Procedures & Diagnostics

Dr. Bronfin will review your history in details. You will only see the doctor . We do not employ nurses or nurse practitioners. All diagnostic tests are done by doctor. The doctor will perform a neurological examination. Examination will test memory, strength, sensation, coordination, gait and reflexes. Doctor will discuss diagnostic plan and treatment with you. Doctor will recommend diagnostic tests that may include:

  • Complete neurological examination
  • NCS and EMG nerve conduction studies for diagnosis of nerve disorders
  • SSEP , BAER, VEP  evoked potentials for diagnosis of brain and spinal cord disorders
  • MRI imaging of nervous system
  • MRA imaging of brain’s vascular system
  • SSR autonomic tests to measure sweating function
  • BLINK  responses for evaluation facial nerves
  • RNS for evaluation of myasthenia gravis

Nerve Conduction Studies (NCS) and Electromyography (EMG)
What are nerve conductions studies and electromyography?

Nerve conduction studies and electromyography are tests to help diagnose diseases of nerves and muscles. A NCS and EMG test is tailored to your specific complaint and the diagnostic question of the referring physician. The test does not treat your condition. Both tests are performed together to help to localize the area of involvement causing your symptoms. A normal NCV/EMG usually lasts 30-60 minutes. There is no lasting effect from the test.

The test involves two parts:

1. Nerve conduction studies (NCS)
Are used to test individual nerves. Peripheral nerves are organs that serve as the “wiring” carrying signals for sensation, muscle commands, and other special functions to and from the brain and spinal cord. The nerves tested travel in predictable routes through the body, well known to each examiner. Testing involves stimulating a nerve with brief, small electrical impulse to the skin surface and recording the response from a muscle or another portion of the nerve via small detection pads on the skin. The electrical stimulations range from barely perceptible to a shock comparable to a static electric shock in winter. These studies are very safe and even the maximal machine output is too small to cause injury. Most studies require only a small fraction of the maximal level. There are no lasting effects. Information on the health of each nerve including the location and type of specific nerve injury is gathered and interpreted.

Patient Experience:
Recording electrodes are applied to the muscle being examined. The nerve is then stimulated with a small electric current. You might feel a tingle or your muscles may twitch.

2. Electromyography (EMG)
Is another type of testing providing complimentary information, usually following nerve conduction studies. In this test a sterile, disposable, very thin needle electrode (about the width of a straight pin (26 gauge)), Teflon coated to ease insertion is placed through the skin into a muscle. The needle is a specialized recording device with a fine internal platinum wire, analogous to an antenna that directly records the muscle’s natural electrical activity at rest and during muscle contraction. Analysis of this activity gives important information about the health of each muscle tested as well as the controlling nerves. Each examination is specially tailored to provide information about the specific clinical questions for a given patient.

Patient Experience:
A sterile needle electrode is inserted into a muscle to “listen” to the electrical activity while you contract and relax the muscle. Nothing will be injected. You will feel the poke of the needle.

Other Special Diagnostic Procedures: