All common neurophysiological and neuropsychological examination methods are available in our practice. These examinations are supplemented by imaging procedures (NMR, CCT, SPECT, PET) and laboratory tests.
EEG (Elektroenzephalogramm; derivation of brain waves)
Measurement of electrical brain activity by deriving voltage potentials on the scalp. An electrical signal is derived simultaneously with 20 surface electrodes. The EEG is helpful in the diagnosis of epileptic seizures, for the detection of focal or also general brain dysfunctions. The examination is painless and takes about 20-30 minutes.
On the day of the examination, please no hairspray use.
EMG & NLG (Elektromyogramm & Nervenleitgspeed; functional measurements of muscles and nerves)
An EMG and ENG (functional measurement of muscles and nerves) is performed if damage to muscles and nerves is suspected. This examination is thus used in cases of inflammation or mechanical pressure on the nerve roots (e.g. due to herniated discs), injuries or compression of peripheral nerves (e.g. carpal tunnel syndrome), generalised diseases of the nerves (e.g. polyneuropathies), myasthenia and muscle diseases.
The EMG examination is carried out by means of thin needle electrodes from the musculature, the ENG or NLG investigation takes place after electrical stimulation of the nerve fibers by conduction of nerves or muscles, usually with surface electrodes. The examinations are harmless and not stressful.
Doppler ultrasound of the cerebral vessels
Ultrasound examinations of the arteries supplying the brain are always used if a circulatory disorder of the brain or a disease of the vessels supplying the brain, which can lead to a stroke, is suspected.
Evoked potentials: VEP, AEP and SSEP (functional measurements of visual and auditory pathways, sensitive pathways)
Just as the EEG represents the entire electrical activity of the brain, individual functional sections of the brain such as the visual pathway (visual evoked potentials or VEP), auditory pathway (auditory evoked potentials or AEP) and sensory perception (somatosensory evoked potentials or SSEP) specifically.
Even the attention function is measurable: Event-related potential P300.
The respective functions are stimulated (e.g. by looking at a monitor with a checkerboard pattern or by hearing sounds) and the electrical signal is derived with an adhesive electrode attached to the scalp.
The examination is completely painless. It lasts about 10-15 minutes.
NMR (Magnetic Resonance Imaging/MRI, Magnetic Resonance Imaging)
The MRI images are very detailed, so that even the smallest changes in the brain and nerve tracts can be detected. Because the examination method is based on magnetism, it - in contrast to computer tomography - does not not with exposure to X-rays here.
These "classic" MTRs are built as a tube. For the examination, a couch moves the patient into the ring-shaped magnetic tunnel until the body area to be examined is in the middle of the tube. For patients with Claustrophobia there is also today open MRI scanners, which do not completely enclose the patient. Talk to the examining doctor about these fears. The examination lasts about 25 minutes.
What should I bear in mind before an MRI? Don't worry, the examining doctor will talk to you before the examination about possible reasons why the examination cannot be carried out, e.g. pacemaker patients or patients with magnetic metal parts in the body (older artificial hip joints), in an explanatory talk.
Newer metal implants are now often made of non-magnetisable material such as titanium. Therefore, they are often unproblematic. Before the examination, however, it is essential to check whether the implant in question is actually suitable for MRI.
Studies have so far shown no side effects with MRI examinations without contrast medium. For safety reasons, however, expectant mothers should only have an MRI in emergencies during the first three months of pregnancy.
CCT (computer tomography)
Computed tomography (CT, CT scan) is a so-called imaging procedure based on X-rays. In addition to magnetic resonance imaging, this method is better at showing bone injuries and also fresh bleeding (e.g. in the brain), but less good at showing soft tissue processes (e.g. inflammatory changes in the brain such as in MS).
For the examination itself, the patient lies down on the mobile examination table, which is then pushed into the CT tube. During the examination, the table moves slowly through the CT scanner so that the measuring devices can produce cross-sectional images of the desired body region or the entire body. In total, the examination takes about 20-30 minutes. Occasionally, the administration of a contrast medium is necessary in order to make structures more visible. The examining doctor will also inform you about this and explain it to you.
PET (Positronen-Emission-Tomography)
Positron emission tomography is a nuclear medical procedure that uses various low-level radioactive substances to visualize metabolic processes in the body.
For a PET examination of the brain, the patient is injected i.v. with a chemically slightly modified form of glucose (sugar), e.g. 18F-fluorodeoxyglucose (FDG), a slightly radioactive substance that is excreted again.
This examination enables the visualization of pathological degradation processes of the brain (dementia), so-called "neurodegenerative" processes.
DATSCan
DaTSCAN™ scintigraphy (dopamine transporter scintigraphy) is a nuclear medicine examination method for imaging the dopamine transporters in the brain.
The patient is injected with a small amount of a radioactively labelled substance (123 Iodine-FP-CIT), which accumulates in central brain areas (the striatum) about 3 hours after the injection, especially where dopamine is present. This imaging examination can be used to check whether Parkinson's disease or syndromes similar to it are present.
Laboratory and cerebrospinal fluid diagnostics (lumbar puncture)
Due to the close contact with the meninges and brain, the composition of the cerebrospinal fluid (nerve fluid) can change, especially in the case of inflammation. Since the brain has its own "immune defence centre", certain diseases of the nervous system such as the Neuro Lyme Disease or even the MS can also not be determined by a blood sample, but a cerebrospinal fluid (CSF) examination may be necessary. The cerebrospinal fluid is extracted by means of a Lumbar puncture.
Colloquially, the term a "spinal tap" or similar is often used. To make this clear: The spinal cord ends well above the sampling site in the lumbar spine and therefore cannot be injured by the puncture.
Many patients are very afraid of a lumbar puncture. In fact, however, it is hardly more painful than a blood sample. It usually requires a short one-day hospital stay. This is not because the examination is dangerous, but because the collected cerebrospinal fluid must also be examined very quickly in a laboratory suitable for this purpose. The patient should lie flat for 24 hours after the collection so that the so-called "post-puncture headache" does not occur.