Peter Bodnar, M.D. - Neurology & Interventional Pain

 NEURODIAGNOSTICS:

Various studies are available for neurological, headache or pain diagnosis. The most important diagnostic study is the physical examination. The other studies are used to confirm the suspected diagnosis. Some of these studies might be appropriate for one condition but not for another. Although there are several other studies and tests that can be performed, the following are perhaps the most common ones. As part of the medical treatment and reassessment cycle, it is important to not only make the diagnosis but also to refine the diagnosis as more information becomes available.





EEG - electroencephalography: This study shows brain activity as it happens, just like an EKG shows heart activity. This study is important when questions arise as to the function of the brain. EEGs are performed for many conditions from seizures to memory loss. Additional information about the various findings in EEG can be found at the eMedicine website.

EMG/NCV - electromyography: This study comprises two components, a needle EMG study and an electric nerve conduction study. This study is important when questions arise as to the function of the nerves and muscles, especially in cases of nerve pinching such as spine disc disease, carpal tunnel and other nerve or muscle conditions. Additional information about the various findings in EMG can be found at the eMedicine website.

Lumbar puncture - CSF analysis: This study involves taking a sample of spinal fluid for analysis. Because the spinal fluid is separate from blood, when there is a question of infection or inflammation in the central nervous system, this study can help determine whether a problem exists, and if so, what the problem may be. Click here to read a basic review of lumbar puncture at another website.

Computed Tomography - CT scan or CAT scan: This study involves computer manipulation of regular X-rays. The CT scanner contains an X-ray machine. The machine takes several X-rays in a row and the computer helps assemble them into a very detailed picture. In neurology, a CT scan is important because it is very rapid and can show serious and life threatening brain events such as brain hemorrhage. The Wikipedia website has a good overview of CT.

MRI - Magnetic Resonance Imaging: This study involves using magnetic pulses to create a very detailed image of the body part being investigated. A neurologist typically orders MRIs of the brain or spine, although many body parts can be imaged. The Wikipedia entry on MRI provides a good overview of the procedure and its purposes.

Injections for diagnosis: Although many patients think of injections as treating the problem, injections also can be performed in a manner that helps provide the diagnosis. These are outlined in the patient handouts and elsewhere.

Provocation Discography: This study can help demonstrate spinal disc disease when other studies fail to show anything or when there is a question as to which spinal disc level is causing the problem. Discography has been a controversial procedure for much of its existence. But done with the ISIS guidelines using manometry and very specific parameters, it is a very accurate and useful tool. A recent level II-2 review of the procedure can be found at the NIH/NCBI Pub Med website disposing of the previous "controversy" regarding the utility of this procedure - which were clearly due to operator error and subjective measures.

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