The initial examination essentially consists of three parts:
1. Medical history
When you come to me for the first time, we start with a detailed discussion, the so-called anamnesis. It is used to record your current ailments, previous illnesses, operations, current medications, family illnesses, etc.
If you have previously seen a doctor about the complaint or carried out an examination, I would ask you to bring the documents with you so that we can go through them together.
2. Clinical-neurological status
Then I will perform a thorough physical examination, the so-called clinical-neurological status. Basically, this corresponds to a check of all sub-functions of the nervous system, such as strength, coordination and language.
3. Planning the further procedure or therapy
Based on your medical history and status, we create your personal diagnosis and therapy plan.
If necessary, we will talk about further tests that I believe are necessary for further clarification. If it is about electroneurography (colloquially also known as “nerve conduction velocity”) or electromyography, I can also offer this to you in the ordination (see below). Is it e.g. a blood sample, an ultrasound examination, an assessment by a colleague from another specialist discipline or an MRI, I will give you the necessary referrals. If you wish, I’ll also give you a recommendation.
If an inpatient admission is required, I can arrange this.
Then I will show you the therapeutic options for your complaints. Many diseases can be treated with different medications, from which we select the most suitable for you. Are non-drug therapy measures indicated in your case, such as Physiotherapy or acupuncture, let’s discuss these too.
Then I make sure that you have been able to ask all the questions you wanted to ask and we will make an appointment if necessary.
If you have been referred by a doctor, he / she will automatically receive a written report after a few days.
A control essentially consists of two or three parts:
1.Re-evaluate your complaints
As part of the new visit, we first note whether your complaints have changed in the course of, e.g. whether new symptoms have appeared or something that already exists has improved or worsened. If necessary, I will examine you again.
2. Assessment of the additional findings (if applicable)
If we have initiated further tests, we will now look through the relevant findings together and discuss what they mean for you and your complaints. So we put the puzzle pieces together.
3. Therapy planning and control
If you have already been prescribed therapy during your first visit, we will now discuss it with regard to its effects and side effects. If necessary, the dosage is adjusted or a change to another medication is made.
If we were still waiting for the additional findings with the therapy planning, we now basically continue with point 3 of the initial examination.
Check-ups may be necessary depending on the illness in different numbers and different time intervals. Some patients only need a visit to my office, where we e.g. rule out a neurological cause of the symptoms or find an uncomplicated migraine. Others need an appointment every few months, e.g. Patients with chronic pain who may not respond to initial therapy.
WHAT IS IT?
Electronurography is also known colloquially as “nerve conduction velocity” – you may have heard this word before. It is used to document damage to one or more nerves. We record various values that, among other things, show how many nerve fibers conduct how quickly. The various values result in patterns that are typical for a clinical picture and thus allow conclusions to be drawn about the type of disease.
WHY DO YOU DO THIS?
The most common questions are suspected compression syndromes (i.e., that a nerve is squeezed in a natural constriction in the body, the best known are the carpal tunnel syndrome and sulcus ulnaris syndrome) or polyneuropathies (generalized nerve disease, e.g. diabetes or hereditary causes). Furthermore, one can differentiate between different types of damage (whether the cables or the protective sheath of the nerves are broken), which types of fibers are affected (motor or sensory), roughly estimate how severe e.g. Nerve injuries are – just to name a few possibilities.
HOW IS THE NEUROGRAPHY PERFORMED?
Two electrodes for recording, similar to those used for an EKG, are stuck to your skin. Then the corresponding nerve is stimulated with electricity at several points and the response is recorded on the device. The triggering electrical stimulus is perceived differently by everyone. Some only describe a tingling sensation, others find it painful. I think you should be prepared for a brief, slightly uncomfortable stimulus, similar to touching a live electric fence.
1. WHAT IS THAT?
Our brain, just like our nerves, works with electric activity. This activity can be registered via the surface of our head and made visible on the screen. Normal activity consists of different types of waves, which typically appear in particular regions of our brain. Diseases of the brain either change that normal pattern or lead to the appearance of new types of waves, that would usually not be present. This change of pattern helps us with diagnosis.Read More
2. WHY DO WE PERFORM THIS EXAMINATION?
In most of the cases, EEG is arranged because of suspicion that you might have suffered an epileptic seizure. Other indications for performing an EEG are mental confusion, changes in state of consciousness or different types of recurring symptoms, e.g. visual or sensory disturbances. If you have already been diagnosed with epilepsy, you might have to undergo regular controls of you brain´s activity.
