Neurology and Neurophysiology

Neurology studies the functions and alterations of the structures of the Central Nervous System (brain, trunk, cerebellum and spinal cord) and the Peripheral Nervous System (nerve roots, nerves and muscles). There are numerous clinical pictures that generally depend on the anatomo-functional site of the injury so that similar symptoms appear in relation to the site of injury, regardless of the cause that causes them.

The most common brain diseases are:

  • Cerebrovascular diseases (stroke, TIA, etc.)
  • epilepsies
  • headaches
  • sleep disorders
  • Inflammatory diseases (multiple sclerosis)
  • degenerative diseases (Alzheimer’s disease, Parkinson’s disease, ALS, etc.)
  • Infectious and neoplastic-based diseases

At the expense of peripheral pathways there may be damage:

  • Of the roots (sciatalgia lumbar)
  • Of nerves (neuropathies)
  • Of neuromuscular plaque (myasthenia)
  • Of the muscles (myopathies)

The neurological examination allows assessment of the integrity of functional systems such as pathways of motility, sensitivity, and coordination, with simultaneous observation of cognitive-behavioral functions. Instrumental examinations are necessary to reach a diagnosis:

  • neurophysiological (EEG, EMG, PE, ecodoppler)
  • neuro-radiology (CT, MRI) that are performed at Casa di Cura San Rossore.

Electroencelography (EEG) is the recording of electrical brain phenomena that are detected through a series of electrodes applied to the scalp. It is a method of investigation used for various brain diseases and is fundamental in epilepsy and sleep disorders.

Electroneurography (EMG) and electroneurography (ENG) are the neurophysiological methods essential for studying diseases of spinal roots, nerves, neuromuscular plate, and muscle fibers.

Evoked potentials (PE) assess transmission at the level of the Central Nervous System, and thus the encephalon and medulla. There are different types of PE depending on the nerve structures to be examined:

  • Acoustic evoked potentials (PEA and BAEPS) assess the functions of the acoustic pathways at the brainstem level
  • sensory evoked potentials (PESS) study the integrity of the sensory pathways that run within the spinal cord all the way to the brain
  • motor evoked potentials (PEM) investigate motor pathways starting from the brain motor neurons to the muscles by traversing the spinal cord structures.
  • The ecocolordoppler of the carotid and vertebral arteries is a popular diagnostic examination because of its total noninvasiveness and high diagnostic power. It allows detection of atheromasic plaques that may prove a major stenosis (point at which the narrowed artery passes less blood) or a complete occlusion.

The transcranial doppler instead observes the blood circulation of the arteries that are inside the brain. It is also used to assess any small embolisms (microembolisms) that form in some patients, for example, in prosthetic heart patients, in individuals with atrial fibrillation, and more recently to observe whether there is patency of the foramen ovale.

Neuro-radiological examinations (TC and Magnetic Resonance Imaging) provide valuable information on the causes and locations of brain and spinal cord injuries.