Neurologia e laboratorio di neurofisiologia
Équipe
Dr. Mauro Giannini
Surgeon
Specialist in Neurology
Villa Stuart Private Clinic
Neurology and neurophysiology laboratory
Neurology is the branch of medicine that deals with the study, diagnosis, and non-surgical treatment of nervous system disorders. The activities include consultations, diagnostic tests (such as electroencephalograms or MRIs), the prescription of pharmacological or physiotherapeutic rehabilitation treatments, and finally, monitoring the management of the disease’s progression.
The neurophysiology laboratory studies the activity of the nervous system using non-invasive techniques and equipment to understand the neural mechanisms underlying cognitive, motor, and sensory functions and to diagnose neurological diseases through neurophysiological tests.
SYMPTOMS
It is recommended to consult a neurologist in the presence of symptoms such as:
- Frequent migraines and headaches
- Severe migraines and headaches
- Dizziness, vertigo, or balance problems
- Muscle weakness, cramps, or tingling
- Difficulty in coordinating movements
- Changes in sensitivity or vision
- Memory or language problems
- Seizures or temporary loss of consciousness
- Sleep disorders
PATHOLOGIES
- Epilepsies
- Parkinsonisms
- Autoimmune diseases
- Neuromuscular disorders
- Muscular diseases, atrophies, myopathies
- Sleep disorders, insomnia, sleep apnea syndromes
- Anxiety states / minor mood depression states
- Muscle-tension headaches
- Migraine syndromes
- Trigeminal neuralgia and cluster headaches secondary to internal diseases
-
Cerebrovascular diseases:
- stroke and cerebral vasculopathies
- cerebral hemorrhages
- cerebral aging - Peripheral nervous system disorders
-
Nerve and spinal root disorders:
- painful syndromes from herniated discs, radiculopathies, disc herniations, spinal canal stenosis -
Neuropathies:
- carpal tunnel
- post-traumatic focal neuropathies
- paraneoplastic syndromes
- plexopathies
- shoulder dislocations
- root avulsions
- thoracic outlet syndrome (TOS)
- diabetic neuropathy
- nephrotic
- alcoholic and drug-induced
TREATMENT
- Specialized neurological consultation
- Neuropsychological assessment with testing
- Memory testing
- Electromyography
- Electroneurography
- Electroencephalography
- 24-hour Electroencephalographic Monitoring
- Sleep study
- Outpatient and Inpatient Overnight Polysomnography
- Overnight oximetric monitoring (Dynamic Saturometry)
- CPAP/Auto-CPAP pressure titration for OSAS
- Motor Evoked Potentials
- Somatosensory Evoked Potentials
- Auditory Evoked Potentials
- Visual Evoked Potentials
NEUROLOGICAL EXAMINATIONS
At Villa Stuart, we perform the following neurological examinations:
ELECTROMYOGRAPHY AND ELECTRONEUROGRAPHY
The electromyographic examination is a diagnostic tool for evaluating peripheral nervous system diseases, representing an extension of the clinical neurological examination and allowing for diagnosis, monitoring the course, and providing a prognosis for major neuromuscular diseases. The examination must always be preceded by a neurological evaluation to identify the neurological deficits to be analyzed and dynamically guide the electromyographic tests.
The procedure involves performing:
- Electroneurography (ENG), studies nerve conduction (measures the ability to transmit motor commands or sensory information from peripheral nerves to the central nervous system.
- Electromyography (EMG), records muscle electrical activity.
The ENG and EMG methods allow for:
- Localizing the disorder
- Identifying the underlying pathological process
- Characterizing the deficit
- Assessing the severity
- Monitoring the disease's progression
- Providing a prognosis
- Evaluating the effectiveness of the adopted therapies
ELECTROENCEPHALOGRAPHY
Electroencephalography (EEG) is the recording of the brain’s electrical activity and, together with the “24-hour dynamic electroencephalography,” represents an investigative tool for the diagnostic and therapeutic assessment of episodes of loss of consciousness, head injuries, sleep disorders, brain tumors, and in the context of competitive sports fitness.
