Neurodiagnostic Solutions

Specialized Neurophysiologic evaluations made convenient.

At , we offer a comprehensive spectrum of diagnostic tests and second opinions, provided by a dedicated senior clinical Neurophysiologist.

Experienced Technicians

Our staff consists of highly trained and certified technicians and electromyographers with 6+ years of clinical experience.

15+ Tests Offered

We offer a spectrum of neurodiagnostic tests including EEG, EMG, NCS, RNS and many more. Each test is specialized and tailored to the patient's clinical profile.

Second Opinions

Second opinions are offered by a senior consultant when dilemmas exist about a test-clinical diagnosis mismatch. Our goal is to answer any questions you have about a diagnosis or treatment plan.

About Us

Dr. Margi Desai M.D.
Fellowship Clinical Neurophysiology, London, UK

Who We Are

Neurodiagnostic Solutions is a neurophysiology-focused diagnostic clinic that specializes in electrodiagnostic tests which localize lesions of the central and peripheral nervous system, neuromuscular junction, muscles, optic nerve, retina and brainstem. Our goal is to utilize our experience and expertise to formulate evaluations such that each test is tailored to the patient’s clinical needs. Attention to detail, meticulous testing and precise reporting is our forte. We always aim to help the referring physician arrive at an electroclinical diagnosis and our trained and courteous staff ensure that your visit and test is pleasant and stress-free!

Dr. Margi Desai is a dedicated Consultant Clinical Neurophysiologist attached to this clinic, with over 22 years of experience in this field.

What we offer

Our clinic boasts state-of-the-art EEG and EMG machines and trained technologists to provide a comfortable testing experience. Our test suite consists of the following neurodiagnostic tests:

Tests

EMG-NCS

Electromyography and Nerve Conduction Study

Mild Prick

Light Snack Prior

No Side Effects

No Oil/Lotions Prior

Duration:

30 - 45 minutes. 60 minutes for extended study

Duration:

30 - 45 minutes. 60 minutes for extended study

Description:

The ENMG test is an electrodiagnostic procedure to test nerve and muscle function. The test is performed in two parts:

Nerve Conduction Study

This test is performed by placing small stick-on surface electrodes on the skin. The nerves are intermittently stimulated with mild electrical impulses that give an unusual vibratory sensation.

Nerve Conduction Studies can identify nerve damage. It can provide information on the severity of nerve injury and type of injury, whether it is neurapraxia (traction injury) or axonotmesis (axon injury).

EMG

This test involves direct recording of muscle activity by inserting a small disposable needle in various muscles, one by one. A pinprick sensation is experienced when the needle is inserted. No electrical shocks are given. The needle picks up the electrical activity generated by the muscle. This electrical activity is displayed on a screen.

Interpretation of EMG signals requires a specialist trained in Electrodiagnostic medicine. At the Neurodiagnostic Solutions clinic, EMG and Nerve Conduction Studies are tailored for every patient. The clinical Neurophysiologist decides which nerves should be tested and which muscles should be sampled according to your complaints. This requires precise knowledge of neurological anatomy and clinical correlation hence, the need for an experienced Electromyographer physician.

Indications

EMG tests can identify most muscle diseases and provide information about reinnervation of muscles after nerve injury. This information helps the physician decide further treatment and management. EMG and Nerve Conduction Studies can help in the diagnosis of the following clinical problems:

Carpal Tunnel syndrome: complaints of tingling and numbness in hands Ulnar nerve palsy and clawing of the hand Foot drop Peripheral neuropathy Suspected Guillain Barre syndrome Cervical and lumbar radiculopathy due to cervical and lumbar spondylosis or canal stenosis Back pain and sciatica Suspected Cuada Equina lesion Brachial plexus injury Lumbosacral plexus lesion Anterior horn cell diseases such as spinal muscular atrophy Motor Neuron disease Muscles diseases like myopathy/muscular dystrophy or inflammatory myopathy Facial palsy (e.g. Bell's palsy)Tarsal tunnel syndrome Traumatic peripheral nerve injury in the upper or lower extremity Sports-related nerve injury

SSR

Sympathetic Skin Response

Duration:

15 minutes

Duration:

15 minutes

Description:

This specialized test helps diagnose small fibre neuropathy and autonomic dysfunction. SSR is usually performed along with routine nerve conduction studies.

Small fibre neuropathy

This disorder is often the cause of burning feet. Symptoms originate in the feet and may progress upwards.

Autonomic dysfunction

Autonomic dysfunction can be found in patients with diabetic autonomic neuropathy or those with hereditary sensory and autonomic neuropathy.

Indications

SSR tests can help in the diagnosis of the following clinical problems:

Burning feet Suspected autonomic neuropathy Suspected complex regional pain syndrome

RNS

Repetitive Nerve Stimulation (Decrement Test)

Duration:

20 - 30 minutes

Duration:

20 - 30 minutes

Description:

Certain diseases causing muscle weakness occur due to defective transmission at the neuromuscular junction. RNS is the most common electrophysiologic test used to evaluate neuromuscular transmission defect disorders.

