NEUROLOGY

The Department of Neurology at Salus offers the patient a complete diagnostic and therapeutic process for all the pathologies of the Central and Peripheral Nervous System. Approaching the patient begins with a careful amnesia, with an assessment of the neurological concerns expressed, neurological objectivity, and with a diagnostic hypothesis. In many cases where we have an accurate diagnosis, we will first focus exclusively on therapeutic precision: this is very important in those pathologies (Parkinson’s disease, epilepsy) in which, after several years, initial therapy no longer appears to be appropriate. , for both the dosage and the type of medication given. EEG (Electroencephalograms) is also used for the examination of epilepsy if the neurologist thinks it is necessary.

The main treatable pathologies are:

Ongoing contact with the Department of Radiology, with the availability of TAC, Magnetic Resonance allows us to cure many neurological pathologies, which require both a detailed diagnosis as well as a surgical treatment.

Also, the Analysis Laboratory is equipped for blood sampling, both for the determination of medications and their dosage (in particular for antiepileptics), as well as for more complex research (definitive anticancer research, genetic research, etc.).

The diagnostic process includes:

EMG is a method that allows us to study the peripheral nervous system from a functional standpoint. The electromyographic diagnosis is performed in two stages: Electronurography (ENG) and Electromyography: these are two complementary techniques and are generally performed concurrently.

EMG finds application:

In the differential diagnosis of neurological damage to the nerve, or myogenic damage to the damaged muscle and neuromuscular plaque. It allows identifying the cause of a muscular atrophy, distinguishing between primary, secondary, or nerve damage. It also allows for the distinction between the secondary force deficit of a myopathy caused by a neuromuscular plaque pathology (Miastenia).
In pathology of inferior motoneurons (spinal and bulbous, as in the case of Amyotrophic Lateral Sclerosis, etc.)
In topical pathology, as a complete ENG tool (spondylogenic radiculopathy, axonal neuropathy, traumatic or compressive neuropathy, ecc.)
In defining the functional compromise of the nerve: from neuroaprazites, to axonothemes to the more severe forms of neurotemesis, in which we have complete nerve detachment with its sides removed.
In the pathologies of muscles (myopathies, muscular dystrophy, polymyositis, myotonia) or neuromuscular plaque (myasthenia gravis and Lambert-Eaton syndrome).
The potentials that are generated due to traction of muscle fibers are analyzed. A small, sterile, single-use needle recording electrode is inserted into the muscle to screen for all the time needed. The technique used is minimally invasive and a little painful. The electrical activity generated by the syringe, the sedative activity, the potential morphology of the motor unit activated by a slight contracture of the muscle, and the recruitment of the motor unit to maximum strain are evaluated.

ENG (Electronurography) is the study of the neurophysiological parameters of nerve conduction and measures the ability to transmit nerve impulses. The conduction of motor and sensitive nerves can be measured.

ENG finds a necessary application in all forms of peripheral deficit of power and sensitivity, as a result of the nerve, plexus, and root of the nerve, or as a result of nerve interest, diffuse and systemic, as occurs in polyneuropathies. ENG finds application in all orthopedic pathologies that cause congestion, or traumatic nerve compression events:

Spondylosic radiculopathy
Disc herniation with an intraforminal occlusion
The cauda equina syndrome
Plesopathy as a thoracic entry syndrome. Intrapolations of carpal tunnel syndrome
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 the potentials evoked by electrical stimulation of peripheral nerves, both motor and sensory. Small electrical impulses are provided through surface stimulants. Potentials are recorded on the surface by different nerves via electrodes of different shapes. The parameters of the obtained potentials are then automatically calculated: amplitude, conduction velocity, responses, reflexes, and latency (silent). The amplitude of the response obtained is measured in milli and micron volts, in relation to the amount of nerve fibers involved, and the pulse transmission rate (measured speed) measured in meters per second is in relation to the myelin sheath integrity.

It is the responses obtained in the spinal cord and parietal cerebellar regions from electrical stimuli of the peripheral nerves that convey a sensitive message.
PSS are obtained by stimulating a peripheral nerve (usually the central nerve in the pulse and the tibial in the cavern) and recording the waves generated in the central system and the spinal cord.
PSS analysis of their presence, response amplitude, timing of peripheral stimulus waves, allow us to evaluate the integrity of central pathways in many neurological diseases (compressive myelathy from disc herniation or nerve damage, myelitis, multiple sclerosis, and degenerative disease). of the central nervous system).
Both electromyography / electronurography and PSS are non-invasive, slightly annoying methods, absolutely applicable to all patients; surface electrodes and a usable age are used; no substance is injected and the power of the current to absorb the responses is barely perceptible. Signal analysis is performed automatically by the computer and neurophysiological analysis responses are generally delivered to the patient upon completion of the examination.

Doctors:NEUROLOGY

Prof. Dr. Fabrizio Monti

Dr. Hajdi Gorica

Articles:NEUROLOGY

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