NEUROPHYSIOLOGICAL ASSESSMENT

 

Neurophysiological Assessment

Definition

                        The measurement of one or more physiological processes that reflect autonomic nervous activity (heart rate, brain electrical activity, body temperature).

Introduction

            A neurophysiological examination is the assessment of sensory neuron and motor responses especially reflexes to determine whether there are lesions in central and peripheral nervous system or there is another diffuse process that is troubling patient. This typically includes a physical examination, a review of patient’s medical history and neuroimaging. It can be used both as screening and investigating tool, the former of which when examining a patient when there is no expected neurological deficits and later of which when examining a patient where you do expect to find abnormality. If problem is found either in investigating and screening than further tests are carried out to focus on a particular aspect of nervous system, then physician determines whether these finding combine to form recognizable medical syndrome.

Purposes of conducting Neurophysiological Assessment

A purpose of neurophysiological evaluation can help to determine the cause of impairment and help clinicians begin to localize the problem. Symptoms that occur unexpectedly suggest a blood vessel or seizure problem. Those that are not sudden suggest the tumor problem. Symptoms that have a warning course with recurrence and worsen over time suggest a disease that destroys nerve cells. Other that is chronic and progressive indicates a degenerative disorder. In cases of trauma, symptoms may be evident upon inspection and causes may be explained by third party. Some patients may require extensive neurological screening examination to determine the cause. It will assist clinicians in diagnosing illness as diverse as seizure disorder, narcolepsy, migraine, dizziness, and dementia. 

Types of neurophysiological assessment

Computed tomography scan (CT scan): A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs.


Electroencephalogram (EEG): A procedure that records the brain's continuous electrical activity by means of electrodes attached to the scalp.


Magnetic resonance imaging (MRI): A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.


Electromyography (EMG) and Nerve conduction velocity (NCV): Studies that evaluate and diagnose disorders of the muscles and motor neurons. Electrodes are inserted into the muscle, or placed on the skin overlying a muscle or muscle group, and electrical activity and muscle response are recorded.


Positron emission tomography (PET): In nuclear medicine, a procedure that measures the metabolic activity of cells.


Arteriogram: It is also called Angiogram. X-ray of the arteries and veins to detect blockage or narrowing of the vessels.


Spinal tap: It is also called a lumbar puncture. A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes the brain and spinal cord.


Evoked potentials: Procedures that record the brain's electrical response to visual, auditory, and sensory stimuli.


Myelogram: A procedure that uses dye injected into the spinal canal to make the structure clearly visible on X-rays.


Neurosonography: A procedure that uses ultra-high frequency sound waves that enable the healthcare provider to analyze blood flow in cases of possible stroke. 


Ultrasound: It is also called sonography. A diagnostic imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs as they function, and to assess blood flow through various vessels.

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