• Sleep Apnea

    How can you tell if you have Sleep Apnea? Ask your spouse, family, or those around you. Here are some questions to ask: 1. Are you a loud, habitual snorer, disturbing your companion? 2. Do you feel tired and groggy in the morning? 3. Do you experience sleepiness and fatigue during the day? 4. Are you overweight? 5. Have you been observed to choke, gasp, or hold your breath during sleep? If you answered yes to one or more of these questions, you should discuss your symptoms with your physician. Blood oxygen saturation is reduced in the entire body during apnea -- sometimes producing serious irregular heartbeats and significantly reduced oxygen to the brain. Common symptoms of Sleep Apnea are a decreased ability to concentrate; loss of energy and/or fatigue; mild to marked depression; irritability; short temper; morning headaches; forgetfulness; anxiety; and, most frequently, excessive daytime sleepiness. Read More
  • Narcolepsy

    Narcolepsy, and related disorders, is typified by the inability to stay awake. Narcoleptics may suddenly fall asleep while they are engaged in an activity (for example, while waiting for a traffic light to change). Attacks are occasionally brought on by laughing, crying, and other strong emotions in a group setting. This illness often goes undiagnosed for years. Read More
  • Insomnia

    Insomnia is an inability to fall asleep or stay asleep. Attacks are often brought on by stress; worry; depression; another illness; persistent pain; and sleeping pill habits. Evaluating insomnia is important even if the condition seems temporary. Read More
  • Other Sleep Disorders

    Some people suffer from nightmares, night terrors, sleep walking, excessive body jerks, or uncontrollable leg movements. These people often get less than four and one-half hours of restorative sleep -something our bodies need. Even though a person spends ten hours in bed, they may only get two hours of restorative sleep. It is important to have your sleep analyzed if you find yourself waking up more tired than when you went to bed. Read More
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Testing Instructions

Neurology Services, Inc.

Patients' Name: _______________________________ 

Date of Appointment: __________________

Time of Appointment: __________________

Appointment is at:  Alexandria       (703)360‑8200: __________                     

                           Woodbridge     (703)878‑0600: __________

                           D.C.               (202)728‑0099: __________

 PREPARATION FOR TESTING 

EEG:

1. Hair must be clean and dry, with no hair tonic, oil, gel, mousse, etc., and especially, no hair spray. If you wear braids, some of them may need to be undone. If you wear a hair‑weave, check with the technician prior to making an appointment.

2. Take your regular medicines, and eat your regular meals. Bring a list of your medications with you.

3. Do NOT drink any beverage with caffeine or alcohol in it for at least 24 hours prior to the test‑this includes coffee, tea, and most soft drinks. You may drink water, milk, fruit juices, or decaffeinated beverages.

4. If the doctor has ordered a sleep‑deprived EEG on you, be sure to get no more than 4 hours of sleep (1/2 your usual amount of sleep) the night before the test, so that you will be able to fall asleep during part of the test. If you feel that you will be too sleepy to get home on your own after so little sleep, be sure to bring someone with you who can help you get home.

24‑Hour EEG:

1. Follow instructions I and 2 for EEG as above. You may have up to 2 caffeinated beverages or one alcoholic beverage the day prior to the test, but you should not have caffeine or alcohol on the day of the test, or during it. You do not need to be sleep‑deprived.

2. Wear a shirt or blouse that buttons up the front, as otherwise it will be quite difficult to take it off.

3. Wires are glued to your head, going to a soft collar worn around the neck, with a cable going from there to a tape‑recorder worn on a belt around the waist, which you wear home. You will look somewhat peculiar, so you may want to bring a hat or scarf, and possibly a coat.

4. The solution used to remove the glue is somewhat oily, so plan on going home and washing your hair, after having the wires removed on the second day.

Q‑EEG (Quantitative EEG):

1. Follow instructions I and 2 for EEG as above. (If you normally drink more than two alcoholic beverages per day, or five or more caffeinated beverages per day, you should stay off of alcohol and caffeine for 48 hours, to give them sufficient time to clear out of your body.) You should not be sleep‑derived, as you need to be awake and alert for this test.

