DEPARTMENT OF NEUROLOGY
The Department of Neurology offers comprehensive consultation, evaluation, and treatment services for adults with neurological disorders. Conditions treated include:

• Seizures
• Strokes
• Headaches
• Blackout spells
• Dementia
• Muscle weakness and dystrophies
• Peripheral neuropathies
• Tremor and other movement disorders
• Multiple sclerosis
• Numbness

Besides providing general neurology evaluation and treatment, physicians in the Creighton University Medical Center  System specialize in specific areas of neurologic disease.
Dr. John Bertoni specializes in Parkinson's Disease and is responsible for the Parkinson's Assessment Clinic. Dr. Patricio Reyes works with aging and Alzheimer's Disease and is responsible for the Center for Aging and Alzheimer's Disease.

The Department of Neurology works closely with Neurodiagnostic Services to bring together a diverse group of healthcare professionals, including physicians, nurses, researchers, technical, and administrative staff, whose purpose is to diagnose and treat neurologic disorders.

For further information, call the Department of Neurology at 402-280-4686 between 8:00 a.m. and 4:30 p.m. Monday through Friday.

NEURODIAGNOSTIC SERVICES
Neurodiagnostic Services at Creighton University Medical Center is a department devoted to the recording and analysis of the electrical activity of the brain and nervous system. Technologists and physicians perform and interpret the testing.

The Department of Neurodiagnostic Services is staffed Monday through Friday, 8 am to 4:30 p.m. Testing is performed by appointment after referral from a physician. Physicians or their staff can schedule appointments by calling 402-449-4095.

Electroencephalogram (EEG)
An EEG is a continuous recording of the electrical activity of the brain. It assesses function of the brain as opposed to CT or MRI scans, which look at the structures of the brain.

By evaluating the patterns formed by the electrical activity of the brain, physicians determine the functional state of the brain cells at any given moment. Physicians use EEG to assist in the diagnosis of various brain disorders and order EEGs on patients suspected of having epilepsy or seizures; underlying metabolic, congenital, or infectious disease; or cerebrovascular disorders. EEG is sometimes used as a monitor of central nervous system function during selected surgical procedures.

The EEG takes approximately 1.5 to 2 hours. A technologist measures the patient's head and marks the locations for each electrode (about 25 electrodes). Each location is prepped with a special solution. The tech attaches the electrodes to the patient's scalp with a paste-like material or glue that is dried with a stream of air. The electrodes are checked for adequate connection.

The patient relaxes on a bed while the tech monitors the EEG recording. The patient is generally quiet with eyes closed--sleep is encouraged! At other times the patient looks at a series of flashing lights or performs deep breathing for 3 minutes. When testing is finished, the tech removes the electrodes and residual from the patients scalp and hair. The procedure is painless and there are no after-effects.

A physician specializing in neurology and EEG prepares a report and interpretation of the EEG recording.

Evoked Potential Studies (EP)
An EP is a recording of electrical activity of the brain, spinal nerves, or sensory receptors which occurs in direct response to external stimuli. EPs form a series of waves that require computer averaging to visualize. There are three types of evoked potentials--auditory, visual, and somatosensory. Depending on the clinical symptoms, patients undergo one or more EP procedures.

The Brainstem Auditory Evoked Potential (BAEP) assists in the evaluation of the auditory nerve pathway from the ear through the brainstem. It provides physicians with information dealing with hearing integrity as well as brainstem function.

The Visual Evoked Potential (VEP) evaluates the pathway from the retinal receptors in the eye to the occipital cortex of the brain. It is useful in the assessment of the parts of the eye and optic nerve that cannot be visualized during a routine eye exam.

The Somatosensory Evoked Potential (SSEP) assesses pathways from the peripheral nerves in the arms or legs, through the spinal cord, to the brainstem or cerebral cortex. It is useful in localizing lesions in the spinal cord.

Physicians use EPs to reveal abnormalities in patients with suspected multiple sclerosis, optic neuritis, brainstem disorders, or spinal cord disease; they are useful in the evaluation of hearing or vision in patients who cannot cooperate with traditional testing; they are used to monitor the integrity of the nervous system during surgical procedures involving the brain or spinal cord.

Evoked potential testing requires approximately 1 to 3 hours. The SSEP usually requires the most time. A technologist locates sites on the patient's head, arms, legs, or spine and marks the locations for each electrode. Each location is prepped with a special solution. The tech attaches the electrodes to the patient's skin with tape or a glue that is dried with a stream of air. The electrodes are checked for adequate connection.

The patient is quiet with eyes closed while the tech collects the BAEP and SSEP data--sleep is encouraged! The patient receives stimuli for the BAEP from headphones that deliver click sounds to each ear. Brief electrical pulses causing slight muscle twitching in the thumb or foot are delivered to patients for SSEP testing. The patient is awake for VEP testing and focusing on a TV screen that is generating a black and white checkerboard pattern. When testing is finished, the tech removes the electrodes and glue residual. EP studies are not painful and do not cause after-effects.

A physician specializing in neurology and EP technology prepares a report and interpretation of the EP recording.

Electromyogram (EMG) and Nerve Conduction Studies (NCS)
An EMG is the recording of the electrical activity of the muscle. It assesses function of the muscle and the nerves that innervate the muscle. The EMG assists in the evaluation of nerve and muscle diseases and disorders. Patients with complaints of generalized or specific pain, numbness, tingling, or weakness often undergo EMG testing. A physician inserts a very fine needle electrode into individual muscles, one at a time. The muscle activity forms patterns of waves that are analyzed on an instrument screen that is also attached to a loud speaker for sound interpretation. The procedure is not completely painless, however, it should be tolerable. The number of muscles tested depends on the nature of the problem being assessed.

The NCS is a recording of electrical activity during stimulation of a nerve. It reveals how easily and quickly a nerve functions and evaluates the integrity of motor and sensory nerves. Patients with complaints of generalized or specific pain, numbness, tingling, or weakness often undergo NCS testing along with EMG testing. A specialized instrument delivers brief electrical pulses to activate nerves and records the electrical responses, which are then measured and analyzed. The number of nerves tested depends on the extent of the problem needing evaluation. The electrical pulses feel like tingling sensations and may cause muscles to twitch, but only during the time the pulses are active.

EMG and NCS testing requires approximately 1 hour total time. A neurologist specializing in EMG and NCS prepares a report and interpretation of the EMG and NCS recordings.