Chicago Neuroscience Institute
(847) 888-1811 Elgin, Illinois
(847) 888-1811 Elgin, Illinois
diagnostic Tests
NEUROLOGY AND NEURODIAGNOsTIC CONSULTATION
A neurologist is a doctor with specialized training in diagnosing and treating diseases of the brain, spinal cord, peripheral nerves, and muscles. Most of the time, a primary healthcare provider refers patients to a neurologist if they have symptoms that indicate a neurological condition. A neurologist is a doctor with specialized training in diagnosing and treating diseases of the brain, spinal cord, peripheral nerves, and muscles.
The chiropractic neurologist is doctor of chiropractic who has obtained post-doctoral training in neurology over a 3-4 year period. The chiropractic neurologist is trained in the evaluation, diagnosis, and care of neurological disorders and related musculoskeletal complications and movement disorders. A board certified chiropractic neurologist may further specialize in areas such as neuroimaging, clinical neurophysiology (electrodiagnosis), and neurorehabiliation.
A neurology consultation or neurodiagnostic consultation refers to a procedure requested by one of an individual’s healthcare providers. The neurology consultation typically consists of a review of the patient's medical history, examination of the patient, review of prior records and the ordering or performance of additional diagnostic tests if necessary. The goal of the consultation process is to render an expert opinion and to make recommendations regarding the care of the patient.
Diagnostic Divisions
CLINICAL NEUROLOGY
The Division of Clinical Neurology refers to services involved in the initial and follow-up evaluation of the patient including the history and physical examination. Most patients are seen in this division during their initial visit. Clinical neurology involves integration of the patient’s history, physical examination and the correlation of findings from specialized neurodiagnostic services. All patients are assigned a neurological specialist in the Division of Neurology during their initial visit. Most of the patients referred to CNI by their attending physician(s) are suspected of having a disorder or disease of the autonomic, peripheral and/or central nervous system.
Neurological disorders are often associated with one or more of the following signs or symptoms; pain, numbness, tingling, weakness, incoordination or cognitive impairment. The history and physical examination process is used to help identify the location, nature and severity of neurological compromise. It is also used to help identify complications associated with neurological involvement. The initial and follow up physical examination help the attending neurologist or other neurological specialist direct further diagnostic assessment and therapeutic intervention.
Evaluations which are be performed in this division of services include:
- History
- Physical Examination
- Digital Phonocardiography
- Digital Phonoangiography
- Quantitative Audiometry
- Panoptic Retinal Examination
NEUROPHYSIOLOGY
The CNI Division of Clinical Neurophysiology (Electrodiagnostic Medicine) is staffed and equipped to provide specialized quantitative electrophysiological assessment of neurological and neuromuscular function. Systematic tests are performed to evaluate and characterize the pattern of nerve signaling (electrical activity) in different regions of the nervous system including the brain, brainstem, spinal cord, nerve plexus, spinal nerve roots, autonomic nervous system and peripheral nerves. Sophisticated technology and advanced protocols are used to help identify the specific region or regions of nerve compromise, to quantify the degree of nerve impairment and to help characterize the compromise. Highly trained CNI staff evaluates the electrodiagnostic findings and renders a detailed report for other providers.
Patients may be referred back to the CNI Division of Clinical Neurophysiology for limited follow up assessment to objectively assess treatment outcome and to rule out. Neurophysiological (electrophysiological) testing can be used to assess the pattern of nerve recovery after conservative, pharmaceutical, rehabilitative or surgical intervention. The diagnostic process is often referred to as “nerve testing”.
Evaluations which are performed in this division of services include:
- Needle Electromyography
- Quantitative Needle
- Electromyography
- Nerve Conduction Studies
- Sensory Evoked Potentials
- Brainstem Evoked Potentials
- Visual Evoked Potentials
- Myoneural Synaptic Studies
NEUROIMAGING
The CNI Division of Neuroimaging houses imaging technology and advanced imaging interpretation stations. Advanced imaging studies such as MRI, CT, PET are not performed onsite. They are often performed at local outpatient hospital settings in order to access the latest technology. The images and data are received and reviewed at CNI. CNI does offer advanced ultrasound imaging studies. The Division of Neuroimaging has unique image interpretation workstations with access to many resident and online data analysis solutions. The imaging workstations are used to perform correlative review of advanced imaging studies such as computerized tomography CT, myelography and various types of magnetic resonance imaging (MRI) studies including MRA. Some of our imaging workstations support 3-dimensional depiction and interrogation of normal tissues and pathology in vivo.
