NEUROLOGIA

Il Dipartimento di Neurologia del Salus offre al paziente un percorso diagnostico e terapeutico completo per tutte le patologie del Sistema Nervoso Centrale e Periferico. L'approccio al paziente inizia con un'attenta amnesia, la valutazione dei disturbi neurologici comparsi, l'obiettività neurologica e un'ipotesi diagnostica. In molti casi in cui abbiamo una diagnosi accurata, ci limiteremo innanzitutto esclusivamente alla precisione terapeutica: questo è molto importante in quelle patologie (morbo di Parkinson, epilessia) in cui dopo qualche anno la terapia iniziale non è più adeguata, sia per la dosaggio e tipo di farmaco somministrato. L'EEG (elettroencefalogramma) viene utilizzato anche per l'esame dell'epilessia se il neurologo lo ritiene necessario.

Le principali patologie trattabili sono:
morbo di Parkinson
Epilessie
Mal di testa ed emicranie
Malattia da danno alla mielina (sclerosi multipla)
Vasi sanguigni e patologie degenerative del Sistema Nervoso Centrale
Patologia del sistema nervoso periferico (neuropatia, sindrome da intrappolamento, radicolopatia)
La sindrome vertiginosa non è competenza dell'otorinolaringoiatria
Patologie del sonno (insonnia, gambe senza riposo) e patologie psichiatriche (nevrosi d'ansia, sindrome ansioso-depressiva)
Il costante contatto con il Reparto di Radiologia, con la disponibilità della TAC, la Risonanza Magnetica ci permette di curare numerose patologie neurologiche, che necessitano sia di una diagnosi approfondita che di un trattamento chirurgico. Inoltre, il Laboratorio Analisi è attrezzato per prelievi di sangue, sia per la determinazione di farmaci e il loro dosaggio (soprattutto per gli antiepilettici), sia per ricerche più complesse (ricerca di anticorpi definiti, ricerca genetica, ecc.)

In the Neurology unit, the diagnostic process includes:
  Electromyography (EMG)
EMG is a method that allows us to study the peripheral nervous system from a functional point of view and is a continuation of the clinical neurological examination. The electromyographic study is performed in two stages: Electroneurography (ENG) and Electromyography: these are two complementary techniques and are generally performed simultaneously.

EMG finds application:

In the differential diagnosis of neurological damage to the nerve, or myogenic damage to the damaged muscle and neuromuscular plate. It allows the identification of the cause of a muscular atrophy, distinguishing between primary muscle damage and secondary nerve (or root) damage. It also allows the distinction between a strength deficit secondary to a myopathy caused by a pathology of the neuromuscular plate (Myasthenia).
In the pathology of inferior motoneurons (spinal and bulbar, as in the case of Amyotrophic Lateral Sclerosis, etc.)
In action pathology, as a complete tool of ENG (spondylogenic radiculopathy, axonal neuropathy, traumatic or compressive neuropathy, etc.)
In determining the functional compromise of the nerve: from neuroaprasis, to axonotmesis to the most severe forms of neurotmesis, in which we have the complete disconnection of the nerve with the removal of its sides.
In muscle pathologies (myopathy, muscular dystrophy, polymyositis, myotonia) or neuromuscular plaque (myasthenia gravis and Lambert-Eaton syndrome).
The potentials generated due to the traction of muscle fibers are analyzed. A small-diameter, sterile, single-use needle recording electrode is used that is inserted into the muscle to perform the examination for the entire time required. The technique used is minimally invasive and slightly painful. The electrical activity generated by the gizzard, the relaxing activity, the morphology of the potential of the motor unit activated by a light contraction of the muscle, as well as the recruitment of the motor unit to a maximal effort are evaluated.

  Electroneurography (ENG)
ENG (Electroneurography) is the study of the neurophysiological parameters of nerve conduction (transmission) and measures the ability to transmit nerve impulses. Motor and sensory nerve conduction can be measured.

ENG finds a necessary application in all forms of peripheral deficit of power and sensibility, as a consequence of the interest of a nerve, plexus, and sw nerve root, or as a consequence of the interest of the nerve, diffusely and systematically, as occurs in polyneuropathies. ENG is used in all orthopedic pathologies, which cause conduction blockages, or traumatic compressive events of the nerve:

Spondylotic radiculopathy
Disc herniation with an intraforaminal involvement
Cauda equina syndrome
Plesopathy as a thoracic inlet syndrome. Intrapolyme carpal tunnel syndrome
The EMG is the study of the electrical activity of a particular muscle, it studies the neuromuscular plate, the nerve and the motor root.

It is the study of potentials evoked by electrical stimulation of peripheral nerves, both motor and sensory. Small electrical impulses are given through surface stimulators. Potentials are recorded on the surface from different nerves through electrodes of different shapes. The parameters of the resulting potentials are then automatically calculated: amplitude, conduction velocity, responses, reflexes and latent (silent) state. The amplitude of the response obtained is measured in millivolts and microvolts, in relation to the amount of nerve fibers involved, while the speed of impulse transmission (speed of conduction) measured in meters per second, is in relation to the integrity of the myelin sheath. .

  Somatic Stimulated Potentials (PSS)
They are the responses obtained in the spinal cord and in the parietal cerebral regions, from the electrical stimuli of the peripheral nerves which convey a message of the sensitive type.
PSSs are obtained by stimulating a peripheral nerve (usually the median nerve at the pulse and the tibial nerve at the ankle) and recording the resulting waves in the central nervous system and spinal cord.
Analysis of PSS, their presence, amplitude of the response, time of appearance of the waves from the peripheral stimulus, allow us to evaluate the integrity of the central pathways in many neurological diseases (compressive myelopathy from disc herniation or nerve damage, myelitis, multiple sclerosis and degenerative diseases of the central nervous system).
Both electromyography/electroneurography and PSS are non-invasive methods, slightly annoying, absolutely applicable to all patients; disposable surface and edge electrodes are used; no substance is injected, and the power of the current to elicit responses is scarcely perceptible.L'analisi dei segnali viene eseguita automaticamente dal computer e i risultati dei test neurofisiologici vengono generalmente consegnati al paziente al termine dell'esame.