Neurology is the branch of medicine that studies the functions, conditions and disorders of the central (brain, cerebellum, spinal cord) and peripheral (nerves, muscles) nervous system. In many clinical cases the damage is closely linked to its location within the nervous system, that is why there may be similar symptoms in the same damaged area, no matter what caused them.
The most common brain pathologies are:
- cerebrovascular disease (ictus, transient ischemic attack, etc…)
- sleep disorders
- inflammatory disease (such as multiple sclerosis)
- degenerative diseases (such as Alzheimer’s and Parkinson’s diseases, amyotrophic lateral sclerosis – ALS – etc…)
- infectious or neoplastic diseases
As far as the peripheral system is concerned, damages can affect:
- nerve root (lumbosciatalgy)
- nerves (neuropathy)
- neuromuscular junction (myasthenia)
- muscles (myopathy)
The neurological test allows to verify the integrity of the various functional systems, such as motility, sensitivity, coordination, etc…while monitoring temporarily the cognitive and behavioural functions. But very often to come to a diagnosis some instrumental tests are needed, such as:
- neurophysiological tests (EEG, EMG, echo doppler)
- neuroradiological (TC, MRI)
that can be carried out at the San Rossore Medical Center.
The electroencephalography (EEG) is the recording of electrical activity along the scalp; it measures voltage fluctuations resulting from ionic current flows within the neurons of the brain. EEG is a test widely used in many cerebral pathologies and it is fundamental in epylepsy and sleep disorders.
The electromyography (EMG) and electroneuronography (ENG) are the essential neurophysiological methods to investigate diseases affecting the spinal nerve roots, the nerves, the neuromuscular plate and muscular fibers.
The evoked potentials (EP) record the electric transmission within the central nervous system, from the encephalus to the spinal cord. There are as many types of evoked potentials as the nervous structures that can be taken into examination:
- auditory evoked potential (AEPs) that traces the signal generated by a sound through the ascending auditory pathway to the cortex
- somatosensory evoked potential (SSEPs) are used in neuromonitoring to assess the function of a patient’s spinal cord and the cerebrum.
- motor evoked potential (MEP) that are recorded from muscles following direct stimulation of exposed motor cortex.
The echo-color doppler examination of the carotid and vertebral arteries is a very valued diagnostic test because it is absolutely non-invasive and it is extremely effective. It allows to observe the atheromatous plaques that may cause a dangerous stenosis (the point in which the blood vessel abnormally narrows) or a complete occlusion.
The transcranial doppler (TCD) measures the velocity of blood flow through the brain’s blood vessels. It is used to help in the diagnosis of emboli, stenosis and vasospasm that sometimes affect patients with prosthetic heart valves or suffering form atrial fibrillation but it has recently been adopted also to analyse the condition of the foramen ovale.
The neuro-radiological tests (TC and MRI) are very helpful in having exact information about causes and locaton of damages affecting the encephalus or the spinal cord.