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Diagnostic Testing Dr. Bakker, Physician's Assistant Sarah Layman, or your referring physician may order some of the diagnostic tests or precedures listed below. Please bring these test or precedure results with you when you visit Comprehensive Neurology and Sleep Medicine. EEG: A brainwave study, electrodes are applied to the scalp, the patient is monitored in a quiet environment for approximately 45 minutes. This is a painless procedure and is especially helpful in diagnosing seizures or epilepsy. It also may be ordered in patients with "black out spells" or who have passed out.
EMG: Is useful in determining nerve damage and the muscle's response to that nerve damage, a small needle is placed in various muscles of the affected limb and in the muscles near the back bone. This test may be uncomfortable but is not terribly painful; needles are not placed in the spine and there will not be a shocking sensation through the needle. NCV: Nerve conduction velocity helps to determine damage to nerves; this is a common test for carpal tunnel. During the test a small electrical current will be applied in various locations along the affected limb. This test may be uncomfortable, but no sustained pain will occur. This is a non-invasive test. VNS adjustment: A Vagus Nerve Stimulator is an implanted device used to help to control epileptic seizures. After being implanted by a neurosurgeon the device can be programmed and adjusted in our office. This is a painless procedure lasting approximately 5 minutes. BOTOX®: Botulinum toxin may be injected in small doses for various neurologic conditions. Although it was first used for cosmetic purposes, we use it for the treatment of medical ailments. BOTOX® may be injected in the forehead and neck for migraine headaches, near the eyes for blepharospasms (uncontrolled blinking of the eyes), torticollis (involuntary, painful turning of the neck muscles), hemifacial spasms, and spasticity involved with various neurological disorders including stroke, MS, and cerebral palsy. Evoked Potentials: There are three types of evoked potentials: auditory, sensory, and visual. During each study the patient's brainwaves will be monitored with painless electrodes on the scalp while an auditory (sound), sensory (touch), or visual stimulus is applied. This test may be helpful in making the diagnosis of multiple sclerosis. If all three portions of the test are completed, the time for the test is approximately three hours.
MRI: An MRI uses a strong magnet to produce pictures of the human body; it does not use X-ray radiation. Some people are unable to have MRIs; examples include those with pace-makers or with metal fragments near the eyes. An MRI may be given with or without dye depending on which condition your provider is concerned you may have. If needed the MRI dye, called gadolinium, is given through an IV; it is very well tolerated and virtually free of allergens. An MRI is a painless procedure, however, some people may become claustrophobic during an MRI. If you believe you will become claustrophobic discuss this with the provider who ordered the MRI to find ways that the procedure may be more comfortable. An MRI of the brain typically lasts 20 minutes. An MRI of the brain may be ordered to test for a stroke, a brain tumor, or MS; MRIs may also be helpful in evaluating patients with seizures, headaches, or memory loss. An MRI of the spine may be ordered to look for a herniated disk that may cause a pinched nerve. Carotid Ultrasound: A painless procedure in which an ultrasound wand is rolled over the carotid arteries in the neck. This test looks for clogged arteries that may put you at risk for a stroke. Sleep-Related Testing PSG: Polysomnogram or sleep study, this study is completed at a sleep lab; it is an overnight test. During the study extensive testing is completed including monitoring brain waves, heart rate, oxygen level in the blood, and movement of the legs. This test is particularly helpful to discover if a person suffers from sleep apnea. CPAP Titration: Similar to a PSG, this test is ordered after a patient is diagnosed with sleep apnea and has decided to pursue treatment through a CPAP machine. In addition to the monitors set up for a PSG the patient will also be placed on a CPAP mask. This mask will be connected to a machine that blows air into the throat to keep the throat open during sleep. The purpose of the test is to determine the pressure at which the machine should blow the air in order to control your individual sleep apnea. Split Night Study: A combination of a PSG and a CPAP titration. The goal of this test is to combine two tests into one. For the first two hours of the night a PSG is completed, then if the patient is found to have significant sleep apnea they will be awakened and placed on a CPAP mask so a CPAP titration study can be completed for the rest of the night. MSLT: Multiple sleep latency test; this test is a "daytime sleep study." It is used to evaluate patients who feel excessively sleepy during the day. During the test you will be wired as if to have a PSG, however the test will occur in the daytime not during bedtime. During the study you will be asked to lay down and try to take brief naps throughout the day. The time to the onset of sleep and the ability to reach REM (rapid eye movement) sleep will be recorded. This test is used to diagnose narcolepsy and idiopathic hypersomnolence.
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Ambers Professional Center 172 Thomas Johnson Drive, Suite 100 Frederick, MD 21702 Tel: 301.694.0900 Fax: 301.694.0657 VIEW MAP
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