Neurodiagnostic Testing Services

Electromyography (EMG)

Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by skeletal muscles. EMG is performed using an instrument called an electromyograph, to produce a record called an electromyogram. An electromyograph detects the electrical potential generated by muscle cells when these cells are electrically or neurologically activated. The signals can be analyzed to detect medical abnormalities in conditions such as numbness, tingling, and weakness in the arms, legs, and trunk, neck pain, and lower back pain.

Nerve Conduction Studies (NCS)

A nerve conduction study (NCS) is a measurement of the speed of conduction of an electrical impulse through a nerve. NCS can determine nerve damage such as due to compression or disease (e.g. diabetes) During the test, the nerve is stimulated, usually with surface electrode patches attached to the skin. Two electrodes are placed on the skin over the nerve. One electrode stimulates the nerve with a very mild electrical impulse and the other electrode records it. The resulting electrical activity is recorded by another electrode. This is repeated for each nerve being tested. The nerve conduction velocity (speed) is then calculated by measuring the distance between electrodes and the time it takes for electrical impulses to travel between electrodes.

Evoked Potentials Studies

Evoked potentials studies measure electrical activity in the brain in response to stimulation of sight, sound, or touch. Stimuli delivered to the brain through each of these senses evoke minute electrical signals. These signals travel along the nerves and through the spinal cord or brain and are picked up by electrodes, amplified, and displayed for a doctor to interpret.
These studies include:
Visual Evoked Potentials (VEP)
Brainstem Auditory Evoked Response (BAER)
Somatosensory Evoked Potentials (SEP)

Botulinum (BOTOX) Therapy

Understanding BOTOX Therapy

Botulinum toxin type A (BOTOX) and botulinum toxin B (Myobloc) are therapeutic muscle-relaxing agents that cause weakening of overactive muscles or reduced sweating and drooling. These treatments work at the site of the nerves where they are injected, and are associated with few side effects.

Botulinum toxin is injected into the muscle with a very fine needle. Some patients report minor or temporary discomfort from the treatment, which typically is needed no more than four times a year. Each person will experience a different level of relief and therapeutic benefit.

Candidates for BOTOX Therapy

Botulinum toxin therapy can be used to treat symptoms in both adults and children. Patients are seen at the clinic for a variety of neurological conditions such as dystonia (blepharospasm, spasmodic torticollis, writer’s cramp), hemifacial spasm, spasticity in stroke, cerebral palsy, muscle spasms, excessive drooling, and chronic migraine headaches.

Dystonia is a neurologic disorder of unknown cause that causes involuntary muscle spasms. Symptoms of twisting, pulling or prolonged contractions typically start in the face, neck or hands for adults. Secondary dystonias due to injury or stroke can appear at any age. Dystonia can affect any part of the body including the arms and legs, trunk, neck, eyelids, face or vocal cords.

Cerebral palsy is a common, non-progressive neurologic disorder of children that causes stiffness and lack of muscle control in arms and/or legs. Botulinum toxin can be useful when combined with other medical and surgical therapies. Botulinum toxin is commonly used in children who experience toe walking, crouched gait, scissoring (crossing of the legs), or tightness in the arms/ hands.

Note: Botulinum toxin is FDA approved for hemifacial spasm, blepharospasm, and cervical dystonia. Most insurance companies pay for other indications but this may require verification with specific insurance providers.

Specialist Services

  • Alzheimers Disease
  • Amyotrophic Lateral Sclerosis
  • Autonomic Disorders
  • Back Pain
  • Bell's Palsy
  • Brain tumors
  • Carpal tunnel syndrome
  • Cluster Headache
  • Convulsions
  • Dementia
  • Epilepsy
  • Gait disorders
  • Headache
  • Hemorrhagic stroke
  • Memory loss
  • Migraine
  • Movement Disorders
  • Multiple Sclerosis
  • Myasthenia Gravis
  • Myopathies (Muscle disorders)
  • Neck Pain
  • Numbness
  • Parkinson's disease
  • Radiculopathy ("pinched nerve")
  • Sciatica
  • Seizures
  • Sensory Disturbances
  • Stroke
  • Tingling
  • Transient Ischemic Attack/mini-stroke
  • Tremor
  • Vertigo and Imbalance