Hunter Neurology

VESTIBULAR TESTING (HEARING AND BALANCE STUDIES)

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Electroencephalography (EEG)

A series of small non-invasive electrodes are attached to your head to measure the brain’s electrical signals. The technician will inform you during set-up what is required during the test but, for most of the time, you will be lying with your eyes closed and as relaxed as possible (even asleep).
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EEG (Routine) and Prolonged EEG Recordings

Required Preparation for routine EEG appointments:
1. NO fasting is required however, please avoid caffeine (coffee, tea, soft drinks and chocolate) at least 8hours prior to your appointment where possible.
2. Wash your hair the night before or the morning of the appointment, do not use conditioners, hair creams, sprays or styling gels. Please ensure your hair is dry on arrival.
3. .Take your usual medications as normal unless instructed otherwise.
The same electrodes are attached as for a routine EEG but his recording is extended for a further 3-4 hour period. The head electrodes are attached to a portable recorder so you will be able to move around, although the best recording is obtained while you are seated quietly. Please bring along suitable reading matter so that you can occupy your time during this EEG recording.
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Sleep-deprived EEG

A series of small non-invasive electrodes are attached to your head to measure the brain’s electrical signals. The technician will inform you during set-up what is required during the test but, for most of the time, you will be lying with your eyes closed and as relaxed as possible (even asleep).
This recording is performed following sleep-deprivation for a 24 hour period. Please note that you must not sleep the night before the test; you must avoid using any stimulants such as caffeine, alcohol and nicotine to help you stay awake; and you must not drive to or from our rooms (and someone should come with you if public transport is used).
Ocular vestibular evoked myogenic potential studies (OVEMPs) are a novel technique which add to the information forthcoming from cervical VEMP studies (cVEMPs) by assessing lesions affecting the otoliths, superior vestibular nerves, 4th cranial nerves and their intrinsic brainstem connections.
Required Preparation for Sleep Deprived EEG appointments:
1. The night before your appointment, you MUST stay AWAKE until 02:00am.
2. You should sleep between 02:00am – 06:00am (4hours ONLY) Do NOT sleep past 06:00am
3. NO fasting is required however, please DO NOT use caffeine throughout the night nor the morning of your appointment (coffee, tea, soft drinks and chocolate).
4. Wash your hair the night before or the morning of the appointment, do not use conditioners, hair creams, sprays or styling gels.
5. Take your usual medications as normal unless instructed otherwise.
6. It is STRONGLY advised that you have someone accompany you to the appointment. You should

NOTDRIVE yourself to OR from the appointment due to sleep deprivation.

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FAQFrequently Asked Questions

EEG stands for electroencephalogram. This is a non-invasive and pain free test which records the electrical activity of the brain using surface electrodes. The EEG records normal brain waves and can detect particular changes in the brain waves which may be seen in patients with epilepsy or other neurological disorders. An EEG cannot rule out epilepsy or seizures but may help to diagnose them. The EEG is a commonly used diagnostic test for evaluation of patients with suspected seizure or with known epilepsy. EEG may also be used as part of the evaluation of other neurological disorders.
A neurophysiology technician will complete the test with you. They will mark some points on your scalp with a soft pencil. After rubbing these points with an exfoliant, approximately 20 small recording electrodes will be place on the scalp temporarily using a soft paste, and attached to a recording device which is attached to a computer. These products are all water soluble and easily removed. During the recording you will be seated or laying in a comfortable position, the majority of the time your eyes will be closed. You will not feel anything during the recording time. A video may be recorded at the time of recording so that if something occurs during the recording the neurologist who reports the EEG can correlate with the trace to see what happens.

During the recording you may be asked to perform some breathing exercises, this involves taking deep breaths for up to three minutes. Doing these breathing exercisers, you may feel lightheaded or dizzy (this is normal). Hyperventilation is not routinely performed in patients who are pregnant or have significant health problems such as heart or lung diseases so please let our technician know if you have any concerns.

You may also be asked to look at a bright flashing light bar in which turns on and off at different frequencies. This may be uncomfortable so if you are concerned about this please let the technologist performing the study know prior to commencing your study.
A Sleep Deprived EEG is similar to a routine EEG however is performed on a patient that has had little to no sleep leading up to the test. The recording time is also slightly longer than that of a routine EEG. A sleep deprived EEG is performed to increase the chances of you falling asleep during the study itself. We do not use sedation to help people sleep for an EEG.

Unless you have been advised NOT to drive due to a medical event, you are able to drive after your routine or prolonged EEG. However, It is STRONGLY advised that you have someone accompany you to the appointment for the Sleep Deprived EEG and you should NOTDRIVE yourself to OR from the appointment due to sleep deprivation.

