Marcia Dunn and Jonathan Sobel Department of Neurology

The Neurology Department performs general neurological consults for adults and neuromuscular consultations for adults and pediatric patients with various nerve and muscle diseases.

All medical staff members of the department are board-certified neurologists with subspecialties in neurophysiology and neuromuscular diseases.

Neuromuscular Pathology studies are performed by the most advanced methods at the Pathology Laboratory of HSS. Small samples of muscle and nerve tissue (biopsy) are removed under anesthesia by a surgeon for special pathology studies. Muscle and nerve biopsies help to diagnose certain abnormalities in the muscle and/or the nervous system and to check the progress of an already diagnosed condition.

The Neurophysiology Laboratory performs Evoked Potential Tests (EP), Nerve Conduction and Electromyography (NCV/EMG), and studies for routine diagnosis of disorders of the nervous system. Furthermore, Intraoperative Monitoring (IOM) is performed on request by orthopedic surgeons.

  • The evoked potential tests (EP) investigate the integrity of neural pathways carrying electrical signals from the sensory organs to the brain and are used in the diagnosis of disorders of the nervous system to locate the site of nerve damage. Three EP tests are performed in our neurophysiology laboratory: brainstem auditory evoked potentials (BAEP), visual evoked potentials (VEP), and somatosensory evoked potentials (SEP) of upper (SUEP) and lower (SLEP) extremities.

  • In electromyography (EMG) a small needle (an electrode) is inserted into a muscle.  Through such electrodes, the electrical activities of one or more muscles are measured. The resulting signals are displayed on a computer screen and observed by a neurologist and a neurophysiology technologist. The nerve conduction velocity (NCV) test measures a speed of a nerve impulse as it travels trough a patient's extremity and is usually associated with the EMG test.

  • Intraoperative Monitoring (IOM) measures some aspects of peripheral and central nervous system function during certain surgical procedures. It provides objective information about an anesthetized patient that gives the surgeon feedback. This can indicate impending risks related to the surgical procedure or anesthesia. During intraoperative monitoring, neurophysiological signals from muscles and nerves are continuously recorded using EMG and SEP procedures.

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