system that can work without medications and causes no serious side effects.

Patients press the portable SpringTMS device to the back of the head and activate it for a few seconds. The device emits gentle, therapeutic magnetic pulses that harmlessly affect neurons in the brain to reduce the effects of migraine. SpringTMS is the only non-drug therapy clinically proven to effectively stop or reduce pain associated with migraine with aura. Our doctors can prescribe SpringTMS for you to use at home.

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About EEG

An electroencephalogram (EEG) is a test used to detect abnormalities related to electrical activity of the brain.

This procedure tracks and records brain wave patterns. Small metal discs with thin wires (electrodes) are placed on the scalp and record signals to a computer. Normal electrical activity in the brain makes a recognizable pattern. Through an EEG, we can look for abnormal patterns that indicate seizures and other dysfunctions.

Why an EEG test is done

The most common reason for an EEG is to diagnose and monitor seizure disorders. EEGs can also help to identify causes of other problems such as sleep disorders and changes in behavior.

How the test is done

Most EEGs are performed right here in our office. Your child will be asked to lie on a bed or sit in a chair. The technician will attach electrodes to different locations on the scalp using adhesive paste. Each electrode is connected to an amplifier and EEG recording machine. The electrical signals from the brain are converted into wavy lines on a computer screen and stored digitally. Your child will be asked to lie still because movement can alter the results.

EEGs are safe. If your child has a seizure disorder, we may want to stimulate and record a seizure during the EEG. A seizure can be triggered by flashing lights or a change in breathing pattern. The technician will know your child’s medical history and will be prepared for any issues that may arise during the test.

Most in-office EEGs take about an hour to perform. If your child is required to sleep during the EEG, the test will take longer. You might be able to stay in the room with your child, or you can step outside to a waiting area.

Other types of EEGs: ambulatory EEG and EMU

While most EEGs are performed in our office, occasionally the hour allotted for an in-office EEG does not capture the brain activity we want to examine. In this case, we may perform an ambulatory EEG, where the child wears electrodes and a “backpack” for several days to capture the information. An EMU (Epilepsy Monitoring Unit) is an all-day EEG performed at a hospital. In addition to electrodes attached to the scalp, a video camera also records the patient’s behavior in question. The can test takes between 24 and 72 hours of hospitalization.

Please make a follow-up appointment for the results

After your child has taken the EEG, please stop at the front desk to schedule a follow-up appointment to discuss the results with the doctor. If no one is available at the desk, please call to schedule a follow-up appointment.

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About EMG

During an EMG, a very fine needle is inserted into a muscle. The needle is attached to a wire which connects to a to a recording instrument.

Testing lasts about an hour but may take longer, depending on the number of muscles and nerves to be tested. Most patients find this test to be somewhat uncomfortable.

An EMG is usually done in conjunction with a nerve conduction study (NCV), which measures the ability to send a electrical signal along the nerve. Multiple nerves are often tested. This two-part test is conducted in our office.

A technician tapes a set of flat electrodes on the skin over the muscles. A hand held stimulator sends brief electrical stimuli to the nerve. The taped electrodes record the signal. The physician then reviews the response to verify if there is any damage to the nerve or muscle.

Please make a follow-up appointment for the results

After your child has taken the EMG/NCV, please stop at the front desk to schedule a follow-up appointment to discuss the results with the doctor. If no one is available at the desk, please call to schedule a follow-up appointment.

If you cannot keep your appointment, please be sure to call us.

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About VNS (Vagus Nerve Stimulation)

The vagus nerve stimulator was approved by the U.S. Food and Drug Administration (FDA) in 1997 for use in people with seizures that are not well-controlled by medication.

The vagus nerve stimulator is a battery-powered device that is surgically implanted under the skin of the chest, much like a pacemaker, and is attached to the vagus nerve in the lower neck. This device delivers short bursts of electrical energy to the brain via the vagus nerve. Patients usually cannot stop taking epilepsy medication because of the stimulator, but they often experience fewer seizures and

they may be able to reduce the dose of their medication.

Side effects of the vagus nerve stimulator are generally mild but may include hoarseness, ear pain, a sore throat, or nausea. Adjusting the amount of stimulation can usually eliminate most side effects, although the hoarseness typically persists. The batteries in the vagus nerve stimulator need to be replaced about once every 5 years; this requires a minor operation that can usually be performed as an outpatient procedure.

Please make a follow-up appointment for the results

After your child has had the procedure, please stop at the front desk to schedule a follow-up appointment to discuss the results with the doctor. If no one is available at the desk, please call to schedule a follow-up appointment.

If you cannot keep your appointment, please be sure to call us.

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About Botox

Botulinum toxin injections have been shown to be effective for treating focal dystonia, migraines and spasticity.

Botox for Focal Dystonia

The botulin toxin works by blocking the release of acetylcholine, a neurotransmitter that causes muscles to contract. First used to treat blepharospasm, botulinum toxin injections are now used to treat a variety of focal dystonias, particularly cervical dystonia. Though their use carries the risk of temporary paralysis of the muscles being injected or the leaking of the toxin into adjacent muscle groups causing weakness or paralysis in them.

Unlike surgery, the effects of botulinum toxin injections are not permanent. This can be an advantage in some cases, but treatments must be repeated as the effects wear off. The benefits of treatment usually lasts for 3-6 months before the injections have to be repeated.

About 15% of recipients of botulinum toxin will develop immunity to the toxin (Antibodies develop against the toxin). Those that develop resistance to one type of botulinum toxin may be able to use another.

Botox for Spasticity

Botulinum toxin is used to treat spasticity in CP and other UMN problems. It can help stop muscle spasms, and alleviate pain. In general, botulinum toxin is not used to treat widespread severe spasticity because the amount of toxin required would be too great and increase the risk of side effects However, selected spastic muscle groups can be treated to provide improve function.

Please make a follow-up appointment for the results

AAfter your child has had the procedure, please stop at the front desk to schedule a follow-up appointment to discuss the results with the doctor. If no one is available at the desk, please call to schedule a follow-up appointment.

If you cannot keep your appointment, please be sure to call us.

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About TOVA

The Test of Variables of Attention (TOVA) is an objective, neurophysiological measure of attention that helps us diagnose attention disorders.

The TOVA is based on the concept that children with ADHD have greater-than-average difficulty sustaining attention to dull or repetitive tasks. The TOVA assigns such a task, measures responses, and compares the results to those of children without attention disorders within the same age group.

The TOVA is similar to a computer game, so it is easy for young children to grasp. You can sit quietly in the room while your child takes the test, or you can sit in the waiting room. If you choose to be in the testing room, it is important that you not distract your child, as this could affect the test results. The test takes approximately 30 minutes.

Please make a follow-up appointment for the results

After your child has taken the TOVA, please stop at the front desk to schedule a follow-up appointment to discuss the results with the doctor. If no one is available at the desk, please call to schedule a follow-up appointment.

If you cannot keep your appointment, please be sure to call us.

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On-site MRI services

Urgent and same-day appointments available (contingent upon insurance authorization). We welcome patients from outside our practice, including adults. If you have a high deductible, ask about our cash discount.

 

EEG

Our office welcomes adult patients for EEG testing, with a doctor’s referral.