• This is the same as EEG except that there is a video recording to record the patients behavior also.
• The duration of the recording depends upon the frequency of fit.
• This can range from 1-6hours in patients with frequent events (hourly) to 4-5 days in patients with infrequent events and evaluation prior to surgery.
• One attendant should accompany the patient during the procedure.
• The EEG along with video is recorded simultaneously to evaluate the nature of events.

The EMG test is used to evaluate the status of the muscles, nerves, roots and anterior horn cells. A number of neurological disorders present with weakness or atrophy (thinning) of muscles.

Some common disorders are:

• Muscular dystrophy
• Myopathy
• Neuropathy.
• Carpal tunnel syndrome
• Nerve injuries
• Cervical/lumbar radiculopathy
• Motor neuron diseases

The EMG may be done either alone or in combination with nerve conduction studies (NCS) depending on the neurological disorder.

Common symptoms of muscle involvement:

• Difficulty in climbing stairs.
• Difficulty in getting up from sitting/squatting position.
• Difficulty in performing movements like buttoning, breaking chapatis, mixing food, combing hair.
• Raising hands above the head.

Details of Procedure:

• A thin disposable EMG needle is inserted into the muscle to be examined. Depending on the type of disease or more muscles may be required to be tested.
• You may experience mild pain during the procedure.
• There is no risk of transmitting the infection since disposable needles are used and they are destroyed after use.
• You can have your regular food and medication on the day of the test.
• You should wear loose clothes so that the test can be easily done

• Nerve conduction studies are used to evaluate the function of the nerves.
• There are mainly two types of nerves - motor and sensory. The nerve conduction studies are specially designed to perform motor nerve conduction and sensory nerve conduction.

Role of Nerve Test for Nerve Injury

Repetitive nerve stimulation tests are a special type of nerve conduction study. Rather than a single electric shock, a brief series of shocks is applied to a motor nerve and responses are recorded from a muscle supplied by that nerve. The study is generally performed before and after brief exercise of the muscle. Serial response amplitudes are recorded. Repetitive nerve stimulation is useful for evaluating myasthenia gravis and other disorders of neuromuscular transmission.

VEP provides information regarding conduction in visual pathway from the retina to brain (occipital cortex).

VEP is recommended for following diseases:

Impairment of vision due to:

• Multiple Sclerosis
• Optic Neuritis
• Tumours of the brain (pituitary tumours)
• Head injuries
• Drugs which may cause visual impairment
• In children with mental retardation/ delayed development to assess visual status

Details of Procedure:

• The test is performed in dark room.
• Each eye is tested separately.
• The patient is asked to focus on a point on the monitor, which shows
• Checkerboard pattern.
• Small metals plates (electrodes) are applied to the head, which record the
• Electrical potential.
• The procedure usually take approximately 30 minutes.

Instructions:

• Hair should be washed, dried, with no oil, gel, spray etc.
• If the patient is using spectacles or contact lenses than he/she should wear them at the time of examination.
• For children who are uncooperative sedation may be required.

This test examines the integrity of auditory pathway through the brainstem. The sound enters ear canal and stimulates auditory nerve. The electrical impulse travels from auditory nerve through the brainstem to auditory cortex. During testing, the patient hears the repetitive click sound through the earphone.

BAER is recommended for following diseases:

• Hearing problem
• Dizziness/ Vertigo
• Multiple Sclerosis
• Tumours of the Brainstem
• Head Injuries
• Delayed development in children
• Jaundice in children

Details of Procedure:

• The procedure is carried in a sound proof room.
• The stimulus is provided using headphone in one ear followed by second ear.
• The electrical response is recorded by small metal plates (electrodes).
• The test is not painful.

Instructions:

• Hair should be washed, dried, with no oil, gel, spray etc.
• For children who are uncooperative sedation may be required.
• The procedure usually take approximately 30 minutes.