first-examination

First examination

Time frame: 50 minutes

The first consultation essentially consists of three parts:

  1. Anamnesis
  2. When you come to my practice for the first time, we will start with a detailed discussion, the so-called anamnesis. Its purpose is to gather information about your current complaints, previous diseases, any previous operations, current medications, diseases within the family, etc.

    In case you saw a doctor, or underwent examinations beforehand because of your complaints, I would kindly ask you bring any documentation, in order to allow us to go through it together.

  3. Clinical-neurological status

    Afterwards I will perform a thorough physical examination, carrying out the so-called clinical-neurological status. Basically this means checking all partial functions of the nervous system, such as strength, coordination ability and speech.

  1. Planning of further procedure or therapy
  2. Based on anamnesis and status, we will create your personal diagnosis and therepy-plan.

    If necessary, we will talk about further tests, which I might deem necessary for further clarification. In the case of electroneurography (commonly called nerve conduction velocity) or electromyography, I can gladly offer these examinations in my practice (see below).

    In cases of, for example, blood sampling, ultrasound examination, assessment by a colleague of a different medical discipline or MRT, I will give you the necessary referral. If you wish I can also make a recommendation.

    If stationary treatment is necessary, I can arrange admission at the University Clinic of Neurology of Vienna.

    Subsequently I present the therapeutic options for your complaints. A great number of diseases can be treated with different kinds of medication, from which we choose the one that is most suitable for you. If non-medication therapies are indicated in your case, such as physiotherapy or acupuncture, we will also discuss them with you.

    Lastly, I will ensure that you have the chance to ask all the questions you wanted to ask, and if required we will schedule a control examination and, upon request, you receive a detailed report a few days after your visit to my practice (by mail or by email).

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kontrolluntersuchung

Control visit

Time frame: 25 minutes

A check-up essentially consists of two or three parts:

  1. Re-evaluation of your complaints
  2. During your next visit we first find out if your complaints have changed in the meantime, if, for example, new symptoms have appeared or if existing symptoms have improved or worsened. If necessary I examine you again.

  3. Evaluation of additional reports (if applicable)
  4. If we ordered further tests, we now go through the results together, and discuss what they mean for you and your complaints. We assemble them like the pieces of a puzzle.

  1. Therapy planning or therapy control
  2. If we decided on a therapy during your first visit, we now discuss it in terms of effects and possible side effects. If necessary we adjust the dosage or switch to another drug.

    If we postponed therapy planning until we received additional reports, we will now continue with point 3 of the initial examination.

    The number, and frequency of check-ups, depend on the disease. Some patients only visit my practice once. For example, if neurological causes of the complaints can be excluded, or in the case of an uncomplicated migraine. Others need appointments every few months. Again as an example, patients with chronic pains or those without response to primary therapy.

    Finally I will gladly answer any questions you may have, and after your first visit I can send you a detailed report if you wish.

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Electroneurography and electromyography

Time frame: Depending on your specific problem, I will set up an individual program for you, to provide you with an optimal diagnosis.

These two exams essentially serve as confirmation of a suspected disease of a nerve or muscle.

emg

Electromyography

  1. What is this?
  2. Electromyography (EMG) is the examination of a muscle, and the recording of muscle activity when relaxed, slightly tensed and tensed to the maximum. As different parameters are recorded, those patterns allow us to conclude whether we are faced with a disease of the muscle, or the supplying nerve. We can also determine, if the damage occurred a few weeks, months or even years ago. We can assign a possible point in time.

  3. Why do we perform this examination?

    An EMG can help to distinguish between a disease of the nerve, or of the muscle. With both types of disease, loss of muscle mass occurs, but it is not always possible to distinguish between them from clinical appearance. Even if a muscle disease is likely, it should be confirmed. As far as the time frame is concerned it can be determined whether damage really occurred recently, or has progressed insiduously over a longer period of time, until it became so serious that the patient realized that something was wrong. Finally, nerve damage can be confirmed by EMG at an earlier stage, even before anomalies appear in neurography.

  1. How is electromyography performed?
  2. For an EMG, a thin needle is stuck into the muscle at several points, and it is moved a few times in the course of the examination. The muscle is evaluated in three states - relaxed, slightly activated and activated to the maximum.

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nlg

Electroneurography

  1. What is this?
  2. Electroneurography is commonly also called “nerve conduction velocity“. You may have come upon this wording before. It is used to document damage to one, or several, nerves. We record different parameters which show us, among other things, how many nerve fibres conduct, and at what velocity. Patterns appear from these different values, which are typical of a clinical picture, allowing me to reach conclusions about the type of illness.

  3. Why do we perform this examination?

    The most frequent questions are suspected compression syndroms. This is where a nerve is pulled at a naturally narrow passage in the body. The most common of these are the carpal tunnel syndrome and the ulnar neuropathy at the elbow, or polyneuropathies (generalized nerve disease, e.g. in the case of diabetes or hereditary). Different types of damage can also be identified - whether damage is sustained by the cable itself, or if it is the outer protection of the nerve which is damaged. Also, which types of fibres are affected (motoric or sensory), or to assess roughly how serious the nerve damage is, to mention only a few possibilities.

  1. How is neurography performed?
  2. Two recording electrodes, similar to the ones used for an electrocardiogram, are fixed to your skin. Then the affected nerve is stimulated with electricity at various points of its course, and the machine records the findings. The triggering electrical stimulus is perceived differently by every person. Some describe it as a tingling sensation, others find it painful. I think you should be prepared for a short, slightly unpleasant stimulus, similar to when you touch a live farm fence.

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teamarbeit

Interdisciplinary cooperation

Many neurological diseases lead to an overlapping with other specialist disciplines: Ultrasound of the nerves has proved to be a valuable additional instrument of clarification of diseases, and it is partly performed by radiologists. Some diseases make neuro-surgical procedures necessary, e.g. carpal tunnel syndrome. Others go hand in hand with distorted posture and orthopedic complaints, e.g. Parkinson’s disease or congenital polyneuropathies. For this group of patients, I can offer the expertise of appropriate specialistswithin the MedSpa medical Centre.

patientinnenschulung

Patient education

In-depth knowledge about one’s disease is an essential, and underestimated, factor in coping with it. This is especially true of chronic and frequently returning pain, such as headaches.

That is why I offer patient education. Initially depending on interest, then possibly regularly. This is provided free of charge, and is open to all interested persons suffering from migraine. There is a one-hour-lecture, followed by discussion. If you are interested, please send me a message stating your name and telephone number. Once I have received at least 10 bookings, I will inform you of the next scheduled lectures.