This test is a variant of a Nerve Conduction Study. Repeated stimuli are given to the nerve and the responses are recorded when the muscle is relaxed. The same test is repeated after exercising the muscle.

Indications

RNS tests can help in the diagnosis of the following clinical problems:

Suspected Myasthenia gravis Suspected Myasthenic syndrome in babies and children Neuromuscular junction disorders Weakness of limbs and breathing difficulty in critically ill patients

SFEMG

Single Fibre EMG

Mild Prick

Light Snack Prior

No Side Effects

Duration:

45 - 60 minutes

Duration:

45 - 60 minutes

Description:

This is a highly specialized test for the diagnosis of Myasthenia gravis, especially when Repetitive Nerve Stimulation (RNS) tests are inconclusive.

This test also has a good diagnostic yield for Myasthenia involving the eyes, known as Ocular Myasthenia.

Indications

SFEMG tests can help in the diagnosis of the following clinical problems:

Myasthenia affecting the eyelids, known as Ocular Myasthenia Suspected Myasthenia gravis

EEG

Electroencephalogram

Duration:

50 - 60 minutes

Duration:

50 - 60 minutes

Description:

EEG records electrical activity in the brain in the form of brain-waves. These brain waves are analyzed for abnormalities.

Procedure

EEG is a painless and non-invasive test, performed by a trained EEG technologist.

In this test, several small metal disc electrodes (usually 22 to 24 electrodes) are attached all over the scalp with the help of a paste. The paste can be washed off when the test is over. The technologist will probably scrub each position on your scalp with a mildly abrasive cream before applying the electrodes. This helps improve the quality of recording.

The EEG room is quiet and often dimly lit. During the test, the technologist may ask you to:

Open and close your eyes several times.
Look at flashing lights.
Breathe rapidly or deeply.

These are special activation methods known as hyperventilation and photic stimulation.

Additionally, if you fall asleep during the test, that's fine. Sleep EEG is helpful as it can provide extra information. Sometimes the doctor will ask you to sleep only 4 hours the night before an EEG test. This is called sleep deprivation and it can increase the chance of 'epilepsy waves' being recorded.

Once the EEG recording is complete, the technologist will take the electrodes off your scalp. You may then go home and wash the paste out of your hair.

Indications

EEG tests are usually advised for the following conditions:

Newborn babies who fail to cry spontaneously at birth and may have suffered birth hypoxia/ischemia Newborn babies who have minor fits or tonic-clonic convulsions Babies with encephalitis and/or meningitis Babies with staring spells and abnormal eye or limb movements Children with repetitive, unprovoked seizures; often termed as fits or attacks Children with metabolic encephalopathies Children with sleep-related disorders e.g. night terrors, night walking, unusual leg and body movements in sleep Children with degenerative diseases such as Subacute Sclerosing Panencephalitis (SSPE)Individuals with epilepsy and unprovoked seizures.Syncope or fainting spells. EEG is useful in distinguishing these episodes from epilepsy.Dementia Encephalitis Metabolic encephalopathies e.g. hepatic, toxic, uremia etc.Confusion and altered awareness Individuals with recent head injury or trauma Stroke Brain tumours

VEEG

Video Electroencephalogram Recording (Video EEG)

Duration:

Variable: 1 - 4 hours, upto 96 hours

Duration:

Variable: 1 - 4 hours, upto 96 hours

Description:

This test is a simultaneous recording of video and EEG of the patient. The EEG records brainwaves and the synchronized digital video records physical manifestations of a seizure or attack. Video EEG recordings may be necessary for a few hours to a few days, depending on the indication.

The recording machine is located by the patient's bedside. During recording, the patient is free to talk and interact with family members. Additionally, children can sit on the bed and play with toys if they desire. Once the recording is complete, results will be interpreted by the consultant clinical neurophysiologist.

Indications

VEEG tests are usually advised for the following conditions:

Classifying types of seizures and epilepsy Differentiating between seizures and 'pseudo-seizures'. The latter can be a cause for the epilepsy becoming poorly controlled or intractable.Evaluation of complex or unusual pediatric epileptic syndromes.Differentiating seizures from NREM and REM sleep disorders.Pre-surgical evaluation of patients with poorly controlled epilepsy. The test is usually carried out prior to epilepsy surgery.

SSEP/SSER

Somatosensory Evoked Potentials/Responses

Duration:

30 minutes

Duration:

30 minutes

Description:

This test is used to study the function of the sensory pathways from the spinal cord to the sensory cortex of the brain. This test can be performed on the upper and lower extremities.

Procedure

You will be asked to lie down on the couch.
The technologist will attach small metal disc electrodes on your scalp with the help of a paste. This paste can be washed off with water after the test.
You will be asked to close your eyes and relax during the test.
Testing for each extremity typically takes only 5 to 6 minutes.
For the upper limb SSEP test, a nerve will be stimulated at the wrist and you will feel an intermittent vibration during stimulation.
For the lower limb SSEP test, a nerve will be stimulated at the ankle and you will feel an intermittent vibration during stimulation.
There is no vibratory sensation over the head/scalp.