2. As much as possible, you need to be off of all medications for this test, as many medications interfere with the testing and make it less useful. Check with your doctor as to which medications you should continue taking, and bring a list of medicines you've taken with you.

 EVOKED POTENTIALS:

VER: _______ 

P300:______

You need to be awake and alert for these tests. Medications do not affect the tests, unless they make you sleepy. For the VER, if you wear glasses or contact lens, bring them with you.

BAER: ______

Do not drink alcohol for 24 hours prior to test. Certain antibiotics may affect the test‑if you are on antibiotics, tell technician prior to test.

SERs: _______

EMG/NCV: _______

Sensory Perception Testing (CPT or SPT): _______

Do not use any cream, lotions, oils, etc., on the skin‑these make it difficult to record. If you wear loose clothing for the SERs, you may not have to change into a patient gown. These tests are somewhat uncomfortable.

 BEAM (Brain Electrical Activity Mapping):

This includes a regular EEG, Quantitative EEG, VER, BAER, and P300, with extensive quantitative, spectral, and brain‑mapping computer analysis of the various tests. Preparation is the same as for the Quantitative EEG.

 AT (Autonomic Test):

This tests your autonomic nervous system, which controls many of your Involuntary functions, such as how high your blood pressure is, how fast your heart beats, sweating, breathing, etc. For this test, EKG electrodes are applied to the left and right collarbones and to the bottom of the rib cage on the left, and a blood pressure cuff goes on the left arm. You are asked to sit quietly, and then to do some deep breathing, valsalva maneuvers, and then stand up. (Valsalva for this you take a deep breath, hold it and bear down. Technologist will explain it further at the time of the test). The test takes about 30 minutes, and is not painful, but very peaceful and quiet. It is necessary to be able to get at the collarbones, waist and put a blood pressure cuff on, so dress appropriately. There is no preparation for this test.

You should wear clothing that allows us to apply a blood pressure cuff on your left arm, EKG leads on your collarbones, and a lead on your side at the bottom of your rib cage. (i.e., no turtlenecks or one piece dresses, or you might have to change into a patient gown). It is all right to drink alcohol or caffeine the day prior to the test, but please try to have no more than one caffeinated beverage on the day of the test. If you have a defibrillator, implanted vagus nerve or other neural stimulator, check with the doctor prior to having the test. If you have a pacemaker the test cannot be done.

 Doppler Ultrasound:

Doppler ultrasound (a non-invasive test) is a test that uses sound waves to create images and sounds of your blood flow. This test can detect narrow or blocked arteries or ulcerated plaques. An ultrasound scan of the carotid arteries screens for buildup of fatty plaque - the leading cause of strokes. A hand-held probe placed against the skin emits sound waves. The sound waves bounce off the moving blood cells in the arteries and echo back to the probe. The echo is translated into an image that appears on a screen. The test involves no radiation and is harmless, there are no injections of contrast and gives important information about real-time physiology of the vascular systems going to the brain and the Circle of Willis.

Before your test:
Getting ready for this requires little effort. You should wear a button down shirt. This test usually takes from 30 to 45 minutes. Be sure to leave time for check in, and relax while you are getting ready.

Tell the sonographer if you've had:

  • A stroke, hypertension and/or high cholesterol
  • Symptoms, such as short-term loss of strength, speech, or vision.

You may be asked about your health. Your answers will help the sonographer.

During your test:
You will lie down on an exam table. Your head will be turned to the side, as if you were looking over your shoulder. Non-greasy gel will be applied to your neck. The sonographer will then press a hand-held transducer (probe) against your neck.

Be aware that:

  • The gel may feel wet. But don't worry. It wont harm your skin or clothes.
  • You may feel pressure. If the test is painful, let the sonographer know.

During Doppler ultrsound, you may hear a "whoosing" noise. This is the sound of your blood flowing. You may also see tracings of your blood flow on a screen. The sonographer can answer your questions about the test. But only a doctor can explain the results.

After your test:
Before leaving, you may need to wait briefly while your images are being reviewed. You can return to your normal routine right after the test. Your doctor will let you know when the results are ready.