Neurophysiology Procedures

Nerve Conduction Study (NCS) techniques permit stimulation and recording of electrical activity from individual peripheral nerves. This is extremely important in diagnosing the different disorders of peripheral nerves such as Diabetic Peripheral Neuropathy and Carpal Tunnel syndrome. 

NCS test also aids in the differentiation of the different types of Neuropathies. This will help selecting the proper treatment. NCS techniques can also be used to prognosticate regarding clinical course and efficacy of treatment.

Some of the most common applications of Nerve Conduction studies:

• Diabetic Neuropathy
• Carpal Tunnel syndrome 
• Inflammatory Neuropathies such as Guillan Barre syndrome (GBS) and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
• Hereditary Neuropathies

The test will involve placing small electrodes (stickers) on the skin and after providing a sufficient electrical stimulation the response from the individual nerves will be recorded. 

The electrical stimulation is small and well tolerated by almost all patients. 

Important instructions to the patients: 

• Kindly keep hands and feet warm prior to the testing.  This can be achieved by wearing gloves.
• Please try to wear comfortable and loose cloths so arms and legs can be accessed. 
• Remind us of your medications, importantly if you take any anticoagulant (blood thinners). 

EMG is the clinical study of the electrical activity of the muscles. This activity is obtained from the particular muscle at rest and during action. Hence, the cooperation from the patient is crucial. 

The test will involve inserting a small very sterile fine needle into different muscles and record the electrical signals. This will provide very important information about the nerve and muscle disorders. It can also predict the prognosis and help selecting the proper treatment. 

As mentioned above, the needle is a small fine needle, the discomfort and pain are usually minimal, it is very well tolerated by all patients. 

The test is considered invasive so sterile protocol must be followed to avoid infection. The skin is cleaned by alcohol and gloves must be worn by the Neurophysiologist. 

This procedure involves stimulating the facial nerve on both sides and recording the muscle responses from the corresponding muscles on the face. It is useful in cases of Bell`s palsy. EMG of the facial muscles is usually done parallelly. It is a useful procedure for cases of Bell`s Palsy, especially if recovery was delayed. 

This procedure is useful to diagnose Myasthenia Gravis. This is an autoimmune Neuromuscular disorder that results in weakness not of eye and limb muscles but also speech and swallowing muscles. 

This test involves fast repetitive electrical stimulations of muscles of the face, shoulder or the little finger. No needle is involved, and the test is usually well tolerated. 

The stimulations should be applied at rest, and immediately after exercising the muscle to look for any fatigability.