Indications

SSEP tests can help in the diagnosis of the following clinical problems:

To evaluate demyelination of the spinal cord e.g. in Multiple Sclerosis Assessment of patients with imbalance whilst walking Assessment of patients with ataxia Tumours of the spinal cord Assessment of children with Meningomyelocele and spinal cord birth defects

VEP/VER

Visual Evoked Potential/Responses

Duration:

20 - 40 minutes

Duration:

20 - 40 minutes

Description:

There are two types of tests available:

Pattern VEP

Pattern VEP is a sensitive test for detecting optic nerve dysfunction, optic nerve demyelination and lesion of the macula.

Procedure:

The technologist will attach small metal disc electrodes on your scalp with the help of a paste. The paste can be washed off after the test.
You will then be asked to sit on a chair and look at a checkerboard pattern on a monitor. If you have reading glasses, you may wear them if they help you focus on the pattern on the screen.
The test requires visual fixation and cooperation hence, it can only be performed in adults and only in older children.
For babies, toddlers and younger children (under the ages of 8 years), Flash VEP can be performed instead.

Flash VEP

Flash VEP is a test recommended for babies, toddlers and younger children under the age of 8 years, in whom Pattern VEP is not feasible. The younger patients may be sedated with an oral syrup after which the test may performed whilst they are asleep.

During the test, electrodes are attached on the child's scalp with the help of a paste. Whilst the child is asleep, each eye is tested separately with flashes of light.

Indications

VEP tests can help in the diagnosis of the following clinical problems:

Patients with visual problems Sudden onset of blurring of vision in one or both eyes Suspected demyelinating disorder such as Multiple Sclerosis Suspected inherited diseases of the optic nerve or macula.

F-VEP/F-ERG

Flash Visual Evoked Potential and Flash Electroretinogram

Duration:

20 - 40 minutes

Duration:

20 - 40 minutes

Description:

This test is useful for infants and young children under the age of 10 years. The Electroretinogram (ERG) is a test for evaluating function of the retina. The complimentary test, Flash VEP, gives information on the visual pathway, though it is not as sensitive as the Pattern VEP test. When performed together, Flash VEP and Flash ERG provide high-quality data on the function of the visual pathway and retina, respectively.

Procedure

This test is usually performed in a dimly lit or dark room.
A parent or caregiver may stay with the child.
Most children need to be sedated with an oral syrup so that they lie still. This allows us to carry out the test with precision. Test interpretation and results are accurate if there are no movement artifacts during the test.
For the Flash ERG, the technologist will attach small metal disc electrodes below the eyelid and around the eyebrow with the help of a paste. This paste can be washed off after the test is complete.
For the Flash VEP, two disc electrodes will be attached over the scalp at precise points which are measured with a tape. During this test, lights will be flashed over the eyes intermittently. These flashing lights are harmless and have no side-effects.

Indications

Flash VEP and Flash ERG tests can help in the diagnosis of the following clinical problems:

Infants and young children with vision problems Suspected inherited disorders of the optic nerve or retina in children

BAER

Brainstem Auditory Evoked Responses

Duration:

25 - 35 minutes

Duration:

25 - 35 minutes

Description:

This test is used to study the function of the auditory nerve and the brainstem. It can be performed on adults and children though children may need to be sedated with an oral syrup.

Indications

BAER tests can help in the diagnosis of the following clinical problems:

Evaluate demyelination in the brainstem in demyelinating disorders such as Multiple Sclerosis Evaluate brainstem function in cases with Cerebellopontine angle tumours in the brain.Evaluate brainstem function in patients with encephalitis To prognosticate in comatose patients

BERA

Brainstem Electric Response Audiometry

Duration:

35 - 45 minutes

Duration:

35 - 45 minutes

Description:

This test is used to determine the hearing threshold. Premature babies are often required to undergo this test to evaluate for hearing loss.

Procedure

Most children need to be sedated with an oral syrup so that they lie still. This allows us to carry out the test with precision and get accurate results. A parent or caregiver may stay with the child.
The technologist will then attach small metal disc electrodes over the scalp at precise points measured with a tape. The electrodes are attached with a paste that can be washed off after the test.
Headphones are then equipped over the ear and intermittent sound -- clicks of varying intensity (in decibels) -- are given to each ear, independently. This is called mono aural stimulation.
The test results appear as waveforms on the recording machine, which are then analyzed and interpreted by the consultant clinical neurophysiologist.

Indications

BERA tests can help in the diagnosis of the following clinical problems:

Evaluation for sensorineural deafness in infants and young children Screening test for hearing loss in premature infants.

Contact

Appointments

Our clinic accepts walk-in patients, but we highly recommend that patients make appointments via the following methods to avoid long wait-times or cancellations:

02223677788 (Preferred)

neurodiagnosticsolutions@gmail.com

Get Directions

Hours and Address

10:00 AM to 5:00 PM (Mon to Sat)

10:00 AM to 5:00 PM

Monday to Saturday

Neurodiagnostic Solutions, Panchshil Plaza building - 6th floor #613, N.S. Patkar Marg (Hughes road), Mumbai–400007

Next to Dharam Palace, Gamdevi area