| Frequently
Asked Questions
Questions
About General Neurology Appointments
Questions About Botulinum Toxin Therapy
(BOTOX®)
Questions About Electromyography and Nerve
Conduction Studies (EMG/NCV)
Questions About General Neurology Appointments
What
does a neurologist do?
A
neurologist is a medical specialist that evaluates for
neurological diseases, which include disorders of the
brain, spinal cord, peripheral nerve, and muscles. The
initial consultation in the office consists of asking
you many questions about your problem and then doing what
is called a neurological examination. The purpose of the
examination is to evaluate for any signs that might suggest
that there could be a neurological problem (brain, spinal
cord, peripheral nerve, or muscle disorder). After the
evaluation, we discuss the findings and recommendations
about further testing, if needed, or treatments that may
be available for your particular problem.
What
will the doctor do at the first neurological appointment?
Most
of the time during the first appointment will be used
to gather information about your problem and a full neurological
examination. If you have not received any paperwork in
the mail prior to your appointment, please come to your
appointment 15 minutes before the appointed time in order
to be able to complete the paperwork (personal information)
prior to seeing the doctor.
How
long do new patient appointments take?
Allow
at least one hour for new patient evaluations (15 minutes
earlier than the appointed time for completion of paperwork
and 30-40 minutes for the evaluation and making any appointments
that are recommended for testing after you are seen).
The electromyography and nerve conduction studies usually
will take about one hour as well, but this does vary depending
on the complexity of your problem. It is important to
try to be on time if at all possible since this will help
us try to stay on time for all the appointments throughout
the day.
What
is the reason for follow-up appointments?
Follow-up
appointments are important to review any testing that
may have been ordered as a result of your initial visit
and to follow-up your symptoms in response to any treatments
that may have been initiated. The first follow-up visit
after the patient evaluation is also important to reevaluate
what was done at the initial encounter to make sure that
there is no other testing or treatment that might be useful
to you.
Should
I bring my films?
It
is very important to bring any films that you have had
in the evaluation of your problem, or in the past couple
of years (CAT scans or MRIs of the brain or spine in particular)
in order to: 1) Not order any tests that you have already
had done and 2) Since your physician here has expertise
in neural imaging, it is important that these films be
reviewed at the time of your appointment since they will
often times impact greatly on decision making the day
of your appointment.
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Questions
About Botulinum Toxin Therapy (BOTOX®)
What
is BOTOX® and Myobloc?
BOTOX®
is botulinum toxin A and Myobloc is the new, recently
released, botulinum toxin B. These are two of the toxins
produced by the clostridia botulinum bacteria that cause
weakness of the muscles injected. Botulinum toxin A (BOTOX®)
was first used back in the mid-1980s to treat strabismus.
It was later FDA approved for this condition, as well
as in treatment of blepharospasm, and then torticollis.
These latter conditions are focal dystonias or movement
disorders. The use of botulinum toxin has expanded to
multiple areas, including treatment of hyperhidrosis (excessive
sweating), excessive muscle contractions following a stroke
or other injury to the brain or spinal cord, movement
disorders affecting the voice, chronic muscle spasm, and
the treatment of wrinkles. It is a safe treatment in these
conditions and there are minimal side-effects that can
occur (mostly from the injection of the medication such
as bruising). Further information about this can be found
through this web site. If you have a question about insurance,
please do not hesitate to contact the insurance department
Carolina Neurology and Electromyography.
I
have heard that botulinum toxin (BOTOX®) can be used
for cosmetic purposes as well as neurological uses. Is
this true?
Yes.
While BOTOX® injections are used to treat neurologic
conditions, they do have benefits for cosmetic purposes
as well. Dr. Good's focus since 1990 has been on the neurologic
uses of BOTOX® injections, however he also performs
minor cosmetic work. If you would like to discuss this
option with Dr. Good, please call the office to schedule
a free initial consultation.
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Questions
About Electromyography and Nerve Conduction Studies (EMG/NCV)
Does
electromyography (EMG/NCV) hurt?
Electromyography
and nerve conduction studies are used to evaluate individuals
for nerve or muscle problems such as pinched nerves in
the neck, carpal tunnel syndrome, nerve diseases, or muscle
diseases. There are two parts to the study: 1) Electromyography
2) Nerve conduction studies. The nerve conduction studies
consist of stimulating various nerves and recording the
responses over a muscle or the skin. The electrical stimulations
are very short (milliseconds), but can be felt. While
there are no complications to the nerve conduction studies,
the electrical stimulations (even though they are very
brief) can be briefly uncomfortable. Electromyography
consists of placing a very skinny pin into different muscles
(one at a time) and recording electrical activity that
is occurring in the muscles while they are moving and
at rest. The biggest problem with electromyography is
more of the thought of it since most everyone has some
anxiety to needles, or "needlephobia." However,
there are no significant complications to this study other
than some occasional bruising. This latter can be treated
with ice during the first 24 hours and, if there is still
some discomfort after, with heat. During this study, the
muscles do not have much sensation, but there are some
tender spots in the muscles that can be uncomfortable
if touched. Since these spots are in different locations
in everyone, we do touch some of the tender spots throughout
the study, but, if touched, the pin can be withdrawn and
any discomfort usually goes away within a second or two.
Therefore, there can be some discomfort, but it is usually
tolerable and not constant throughout the study. If the
above discussion makes you feel significantly anxious,
you may benefit from taking some medication prior to the
study. Of course, you will not be able to drive to the
study or home if you decide to do this. Please contact
our office in advance of your study so that we can plan
to see you earlier (at least a half hour) to give you
some medication (usually Ativan) if you think that you
might need something to help you relax for the study..
Will
I have my EMG/NCV test results today?
Some
preliminary testing results are usually given to you,
but a detailed discussion and proper counseling as to
the testing results will be done by the physician who
referred you for the study.
Do
I have to do anything special for the EMG/NCV test?
You
can take your medication as you regularly would in the
morning and eat regularly. It is advised that if you shower
the night before or that morning (or bathe) that you do
not put any creams or lotions on your skin (in particular
the areas that are going to be studied). Please advise
us if you have a pacemaker, are taking a medication called
Coumadin, or have any communicable diseases such as hepatitis
B or C, or HIV infection.
Are
there any side effects to EMG/NCV tests?
There
are no side effects or complications from the nerve conduction
studies whatsoever. However, you may experience some bruising
from the electromyography study. If there is any significant
aching, burning, or stinging in the muscles after the
study, this usually signifies that there is a bruise.
Using ice after the study and for the remainder of that
day, and heat the next day, if there is still some discomfort,
is advised.
Will
I be able to drive after the EMG/NCV test?
If
you do not choose to take any medication for the test
which is what most individuals prefer, there are no restrictions
in driving to and from the test.
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