Neurodiagnostic Procedures - EEG Dubai
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Electroencephalogram -EEG Dubai
EEG is a non-invasive, pain-less test to record brain’s bio-electrical activity otherwise called “brain waves” through the skull; think about ECG recording heart activity. EEG is used to help diagnose brain disorders such as seizures, metabolic, infectious, or inflammatory disorders. EEG is not used for headaches or to test your memory for example. Despite “Electro”; there is nothing “electrical” to be applied or given to the patient; it is about recording brain’s bio-electrical activity by applying small metal discs called electrodes on your scalp.
You will be lying on a bed, following the technician instructions; rest, open /close eyes, breathe deeply, look at flickering light and eventually even sleep! Routine EEG can take about 60-90 min or more if required. Your hair should be clean and dry without any oils, gels, eventually shampoo the night before.
If Sleep deprived EEG is requested, you will be asked to only sleep three hours in the night before. You may continue to take your regular medication as usual and have your meal without coffee or tea.
Nerve Conductions Studies & Electromyography NCS/EMG
Nerve Conduction Studies (NCS) and Electromyography (EMG) help in the diagnosis of symptoms like hands or feet numbness and/or pain, tingling, pain in the upper or lower limbs, weakness and of diseases like carpal tunnel syndrome or other nerves entrapment, polyneuropathy, radiculopathy, myasthenia gravis, motor neuron disease and myopathies. It helps testing the function of nerves and muscles in order to determine localization, type of abnormality, severity, prognosis as well as treatment choice.
The test involves 2 parts: The first; NCS is done by a technician. The study is done by delivering a modified small electrical current over 2 points of a nerve and recording the response over the nerve or a muscle. This allows to measure the velocity of the nerve conduction as well as other parameters. The second part; EMG involves the use of a small, thin needle inserted in some muscles to “listen” to the electrical activity of the muscles at rest and during a voluntary contraction. EMG is about muscles, here no electricity is delivered. EMG is always performed by the doctor. You will be asked to relax, do a slight then a full-strength muscle contractions. EMG can also be used to better localize BOTOX injection site to treat post-stroke spasticity. There may be a little, transient discomfort but in most of patients it is well tolerated. Please do not apply any lotions, oils, or perfumes and come with loose clothes easy to be pulled. Eat normally and take your daily medication.
EMG will not be done if your taking anticoagulants. Depending on the diagnosis; the test can last from 45 to 90 min. The test is “dynamic” and may vary according to the clinical diagnosis and findings encountered. If you will be more than 15 minutes late, please call and let us know as this may delay the patients booked after you. It is a long procedure and cannot be done with “hurries”. If you are unable to come, please contact us as soon as possible; other patients can be waiting.
Visual Evoked Potentials (VEP)
A VEP is helpful in determining the integrity of the visual pathway from the retina to the visual areas in the occipital lobes. A VEP is done in a dark room. You will be seated in front of a screen and asked to focus on the center of a screen displaying an alternating checkerboard pattern. Responses are recorded from electrodes placed on the back of your head.
The VEP measures the time needed for a visual stimulus to travel from the eye to the occipital cortex. VEP helps in diagnosing optic neuropathy often seen in multiple sclerosis but not only. The test may last 45 min and is painless. As for EEG, your hair should be clean and dry without any oils or gels. You do not need to be fasting. You will have to wear your eye glasses as usual.
Auditory Evoked Potentials (AEP)
An AEP helps in assessing the integrity of the auditory pathway from the auditory nerve to the brainstem. A series of clicks are delivered thru an earphone to each ear, alternatively. The response to auditory stimuli is recorded over scalp. It tests the auditory pathway from the inner ear to the brainstem. You need to relax and even sleep. The test may take up to 90 min.
You do not need to be fasting. AEP is helpful in differentiating peripheral from central hearing loss as well as its severity., It also helps in determining the mechanism of the hearing loss whether neuro-sensorial or transmission disorder. Main applications are detecting hearing loss in children, acoustic neurinoma and multiple sclerosis.
Somatosensory Evoked Potential (SSEP)
This test explores the conduction and the integrity of the sensory pathway from the peripheral nerves thru the spinal cord to the brain. A mild and short electrical stimulus is applied to a peripheral nerve in the upper or lower limbs. Responses are recorded through the electrodes applied along the sensory pathway over the peripheral nerve, spine and scalp. The skin and hair need to be clean and dry without any cosmetics such as cremes, oils, perfumes, gels etc. The test may take 90 min. you do not need to be fasting. It is helpful in spinal cord disorders such as transverse myelitis, myelopathy secondary to a disc herniation.
Lumbar Puncture (LP)
A needle is inserted into the spinal canal in the lower back, similar to the way done for epidural anesthesia in pregnant women before delivery but here is done just for collecting the CSF; cerebrospinal fluid for diagnostic purpose. It is helpful in multiple sclerosis, meningitis or encephalitis, Guillain-Barré syndrome, subarachnoid hemorrhage and to measure the CSF pressure in benign intracranial hypertension or normal pressure hydrocephalus.
It can be done either lying on your side or sitting with a local anesthesia. After the LP; it is advisable to remain flat lying 4-6 hours and well hydrated to avoid headaches which in some cases can last several days. Let your doctor know if you have prolonged headaches worse if you are standing-up, numbness and tingling of the legs, persisting pain at the site of the injection or new difficulty to urinate. You can eat normally before the LP.