3. HOW IS EEG PERFORMED?
For performing an EEG, small electrodes are attached to the surface of your head with a kind of a hood. The activity of your brain is registered via these electrodes and transmitted to the EEG-machine. The deduction is carried out for 20 minutes. Most of the time, you will be sitting in a relaxed position with your eyes closed. You will be asked to open and close your eyes several times or to breathe deeply for several minutes. Furthermore, we need to see how your brain reacts to flickering light – again you will be sitting with eyes closed, while registering the flickering light through your closed eye lids.
Ultrasound of the brain supplying vessels
ATTENTION! THIS EXAMINATION IS CURRENTLY NOT AVAILABLE!
1. WHAT IS IT?
Ultrasound is a wonderful method that provides glimpses into the human body
allowed. There are two arteries to supply our brain with oxygen – one
on each side of the neck – responsible, which is commonly called larger
“Carotid artery” known. We look at whether the vessels are healthy or whether
there are signs of calcification, maybe even narrowing.
Read More 2. WHY DO I NEED THIS EXAMINATION? If there is calcification in the area of these arteries, this can lead to a 3. HOW IS THE ULTRASOUND OF THE BRAIN SUPPLYING VESSELS PERFORMED? For you, ultrasound is basically one of the most pleasant
Cause stroke. Your doctor will refer you to this examination,
if calcifications are suspected. Another possibility is that at
You are already familiar with calcification or narrowing and regularly
it must be checked whether this increases.
Less often it can be that there is a suspicion that part of the internal
The vessel wall has loosened, for example through a blow to the neck, and now
also obstructs blood flow.
Investigation methods. You lie relaxed in a darkened room. The
The examiner sits at the head end and moves the ultrasound probe over her neck.
2. WHY DO I NEED THIS EXAMINATION?
If there is calcification in the area of these arteries, this can lead to a
3. HOW IS THE ULTRASOUND OF THE BRAIN SUPPLYING VESSELS PERFORMED?
For you, ultrasound is basically one of the most pleasant
ULTRASOUND OF NERVES AND MUSCLES
PLEASE NOTE: THIS KIND OF EXAMINATION IS NOT AVAILABLE YET!
If you would like to know more, click here.
Read More 1. WHAT IS THAT? Ultrasound of nerves and muscles is a relatively new examination method which adds valuable supporting information to clinical examination and elecroneurogaphy/EMG. Read More 2. WHY DO WE PERFORM THIS EXAMINATION? Ultrasound is suitable for different kinds of diseases of nerves and muscles – but not for all of them. 3. HOW IS ULTRASOUND OF NERVES AND MUSCLES PERFORMED? Ultrasound is one of the most comfortable examination methods. Depending on the nerve or muscles, which we need to check, we define the most comfortable position for you. Then the room is darkened for better image quality and the examiner moves the ultrasound probe across the field of interest.
For this kind of examination special, so-called “high-resolution” ultrasound probes are used. These allow visualization and assessment of even the smallest nerves during their course through the body.
Optimally it is used for e.g. compression syndromes, nerve trauma or nerve tumors. More and more it is also used for polyneuropathies.
Your treating physician can consult me if it is unclear whether ultrasound can help with establishing your diagnosis
1. WHAT IS THAT?
Ultrasound of nerves and muscles is a relatively new examination method which adds valuable supporting information to clinical examination and elecroneurogaphy/EMG.
2. WHY DO WE PERFORM THIS EXAMINATION?
Ultrasound is suitable for different kinds of diseases of nerves and muscles – but not for all of them.
3. HOW IS ULTRASOUND OF NERVES AND MUSCLES PERFORMED?
Ultrasound is one of the most comfortable examination methods. Depending on the nerve or muscles, which we need to check, we define the most comfortable position for you. Then the room is darkened for better image quality and the examiner moves the ultrasound probe across the field of interest.