An attending neuroscience specialist at CNI may direct the ordering of advanced neuroimaging to be performed at an outside facility such as a hospital or large healthcare system. The attending radiologist typically does not have the benefit of seeing the patient, and therefore, defers final interpretive and correlative judgment to the attending or referring physician(s). CNI staff may request outside diagnostic images and related data to review the findings and correlate the results with a patient’s clinical, laboratory and/or electrodiagnostic presentation. This is referred to as a correlative review or second opinion imaging interpretation. The CNI staff neurologist’s integration of neuroimaging modalities is often a critical step in the evaluation of brain, spinal and peripheral neurological disorders.
Evaluations which may be performed in this division of services include:
- Interpretation of MRI
- Correlative imaging review
- Interpretation of CT
- 3D Reformatting and virtual tissue interrogation
- Evaluation and interpretation of peripheral neurosonography
- Radiological Assessment of spinal segment stability
- Application of computational decision support
NEURO-ORTHOPEDICS
The Division of Neuro-orthopedics refers to a group of services used to evaluate the integrity of nerve, muscle and joint function. Neurological compromise often results in some degree of muscle weakness or dysfunction corresponding to the site and degree of neurological compromise. In this division emphasis is placed upon the evaluation of neurological integrity and its relationship to human physical performance. CNI houses the latest in technology to assess human performance.
The staff at CNI has developed and implemented specialized testing protocols to evaluate neuromuscular function. A combination of tests referred to as a profile are used to measure and quantify sensibility, range of motion, coordination, strength, endurance and integrated physical performance. This type of evaluation provides valuable insight not ordinarily revealed through routine physical examination, diagnostic imaging, laboratory assessment or electrodiagnostic studies. A quantitative baseline of physical performance is valuable for the development of a therapeutic plan and to objectively measure therapeutic outcome.
Evaluations performed in this division of services include:
- Psychometric Functional Assessment:
- Neuromuscular Functional Capacity Evaluation
- Balance and Gait Assessment:
- Quantitative Sensory Testing
- Quantitative Range of Motion Evaluation
- Sensorimotor reaction time testing
- Selective neuromuscular performance evaluation
- Virtual reality-based assessment
NEUROGENETICS AND LABORATORY ASSESSMENT
The Chicago Neuroscience Institute (CNI) offers specialized laboratory services through outside facilities, which include Quest Diagnostics and Mayo Clinic Laboratories (MCL). There is growing dependence upon the assessment of laboratory data and disease-specific biomarkers for the detection and characterization of pathology. Laboratory services are also used to determine whether there are contributing or complicating systemic disorders and to monitor treatment outcome.
With the help of outside laboratory facilities CNI staff is able to develop and access specialized testing profiles. Examples include specialized coagulation (blood clotting) profiles, enzymology, immunoassays, disease and organ specific biomarkers, microbiology, molecular genetics, special protein studies, culture and sensitivity studies and toxicology. The recognition of genetic disorders and patterns is becoming more important in the field of neuroscience. Genetic disorders include inborn errors of metabolism (IEM), some of which have neurological consequences. The human genome project and other similar programs will continue to have a major impact on the diagnostic workup in neurology. CNI has a direct online link to the National Institute’s of Health (NIH) website which is used for acquiring up to date information on available genetic testing for neurological disorders.
Evaluations performed through this division of services include:
- Sensorimotor Polyneuropathy Profile
- Motor Neuropathy Profile
- Immunoprotein Electrophoresis
- Paraneoplastic Profile
- Autoimmune Profile
- Coagulation Profile
- Genetic Testing
NEUROVASCULAR AND AUTONOMIC STUDIES
Cardiovascular disease continues to be the number one cause of death in the United States. CNI is dedicated to helping screen for cardiac and peripheral vascular compromise which could pose a threat to the individuals’ health and well-being through injury to their central and/or peripheral nervous system. CNI houses state-of-the art non-invasive cardiac (heart) and peripheral vascular (blood flow) labs. CNI also houses a state-of-the art microvascular (small blood vessel) testing lab which includes non-mydriatic retinal imaging.
The peripheral vascular lab is used to assess vasospastic, occlusive and vasodilatory disorders. CNI labs may be used to evaluate the integrity and relationships between the sympathetic and parasympathetic elements of the autonomic nervous systems. Improved capture and interpretation of EKG findings combined with advances in ultrasound technology have elevated the CNI Noninvasive Vascular Laboratory to the forefront in the diagnosis of vascular disease. Non-invasive tests are used to help document the presence, location and severity of arterial and venous disease.
Evaluations performed in this division of services include:
- Transthoracic Echocardiography
- Carotid and Vertebral Ultrasound Imaging
- Abdominal Aortic Ultrasound (Duplex)
- Resting 12-Lead
- Electrocardiography
- Vectorcardiography
- Signal Averaged Electrocardiography
- Sonographic Imaging of Extremity Arteries (Duplex)
- Pulmonary Function Studies
- Pulse Oximetry
- Pulse Volume Recording
- Ambulatory Electrocardiography (Holter)
- Non-Mydriatic Retinal Imaging