The EEG and “24-hour dynamic EEG” methods allow for:
- Diagnosis of epilepsy and epileptiform syndromes
-
Differential diagnosis between:
- Epilepsy and anxious somatization
- Fainting, syncope, and other consciousness disorders
- Aftereffects of ischemic or hemorrhagic cerebrovascular events that may generate epilepsy
- Head injuries
- Brain tumors
EVOKED POTENTIALS STUDY
Somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) are methods used to evaluate the integrity of sensory and motor conduction in the nervous system, which is altered in neurological and degenerative diseases.
Auditory evoked potentials (BAERS) are methods used to evaluate peripheral and central auditory pathway disorders, from the cochlear receptor to the auditory cortex, and to study conditions such as neuromas, trauma, intoxications, tumors, and immune-mediated diseases.
Visual evoked potentials (VEP) are methods used to evaluate peripheral and central optic pathway disorders, from the retina to the calcarine cortex, for central visual conditions such as neuritis or optic neuropathies, trauma, tumors, multiple sclerosis, ischemias, or hemorrhages.
SLEEP MEDICINE
Sleep disorders are conditions that worsen the quality and/or quantity of sleep, which, if prolonged over time, can damage the body and predispose it to acute cardiovascular, respiratory, and neurological events (stroke, myocardial infarction, rhythm disorders, increased blood pressure, …).
Sleep disorders can be classified into 4 major groups:
-
Dyssomnias:
- Difficulty or inability to initiate or maintain sleep with the sensation of having slept poorly or insufficiently (psychophysiological insomnia, restless legs syndrome, ...);
- Conditions characterized by excessive daytime sleepiness (narcolepsy, obstructive sleep apnea syndrome, idiopathic hypersomnia, ...) -
Parasomnias:
Disorders present both during the falling asleep phase and during sleep, but not primarily manifested by insomnia or excessive daytime sleepiness, and are divided into:
- Sleep-wake transition disorders (rhythmic movement disorders of sleep, sleep talking, restless legs syndrome, ...)
- Arousal phase disorders (confusional awakenings, night terrors, nightmares, and sleepwalking); - Parasomnias associated with REM sleep (nightmares, sleep paralysis, REM, "sleep behavior disorders")
- Other parasomnias (bruxism, enuresis, ...) -
Sleep disorders associated with medical or psychiatric conditions:
- Respiratory, cardiac, digestive, neurological, mental diseases -
Non-restorative sleep:
- Snoring
- Profuse sweating
- Frequent awakening episodes
- Restless sleep
- Apnea crises with cyanosis
- Breathing difficulties
- Mood and behavioral disorders
- Reduced concentration and work performance
- Daytime sleepiness and increased risk of road accidents
- Irritability and mood depression
- Morning headache and fatigue
- Reduced libido
OBSTRUCTIVE SLEEP APNEA SYNDROME (OSAS)
Obstructive sleep apnea (OSA) are repeated interruptions of normal breathing (apneas lasting more than 10 seconds) during sleep, which cause micro-awakenings of which the patient is unaware.
It can occur at any age. People most at risk are those who snore heavily, are obese and/or overweight, have high blood pressure, and/or craniofacial abnormalities.
The certainty of the diagnosis and especially the assessment of the severity of the pathological condition require polysomnography.
POLYSOMNOGRAPHY
Polysomnography is a non-invasive test performed during the night, consisting of the simultaneous recording of several parameters. It is a multidisciplinary evaluation that includes neurological, otorhinolaryngological, and pneumological assessments, to provide a multidisciplinary overview of the patient, offer a diagnosis, and delve into the pathogenesis of the problem, identifying the most appropriate treatment.
The parameters are:
- Oro-nasal flow: evaluation of any arrests/apneas of the airflow
- Thoraco-abdominal movements: 2 elastic bands record the excursions of the chest and abdomen during nighttime breathing
- Oxygen saturation (SaO2): pulse oximeter for continuous non-invasive evaluation of arterial oxygen saturation
- Cardiac leads: evaluation of heart rate and rhythm
- Electroencephalographic leads (EEG): information on the various stages of sleep
- Electrooculogram EOG: identification of eye movements to distinguish REM and NREM phases
- Surface electromyography (EMG): evaluation of muscle tone
The Villa Stuart Clinic is affiliated with major insurance companies and supplementary health care funds.
For information and bookings
Monday / Friday 8:00 AM – 8:00 PM / Saturday 8:00 AM – 7:30 PM
Emergency service
Service available 24 hours a day