From the Guidelines
High sensitivity neurological testing, such as Magnetic Resonance Imaging (MRI), is the most important paraclinical tool for diagnosing conditions like multiple sclerosis, due to its high sensitivity in depicting plaques in the brain and spinal cord 1. High sensitivity neurological testing refers to specialized diagnostic procedures that evaluate the nervous system's function and structure with great precision.
- Electromyography (EMG) measures electrical activity in muscles during contraction and rest, helping diagnose conditions like muscular dystrophy or nerve damage by inserting thin needle electrodes into muscles.
- Nerve Conduction Studies (NCS) complement EMG by measuring how quickly electrical signals travel through nerves, identifying issues like carpal tunnel syndrome or peripheral neuropathy using surface electrodes.
- Magnetic Resonance Imaging (MRI) provides detailed images of the brain and spinal cord using magnetic fields and radio waves, revealing structural abnormalities, tumors, inflammation, or degenerative changes without radiation exposure, as seen in the diagnosis of multiple sclerosis 1.
- Electroencephalogram (EEG) records electrical activity in the brain through scalp electrodes, helping diagnose epilepsy, sleep disorders, or encephalopathies by detecting abnormal brain wave patterns, and is commonly used in the diagnosis of autoimmune encephalitis to exclude subclinical status epilepticus or monitor treatment response in patients with seizures 1. These tests are typically ordered by neurologists when symptoms suggest nervous system dysfunction, and while generally safe, patients should inform their doctors about implanted devices, pregnancy, or claustrophobia before undergoing these procedures. The use of MRI in the diagnostic work-up of patients with suspected multiple sclerosis is recommended due to its high sensitivity and importance as a paraclinical tool 1.
From the Research
High Sensitivity Neurological Testing
High sensitivity neurological testing refers to a range of diagnostic procedures used to evaluate the nervous system. These tests are designed to detect abnormalities in the nervous system, including damage to nerves, muscles, and the brain.
Types of High Sensitivity Neurological Tests
- Electromyography (EMG): a test that measures the electrical activity of muscles to diagnose muscle disorders, such as muscular dystrophy, and nerve disorders, such as peripheral neuropathy 2, 3.
- Nerve Conduction Studies (NCS): a test that measures the speed and strength of electrical signals in nerves to diagnose nerve damage or disorders, such as carpal tunnel syndrome 2, 3, 4.
- Magnetic Resonance Imaging (MRI): a non-invasive imaging test that uses magnetic fields and radio waves to produce detailed images of the brain and spinal cord to diagnose conditions such as multiple sclerosis, stroke, and spinal cord injuries 5.
- Electroencephalogram (EEG): a test that measures the electrical activity of the brain to diagnose conditions such as epilepsy, seizures, and encephalitis.
Applications of High Sensitivity Neurological Tests
- Diagnosis of Motor Neuron Disorders: EMG and NCS are essential in the evaluation of suspected motor neuron disorders, such as amyotrophic lateral sclerosis (ALS) 2.
- Diagnosis of Peripheral Neuropathy: NCS and EMG are used to diagnose peripheral neuropathy, a condition that affects the nerves outside the brain and spinal cord 3, 4.
- Diagnosis of Central Nervous System Disorders: MRI and EEG are used to diagnose conditions that affect the brain and spinal cord, such as multiple sclerosis and stroke 6, 5.