A routine EEG is booked for 1hour, Sleep Deprived EEG’s are generally booked slightly longer and Prolonged Studies are book for a minimum of 3.5hrs.
The procedure is the same for a child. For young children they may sit in your lap during the recording, whilst older children can sit on their own. You can remain in the room with your child whilst the study is performed.
We ask our patients to allow 1 working week for routine and sleep deprived EEG reports. Prolonged Studies may take up to 2 weeks due to the length of the recording to be reviewed. All results will be released to your referring doctor directly. It is recommended that you arrange an appointment with the referring doctor to obtain these results.
Please contact the rooms immediately to ensure the technician can still fit you in if you arrive late. Our team will do our best to accommodate you. We highly recommend planning your trip allowing extra time for traffic during peak travel times.
You should contact us directly, if our administration team are unable to answer any of the questions you have, they will arrange for one of our neurodiagnostic technicians to return your call when they are available.
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Nerve conduction studies (NCS)

These are electrophysiological studies, usually of the arms or legs, where electrical stimulation of selected nerves measure the responses of the motor and sensory nerve fibres.
Required Preparation for NCS Appointment:
1. NO fasting is required
2. Please shower on the day of the test or night before and wash your arms and legs well to remove body oils or creams you may have used.
3. DO NOT use ANY lotions, moisturises, bath oils or creams after showering or prior to your appointment. These products interfere with the quality of the recordings.
4. Take your usual medications as normal unless instructed otherwise.
5. Wear comfortable, loose-fitted clothing, and remember to bring shorts (if we are testing your legs) and a short-sleeved shirt (for testing of your hands and arms).
faq

FAQFrequently Asked Questions

Nerve Conduction Study (NCS) is a diagnostic test that involves activating nerves with small electrical pulses and recording the activity with surface electrodes on the skin, usually on your arms or legs. This is to measure how quickly the electrical pulses take the to travel along the nerves from one point to the other. This procedure is very safe and non-invasive.
Surface electrodes are used to record your responses. These sticky electrodes will be moved around during the study. Several, brief electrical pulses will be sent along the nerve
The pulses you feel are like little static electric shocks. You may feel some discomfort depending on how strong the impulses are at the time. You should feel NO pain once the test is completed.
Approximately 30minutes.
Yes, you should be able to return to allofyour normal activities after the test is completed. It is rare to have any side effects from NCS procedures, although some discomfort is experienced during the test, there are often any complications.
Unfortunately, we do not perform Nerve Conduction Studies on children under the age of 16y/o. These studies would need to be referred to a Paediatric Neurologist who will consult the patient and arrange the necessary testing for your child.
We ask our patients to allow 1 working week. Please inform our administration team if you have an appointment within the week of your testing date.
Please contact the rooms immediately to ensure the technician can still fit you in if you arrive late. Our team will do our best to accommodate you. We highly recommend planning your trip allowing extra time for traffic during peak travel times.
You should contact us directly, if our administration team are unable to answer any of the questions you have, they will arrange for one of our neurodiagnostic technicians to return your call when they are available.
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Vestibular function testing (VFT)

These tests include the 4 sets of tests which are listed below:

Audiometry & Tympanometry

general hearing tests

Brainstem auditory responses (BAER)

Clicking sounds via headphones stimulate the auditory nerves. Electrodes are placed behind the ears and on the head to record responses from the auditory nerves while you are relaxed and lying quietly

Vestibular evoked potentials (VEMP)

Measures the response of the balance system from small electrodes are placed over muscles of the neck or face after clicking sounds are heard through headphones or after light taps on the forehead.

Video Head Impluse Testing (vHIT):

The patient wears a pair of light weight tightly fitting goggles with a silvered mirror which reflects the image of the patient’s eye into a very small camera. The patient fixates on a target while the technician gives the patients head very quick horizontal and vertical head rotations at a very small angle of about 10-20 degrees. The small sensor on the googles measures the head and eye movement. This test is used in the assessment of patients with complaints of dizziness, disequilibrium and vertigo. SPECIAL INSTRUCTIONS: Please DO NOT wear any eye makeup ESPECIALLY MASCARA for this test.
Required Preparation for Vestibular Function Testing:
1. NO cigarettes, alcohol or caffeine (coffee, tea, soft drinks and chocolate) for 24hours prior to your testing appointment
2. Medications for dizziness (ie: Serc or Stemetil) and sleep disturbance should NOT be taken 24hours prior to testing. Consult your local doctor OR pharmacist if you require confirmation regarding your medications use. All other regular medication as normal please.
3. Please DO NOT wear any makeup (especially eye makeup) as this interferes with electrode attachment and infrared video recording of the eye movements.
4. Please bring your hearing results if you have a copy available.
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