Diagnosing Neurological Conditions

When you have symptoms that could point to a neurological disorder (a problem of the brain, spinal cord or nerves), you want to understand what’s wrong and to know your treatment options.

Our experienced specialists and certified technologists work together to diagnose your condition. We share the exam results with you and your doctor, and work together to create a treatment plan for you.

We use the latest diagnostics available for both children and adults, including imaging technology, neuropsychological testing, and neurodiagnostic testing.

Imaging Technology

Some conditions require that we get a better look at what’s happening inside your body. These imaging technologies allow us to diagnose your neurological disorder quickly and accurately:

CT (computed tomography)
MRI (magnetic resonance imaging)
SPECT (single-photon emission computed tomography)
PET (positron emission tomography)Ultrasound

Neuropsychological Testing

Depending upon your condition, we may also recommend neuropsychological testing. We use standardized tests to examine different aspects of thinking. These may be things like memory, executive skills, attention, language, and processing speed.

We also look at your behavior to better understand your individual profile of abilities and challenges. Sometimes the root causes of what appears to be a neurological disorder may in fact be psychological or behavioral in nature, requiring a different approach to treatment.

Neurodiagnostic Exams

In addition to imaging and neuropsychological testing, we provide a wide range of neurodiagnostic exams. We use polysomnograms (Sleep studies) and transcranial doppler (TCD), as well as these advanced diagnostic procedures:

Electromyography (EMG)

We use electromyography (EMG) to assess the health of your muscles and the nerve cells that control them. EMG can detect problems by recording electrical activity. During the test, we place a needle into the muscle we need to test or place electrodes on your skin for nerve conduction studies. Your doctor may request EMG testing if you experience:

Muscle weakness
Muscle pain or cramping
Numbness
Pain in your limbs
Tingling

We perform EMG studies for both inpatients and outpatients, and for children and adults.

Conditions We Diagnose with EMG

The Neurodiagnostics & Sleep Center within Baystate Medical Center features a state-of-the-art electromyography (EMG) suite. Our specialists use it for comprehensive testing for both common and complex neuromuscular disorders, including:

Amyotrophic lateral sclerosis (ALS, also called Lou Gehrig’s Disease)
Carpal tunnel syndrome
Guillain-Barre syndrome
Muscular dystrophy
Myasthenia gravis
Myopathies

The EMG laboratory staff also provides:

Electrodiagnostic assessment of patients with urinary and rectal incontinence
Treatment of movement disorders with botulinum toxin

Electroencephalograms (EEG)

An electroencephalogram (EEG) is a test that detects and measures electrical activity in your brain. During the test, we attach electrodes to your scalp. There are several different types of EEGs our doctors can use depending on your condition:

Ambulatory EEGs (AEEG)
EEGs performed as part of a sleep study
Six-hour video EEGs
Video EEGs (VEEG)

Conditions Diagnosed with EEG

Your doctor may request that you have an EEG to help diagnose or evaluate:

Brain dysfunction
Brain tumor
Cognitive impairment/memory disorders
Epilepsy/seizure disorder
Head injury
Inflammation of the brain (encephalitis)
Sleep disorders
Stroke

Evoked Potential (EP) Tests

Evoked potential (EP) tests can help determine a diagnosis of multiple sclerosis (MS). The tests measure the electrical activity of the brain in response to stimulation of specific sensory nerve pathways.

Types of EP Tests

Electrodes and wires are placed on your scalp to measure your brain’s response during stimulation. The visual evoked potential test is the most common. During this test, you sit in front of a screen that shows alternating patterns and the test measures your brain activity.

We also perform upper/lower somatosensory evoked potential (SSEP). During this test you will feel short electrical pulses on your arms or legs.

During the brainstem audio evoked potential (BAEP) you hear a series of clicks in each ear.

Wada Test

If you are considering surgery for epilepsy, your doctor may order a Wada test (named for Dr. Juan Wada, the first doctor who performed the test). This test helps determine the side of your brain that controls language and memory functions.

During the test, the neuroradiologist puts part of your brain “to sleep” using anesthesia, while an angiogram shows blood flow. The epileptologist (a neurologist who specializes in epilepsy) shows you several pictures and words. The doctor then “reawakens” the part of your brain that was asleep, and asks you to recall what you saw. The procedure is then repeated on the opposite side of your brain.

Doctors review and compare results from each side to determine which side of your brain is dominant in each function. This helps the doctors map out areas of the brain so the surgery doesn’t harm these important functions.