What to Expect During Your Initial Neuro Appointments
At SWBPC, our New Neuro Appointments are a combination of several very thorough and detailed appointments. In order to determine the overall condition of each of our patients, we combine a QEEG brain map, advanced diagnostic testing, a complete functional neurological examination, and additional laboratory testing, if necessary.
As a New Neuro patient, you will be scheduled for four individual appointments:
- Brain Map (QEEG) - this appointment will last an hour.
- Diagnostic Testing - this appointment will last an hour to an hour and a half.
- Report of Findings for the Brain Map - this appointment will last an hour.
- Neuro Evaluation - this appointment will last an hour and a half.
QEEG BRAIN MAP
A Quantitative Electroencephalogram (QEEG), better known as a Brain Map, is an assessment tool designed to objectively and scientifically evaluate a person’s brainwave patterns.
With you sitting in a comfortable chair, your doctor will place a snug cap on your head, much like a tight fitting swim cap. Embedded within the cap are 19 small sensors that are designed to measure and record brainwave activity. Saline gel is injected into the connection ports to ensure a good connection to the system. The gel will sit on your scalp and in your hair, and is not injected into the skin. It is important to note these sensors do not put any electrical current in the brain, they simply record signals coming from the brain. During the Brain Map, your doctor will instruct you to keep your eyes open or closed while the computer is collecting data. Once the results are processed, your doctor will review this information with you at a subsequent appointment.
We use cutting-edge diagnostic techniques and technologies to measure postural control, reaction times, motor accuracy and neurological endurance, all in a concerted effort to identify the areas of the brain and central nervous system that are being affected. The initial diagnostic testing results serve as benchmarks against which therapy results are measured.
DIAGNOSTIC TESTING WE USE
C3 Logix was designed by the Cleveland Clinic to collect data for athletes with traumatic brain injuries and to objectively qualify their ability to return to play. The system uses an iPad to assess symptoms, memory, processing time, neurocognitive testing and visual acuity.
The Vestibular Technologies CAPSⓇ (Comprehensive Assessment of Postural Systems) is used widely by clinics for balance assessment and a variety of training applications. The system uses force plate technology, which can graph out balance, instability and sway patterns while a patient is standing on a flat and foam surface with eyes open/eyes closed. The results of this test can identify issues with a patient’s cervical spine, proprioception and vestibular system.
The Right Eye system is able to uncover eye issues that an observation-only exam cannot by using advanced, eye-tracking technology. This technology makes it possible to identify vision and brain issues, identify the root cause of reading problems, and improve athletic performance - Right Eye is truly a game-changer!
Videonystagmography testing can be used to identify issues with a patient’s vestibular system. During the VNG testing, the patient will wear a set of infrared goggles that record eye movement as the doctors lead you through a series of tests. These are designed to evaluate the functioning of the vestibular system, and can also detect signs of neurological problems. As VNG tracks eye movements directly, it is considered to be the standard of vestibular examination as it does not measure the movement based on the muscles surrounding the eyes.
This mobile technology is used to evaluate and monitor quantitative pupillary light reflex (qPLR). It provides objective data within seconds, which can be indicative of deficiencies in a patients' autonomic nervous system.
A COMPLETE FUNCTIONAL NEUROLOGICAL EXAMINATION
At the start of the examination, your doctors will take your vital signs - heart rate, oxygenation, blood pressure and temperature. These stats can help to identify underlying Dysautonomia, which is a condition in which the autonomic nervous system (ANS) does not work properly. Your doctor will also review your medical history with you in order to gain an understanding of the potential neurological condition.
The next phase of the examination deals with identifying the regions of the brain or nervous system that have dysfunction or have been injured. You may be asked to perform tasks such as touching your finger to your nose, walking in a straight line, reciting the alphabet while skipping every other letter, or even following a target with your eyes as it moves. While these tasks seem basic, your performance of each one provides important clues to your neurologic health puzzle. Your doctor will then perform a thorough structural exam to identify any muscular imbalances and areas of pain, focusing on the specific areas of complaint.
To conclude the exam, your doctor will review the results of your physical examination and diagnostic testing. Additional laboratory testing may be recommended in order to provide the doctor with more precise information. The combination of your results and medical history provide the basis for a customized treatment plan that is tailored to your unique condition(s).
ADDITIONAL LABORATORY TESTING
Brain function can often be impacted by immune problems and gut issues. Comprehensive blood panels may be ordered in order to determine the most appropriate way to manage your condition. At SWBPC, we utilize the testing provided by several laboratories: Labrix by Doctor’s Data, Dunwoody Labs, US BioTek Laboratories, Brain Span, and Cyrex Laboratories.
Our doctors only select the necessary tests to assess your comprehensive metabolic panel, food sensitivities, gut health, hormone levels, and inflammatory markers. We will refer you to the appropriate local phlebotomy lab for blood work, as we do not perform these services in house.