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Test Procedure:
During the test patients are lying on their back. The
treating doctor instructs to contract and relax the muscle (which
will be checked at rest and at extended effort). Very fine
disposable needles are inserted into the muscle. The number of
tested sites (the muscles) depends on the reason for the referral.
The test involves slight discomfort, which is generaly not
long-lasting. Slight pain in the test area is possible for a few
hours after the test. Duration of the test is about 30 minutes.
NCV
- nerve conduction test performed in order to check the
condition of peripheral nerves and any defects in them.
Test Procedure:
The treating doctor will attach electrodes over the muscle
and/or the nerve to be tested. The number of stimulations given via
the electrodes depends on the reason for the referral. The test is
accompanied by a feeling of discomfort (usually painless) during the
electrical stimulations. There is no risk in the test. There are no
other side effects during this 30 minutes' test or afterward.
EEG
– testing the electrical activity of the brain in
order to estimate the electrical activity of the brain waves.
Test Procedure:
A technician places 20 electrodes on the surface of the patient's
head, with the help of clear gel, which does not stain clothing.
During the test the patient is instructed to close eyes (simply, or
against a flashing light) and to breathe deeply. Full cooperation is
required during this test in order to obtain a precise diagnosis.
Electro encephalogram is sometimes done also during natural sleep,
or under mild sedation.
VEP
– BERA
– this test records the responses of sight and
hearing nerves, in several conditions, including impaired balance
and vertigo of all kinds.
Test Procedure:
Technically BERA is almost exactly as EEG. In cases of serious
vision defects as a result of eye disease, it is recommended to
carry out VEP in an eye clinic.
TCD
– A complete measurement of flow in the brain's blood
vessels. Is carried out in order to evaluate speech functions,
memory, attention, concentration and understanding in different
situations e.g. stroke, depression, post head-trauma, age related
situations and others.
The
Neuro-immunology Laboratory
The neuro-immunology laboratory deals with specific tests for the
diagnosis of autoimmune diseases of the nervous system.
The tests:
1. Oligoclonal immunoglobulin in cerebrospinal fluid for the
identification of multiple sclerosis and brain inflammation
2. Transferring beta-2 for the identification of leaking
cerebrospinal fluid
3. Alpha-fetoprotein for the identification of birth defects in the
nervous system, Hepatoma and pregnancy
4. Myelin basic protein and antibodies to myelin for the
identification of the process of myelin destruction
5. Antibodies against MAG and galactocebroside for the
identification of peripheral neuropathy
6. Antibodies against gangliodies: GM1, GD1a, GD1b, GQ1b for the
identification of diseases of the peripheral nervous system
7. Antibodies to the acetylcholine receptor for the identification
of myasthenia gravis
8. Antibodies to pre-neoplastic diseases Hu, Yo, Ri, Ma and to
calcium channels for the identification of secondary phenomena of
injuries to the nervous system and in a condition of malignant
disease.
The Neurogenetics Laboratory
This laboratory enables the diagnosis of rare genetic
diseases which affect the central nervous system and skeletal
muscles' functions.
The tests:
1. Protein 14-3-3 in cerebrospinal fluid for the identification of
Creutzfeldt-Jacob disease
2. TAU protein in cerebrospinal fluid for the identification of
Alzheimer's disease
3. The faulty prion protein in urine for the identification of
Creutzfeldt-Jacob disease
4. Mutation in the TAU protein (P301S) for the identification of
dementia with Parkinsonism
5. Mutation in the glycogen branching enzyme (Y329S) for the
identification of glycogen storage disease
6. Mutation in the aldehyde dehydrogenas enzyme (C682T) for the
identification of Svegren-Larsen disease
7. Mutation in the transseritin protein (Y77S) for the
identification of ameloid disease
8. Mutation in the prion protein (P102L) for the identification of
Gerstman's disease
9. Mutation in the prion proteins (E200K, D178N) for the
identification of genetic Creutzfeldt-Jacob disease
10. Mutation in the disperlin protein for the identification of
muscular atrophy disease (Limb-Girdal)
11. Mutation in the CD45 protein for the identification of familial
multiple sclerosis.
