Other Services

1. EMG (Electromyography) and Nerve Conduction Study

When your muscles are sore or weak and you don’t know the reason, there are a couple of tests that can help give you answers.

One is electromyography (EMG). The other is a nerve conduction study (NCS). They are often done at the same time.

Your doctor can use the results of these tests to figure out whether you have a muscular problem or a nerve problem.

Your muscles move when nerve signals from the brain tell them to get to work. Electromyography measures how well your muscles respond to those signals.

If the test picks up a problem, you may be diagnosed with what is called a neuromuscular disorder.

Nerve signals are electrical impulses that travel quickly throughout your nervous system. Sometimes, problems with the electrical activity in your nerves can cause pain, tingling, or weakness in your muscles.

NCS measures how fast and how strong the electrical activity is in a nerve. The test can tell whether a nerve has been damaged.

Neither NCS or EMG will solve your muscle or nerve problems, but they will give doctors key information about how to help you start feeling better soon.

2. SLEEP STUDY

Polysomnography, also called a sleep study, is a comprehensive test used to diagnose sleep disorders. Polysomnography records your brain waves, the oxygen level in your blood, heart rate and breathing, as well as eye and leg movements during the study.

Polysomnography monitors your sleep stages and cycles to identify if or when your sleep patterns are disrupted and why.

Your doctor may recommend polysomnography if he or she suspects you have:

Results

The measurements recorded during polysomnography provide a great deal of information about your sleep patterns. For example:

3. BERA: Brainstem evoked response auditory

Brainstem evoked response auditory is a test to measure the brain wave activity that occurs in response to clicks or certain tones. Early detection and rehabilitation of a hearing loss is important for the development of speech and language skills in hearing impaired children.

BERA is an effective and non-invasive means of assessing the functional status of the auditory nerve and brainstem auditory sensory pathway. It is not significantly altered by the state of consciousness, drugs and variety of environmental factors

BERA can be done without the patient needing to do anything. Patients only need to lie down and preferably in a calm attitude or while sleeping. For children, this examination can be done in the wake, sleep, or in anesthesia (although rarely). Electrodes will be placed on the patient’s head and behind the ear during the BERA test procedure. During the examination, the patient will hear various sounds through headphones. This examination measures changes in brain electrical activity (EEG) in the provision of acoustic stimuli. Abnormalities that occur in the transmission of signals when the sound is heard indicates hearing loss.

4. Somatosensory evoked potential (SSEP)

A somatosensory evoked potential (SSEP) is an evoked potential caused by a physical stimulus (usually a small electric pulse). Electrodes positioned over particular areas of the body record responses of the SSEP, these are then observed as a reading on an electroencephalogram (EEG). A SSEP can most commonly involve stimulation of the median nerve at the wrist, or the posterior tibial nerve at the ankle. This investigation therefore tests the pathway of the sensory nerves to the sensory areas of the brain, even though the stimuli are non-physiological.

A doctor may recommend you go for a SSEP test if you have been experiencing feelings of numbness or weakness in your arms or legs that may be due to problems affecting the somatosensory nerve pathway. These feelings are often very subtle and not easily detected in a routine clinical examination.

From the SSEP, a neurologist is able to determine the time it takes for nerve fibres to relay a stimulus from the point of stimulation (wrist or ankle) to a detection site on the scalp, neck or back. By analysing the SSEP pattern, the neurologist can get an idea of how well these sensory nerves are working. Multiple sclerosis (MS) for example, can damage the myelin sheath insulating nerve fibres of the brain and spinal cord in a process called demyelination. The damage means it takes a longer time for signals to be relayed along nerve pathways, or they may be blocked, resulting in changes in the SSEP.

Clinical usefulness of the SSEP

5. Ambulatory blood pressure monitoring (ABPM)

Ambulatory blood pressure monitoring (ABPM) is a relatively new technique for assessing a person’s blood pressure. ABPM allows a doctor to assess your blood pressure during your routine daily living, instead of when you are sitting nervously on the doctor’s examination table.

Ambulatory blood pressure monitoring is accomplished with a special device that consists of a blood pressure cuff that is worn on your arm and is attached to a small recording device that you wear on your belt. You wear the ABPM device for either 24 or 48 hours, and it records your blood pressure periodically (usually at 15-minute or 30-minute intervals) throughout that period, during your routine daily activities and while you are sleeping.

So the ABPM provides your doctor with a complete record of your blood pressure for a one- or two-day period.

ABPM has been helpful in assessing people with white coat hypertension, allowing their doctors to decide whether their in-office blood pressure elevations actually reflect a “non-resting” state (that is, a state of anxiety), instead of the “quiet resting state” that is required for an accurate in-office blood pressure recording. While many times high in-office blood pressure readings truly indicate that hypertension is present, sometimes that is just not the case.

ABPM has also been useful in situations in which it has been difficult to determine the effectiveness of an anti-hypertensive treatment regimen, or when a person is suspected to have abnormally wide fluctuations in blood pressure that make diagnosing and treating hypertension difficult. ABPM can also help in the diagnosis and treatment of some forms of dysautonomia, especially when intermittent and unpredictable episodes of very low blood pressure are suspected.

6. HOLTER TEST

A Holter monitor is a small, battery-powered medical device that measures your heart’s activity, such as rate and rhythm. Your doctor may ask you to use one if they need more information about how your heart functions than a routine electrocardiogram (ECG) can give them.

Twenty-four hour Holter monitoring is a continuous test to record your heart’s rate and rhythm for 24 hours. You wear the Holter monitor for 12 to 72 hours as you go about your normal daily routine. This device has electrodes and electrical leads exactly like a regular ECG, but it has fewer leads. It can pick up not only your heart’s rate and rhythm but also when you feel chest pains or exhibit symptoms of an irregular heartbeat, or arrhythmia.

Holter monitor testing is also sometimes called ambulatory electrocardiography. There are other types of devices that can be used to measure heart activity for longer periods of time.

The Holter monitor may reveal that your medicine isn’t working or your dosage needs to be altered if you’re already taking medication for an abnormal heart rhythm. It’s especially useful in detecting abnormal heart rhythms that are painless and unknown to you.

Wearing a Holter monitor is painless and one of the best ways to identify potential heart problems or other issues.