Gazi Hospital Neurology Departments are working to provide diagnosis, treatment and follow-up services for in and outpatients. Efforts are being made to provide quality and effective health services through multidisciplinary team work in the light of current scientifically accepted data on headache, dizziness, central nervous system vascular diseases, movement disorders, Parkinson’s, stroke, epilepsy and sleep disorders.

To make an appointment for medical examination by a specialist call 0212 650 18 19 Gazi Hospital.

Headache Unit, Epilepsy Unit, Electroencephalography (EEG) and Electromyography (EMG) Unit and Neuro-ophthalmology Unit are operating in the Gazi Hospital Neurology Department.

 

Cerebrovascular diseases

• Acute Ischemic Stroke
• Cerebral Bleeding
• Degenerative Diseases
• Vascular Dementia,
• Alzheimer’s Disease,
• Movement Disorders ALS, etc.
• Parkinson’s Disease,
• Dystonia,
• Dyskinesia,
• Essential Tremor,
• Restless Leg Syndrome,
• Huntington’s Chorea
• Epilepsy
• Focal,
• Generalized Epilepsy,
• Status Epilepticus
• Demyelinating Diseases
• Multiple Sclerosis,
• Acute demyelinating Encephalomyelitis,
• Transverse myelitis
• Central nervous system vasculitis,
• Neuropathies
• Toxic metabolic,
• Immune neuropathies,
• Guillen’s Barre syndrome, etc.

Muscle disorders

Neuromuscular junction diseases

• Myastenia Gravis

Headaches, Back Pains and Neck Pains

• Vascular,
• Tension,
• Cervicogenic headaches,
• Temporal arteritis,
• Neuralgia etc.

Confusional Conditions

• Delirium,
• Encephalitis etc.

 

EMG (ElectroMyeloGraphy)

What is EMG?

EMG is the abbreviated name for electromyography. It is a muscle examination that monitors and interprets the electrical activity that causes muscle contraction. Muscle contraction is caused by electrical potentials, known as motor unit action potentials (MUAP), which are generated in the muscles by stimulating potentials transmitted from the brain through the nerves.

The amount of contraction increases with the increase in the number and frequency of MUAP’s. In cases where muscles are not contracted or contracted, MUAPs are examined, whether the shape or frequency is within normal limits, or the electrical activities that are not normally encountered are variables that are examined to identify problems in the muscles. When it comes to EMG examination in daily use, it means the whole of the tests including the muscle examination as well as the nervous examination.

What is the Place of EMG to Diagnose Diseases?

Even though it does not hold for the direct examination methods, EMG guides these methods. In many cases, without needing direct methods, sometimes by itself sometimes together with other indirect methods, it leads to treatment by helping the clinician to diagnose.

Why is it requested?

EMG and nerve conduction studies are direct methods used to diagnose the diseases of anterior horn cells of the spine, nerve roots, nerve nets, end nerves, neuromuscular junction and muscle respectively, and often due to ease of application, often alone or in combination with other assistive methods (i.e. imaging methods, blood biochemistry) leads to the most definitive diagnosis possible, or refers the physician directly other methods (i.e. biopsy, direct view of the problematic area by operation) for diagnosis. It is often used to measure how damaged nerves and muscles are in back and neck hernias, in painful conditions that is caused by compressed end nerves and sensation defects, in conditions where arm and leg weaknesses are seen, in limited or generalized muscle wasting.

How Is EMG Performed?

Needle electrodes are used in the EMG examination for the diagnosis of muscle problems. This is why it is also called the needle EMG. Usually concentric needles are used. These needles were transformed into recording electrodes by placing a very thin wire into the known injector needles. A needle attached to the device raises the fear that electricity will be given to the patient when first seen. However, no electrical stimulation is given in needle EMG examination. It is only used to record normal or abnormal electrical activity in the muscles. The tip of the needle is inserted directly into investigated muscle. MUAPs or other electrical activities generated by stimuli sent from the brain for contraction of that muscle in the muscle region near the needle tip are amplified through special amplifiers and are displayed on the screen of the device. Besides the visual examination, the same signals are made audible through the loudspeaker, which makes an important contribution to the evaluation of the examining doctor.

How long is the examination?

It is always necessary to examine multiple nerves and muscles in a body region. Because the method can be painful due to the way it is applied, unnecessary interference is avoided by limiting the examination with the help of the practitioner’s knowledge and experience. Sometimes seemingly limited and short-time planned studies can be extended according to the data obtained during the application. In EM, it is difficult to talk about a standard duration of examination because individual patient-specific examination is planned for each patient. This period can be extended from 30 minutes to 2 hours. During this period, the patient’s help to the doctor as much as possible will ensure that the examination is healthier and will prevent unnecessary time span.

EEG (24 Hours Sleep EEG)

Electroencephalography or EEG is a method of measuring brainwave activity with electrical methods. Since the patient is not given an electric current, he does not feel pain or ache.

The record obtained by electroencephalography is called electroencephalogram (EEG). This technique, called electroencephalography, or “”obtaining brain electrography”” commonly used by the public, was developed by the German psychiatrist Hans Berger in 1929.

The procedure in EEG is done by sticking small electrodes to the hair by placing a conductive substance called “”paste””. The electrical potential changes between the two electrodes are recorded on the computer and the result is interpreted by the expert and the patient is given the necessary information. Upon examination of the obtained record, based on the fact that there are deviations from normal, many brain malfunctions (epilepsy, etc.) can be diagnosed.

The human nervous system contains about 10 billion nerve cells. Most of them are in the brain, rest of them are in spine and other parts of the body, in the related nerves. Each brain cell is linked to 5,000 to 50,000 nerve cells. Nerve fluxes are carried along the nerve fibers and lead to electric waves in the brain. These electric waves can be measured at the scalp of the head.

EEG abnormality may not be shown in every patient with clinical seizure, and EEG abnormalities may be seen in people without seizures or epilepsy. In patients with seizures or epilepsy, during seizures, EEG may show an average 70% abnormality.

Adults need to wash their hair one day before the procedure. Sleep EEG may require 24 hours of wakefulness. Imaging in children is usually done asleep. For this, medicine can be given and for easy imaging, it is recommended to take the child bed late and wake him early.

Halil Murat ŞEN, MD

Neurology Specialist