Multiple
Sclerosis
The centres specializing in the diagnosis, treatment and follow up
of patients with Multiple Sclerosis and provide the patient with the
best up to date required care.
Multiple sclerosis is a chronic disease of demyelization of the
central nervous system. That is, a disease in which the myelin
sheath of the nerves in the brain and the spinal cord are injured at
a number of foci (called "plaques"). These "plaques" are
concentrated in the "white material" of the brain and the spinal
cord, in particular surrounding the chambers of the brain and the
visual nerves. The white material of the brain is all the area in
which there is a high density of myelin-enveloped fibers; in the
nature of things, since in these same areas there are few neurons
(which are located in the "grey matter" in the brain covering),
multiple sclerosis affects only the branching of the cells, and in
most cases, therefore, does not cause severe cognitive damage as in
Alzheimer's.
Multiple sclerosis is considered an inflammatory autoimmune disease
in which the immune system attacks the myelin self proteins. Due to
the injury in the myelin which acts as a protective envelope on all
the nerves' fibers and as "insulating" material which enables the
transfer of electrical signals, this results in disturbances in the
transfer of electrical "messages" within the brain and the spinal
cord, and defects/disturbances in the functioning of one or more
nervous systems like the motoric system, perception, stability and
coordination system, vision, sphincters, eye movement, etc.
Multiple sclerosis generally strikes people in their twenties and
thirties. The disease is more common in people of European origin
than in people of African or Far Eastern one. There is a connection
between the disease and the geographical area in which the patient
lived in the first years of his life. There is a higher frequency of
the disease in women than in men.
The common symptoms (the clinical phenomena) of multiple sclerosis
include sense disturbances ("pins and needles"), vision disturbances
(blurring and double vision), limb weakness, instability and lack of
coordination and disturbances in sphincter control.
Multiple sclerosis is a variable disease and its progression differs
greatly from patient to patient. Not all patients hit with the
disease will get to a stage of needing assistance in walking or
paralysis. A significant number of patients do not suffer from
disturbances in essential functions even many years after the onset
of the disease and perhaps never will. The rest of the patients
suffer from an acute disease (benign multiple sclerosis) or an
advancing/progressive disease. In some of the patients the disease
begins as an acute disease and then with time becomes progressive
(secondary progressive).
Medicine today offers a range of drugs whose purpose is to ease the
symptoms and slow the progress of damage in the central nervous
system. Three preparations of Interferon-b (Evonax, Ravif, Betaferon)
and Copaxone are more or less efficient in slowing the disease
process, reducing the number of attacks and the damage to the white
material in the brain. These preparations are given by injection
only (1-3 injections per week) and it is recommended to start taking
them with the start of clinical symptoms and following unequivocal
diagnosis of multiple sclerosis.
Mitoxanatron: Administered in the case of worsening
and rapidly progressing disease.
Steroids: are advised in acute cases or as a long-term treatment.
Immunosuppressive preparations: cyclophosphamide, methotrexate and
Imuran are used in deteriorating conditions.
Other treatments: plasmapheresis (filtration of blood
fluids).
Immunoglobulin preparation - administered intravenously.
There are many other treatments which are
administered to ease the different symptoms which derive from the
disease and one may consult with the treating doctor about these.
Neurogeriatrics
These clinics are intended for evaluation and treatment of age
related memory disturbances and neurological disturbances. Within
the framework of the clinic diagnoses for the evaluation of the
source of memory disturbances are performed, including neurological
tests, neuropsychological tests, blood tests and similar tests.
Following the evaluation process, a detailed summary is sent to the
patient and to his personal doctor, summarizing the findings. In
accordance with the findings the patient receives the appropriate
treatment and a follow-up program is recommended in order to
efficiently estimate the treatment and its appropriateness for the
patient. The clinic is in close contact with the family doctor,
geriatric specialists, and services for dementia patients in the
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