LA Chiro Spa Malibu -
Proudly works with Neurolink for all our NCV and EMG testing. As they come to us all testing is done in the comfort of our office. Our testing day is the third Thursday of every month.
Here is some information directly from Nerolink's website:
Utilizes state-of-the-art diagnostic testing equipments and innovations in addressing their clients’ patients’ medical concerns. In addition, we have implemented a leading IT solution system that will facilitate scheduling and documentation. We are highly dedicated to supplying thorough diagnoses and providing equipment that offer the highest quality care while offering convenience for our clients and our clients’ patients. Our medical physicians and highly skilled and experienced technicians with extensive medical backgrounds deliver the testing equipment and perform the on-site diagnostic tests. Our clients eliminate the need to refer out to other specialists, therefore maintaining control and complete autonomy over their patients’ care.
Neurolink provides the following services on-site:
Nerve Conduction Velocity (NCV) Tests
A nerve conduction velocity study aids in diagnosing peripheral nerve injuries and diseases affecting the peripheral nervous system. NCV testing is a non-invasive procedure that utilizes an electrical stimulator on the skin. This study measures the speed of conduction of impulses along the nerves. The nerve is stimulated, usually with surface electrodes, which are patch-like electrodes placed on the skin over the nerve at various locations. One electrode stimulates the nerve with a very mild electrical impulse. The sensation from the electrical impulse is very similar to the shock of static electricity. The resulting electrical activity is recorded by the other electrodes. The distance between electrodes and the time it takes for electrical impulses to travel between electrodes are used to calculate the nerve conduction velocity. A damaged nerve will conduct the electrical impulse at a slower rate, which is quantified in a report. This study also analyzes the strength of the electrical impulse, which allows the interpreting physician to make an estimated determination of the severity of the respective injury. A NCV test takes approximately 30 minutes to complete and is administered by Neurolinks’s highly experienced Board or Board Eligible technicians that have extensive medical backgrounds.
Evoked Potential (EP) Studies
Evoked potential studies measure electrical signals along the nerve pathways. These signals are recorded by wires placed over the nerves on the surface of the skin. The technician conducting the test evokes the patient’s neural activity by visual, auditory, or electrical stimulation. This study can locate nerve lesions and the presence of nerve damage in the central nervous system. EP studies are painless and noninvasive and usually involve very mild electric shocks. This study will be included in the NCV report if conducted.
Electromyography (EMG) Tests
EMG studies measure and record the function and stimulation of individual nerves and muscles. During an EMG study, a thin needle is inserted into several muscles to test if a particular muscle is responding appropriately to stimulation. The sensation, when the needles are inserted, is similar to that of an acupuncture needle or intramuscular injection. The presence, size, and shape of the wave form – the action potential – produced on the oscilloscope provide information about the ability of the muscle to respond when the nerves are stimulated. Recordings are made while the muscle is at rest and during contraction. Some patients experience mildly uncomfortable sensations when asked to contract the muscle, but this is brief and should subside immediately. Neurolink’s licensed medical doctors consisting of physiatrists and neurologists will conduct all needle EMG studies. This study takes approximately 15 to 30 minutes to complete.
Problem-Focused Neurological Exams
Before any diagnostics are performed, Neurolink performs an examination that is specific to the injury or complaints that have been noted in the patients chart to further ensure efficiency and correct utilization of the different tests. This step is important because it assures the patient, the clinic, and the insurance carrier the most appropriate thorough application of care available.
Due to the mounting pressure from law makers and insurance carriers, evidence based medicine is now, more than ever, required by physicians to administer care. Insurance companies need objective documentation in order to accept the treatment or care required for patients. This translates to the utilization of more diagnostics (i.e. MRI’s, NCV’s, CT-Scans, etc.) in your practice.
Neurolink Diagnostics is providing state-of-the-art on-site neurological diagnostics in the comfort of the ordering and treating physician’s clinic. As you would order an x-ray for a potential fracture, you would order a Nerve Conduction Velocity (NCV) test for a suspected nerve injury. NCV tests are the only diagnostic test that can determine both Motor and/or Sensory nerve damage.
You must remember that this is simply another tool that you are utilizing to determine more definitively the diagnosis, or multiple diagnoses, of the respective patient. Clinically the treating physician needs to incorporate this valuable diagnostic tool in his differential diagnostic process and correlate the results with his clinical findings to ensure the best management of his patient injury.
These NCV and EMG tests help improve patient care, identify any neurological damage, evaluate severity of injuries, monitor recovery of injured nerve, substantiate the appropriateness of care to insurance carriers, and most importantly, can help the treating doctor determine the most effective and efficient treatment protocol for their patient.
Re-testing your patients. The American Academy of Electrodiagnostic Medicine (AAEM) and the American Academy of Neurology state that any patient with a positive finding from a neuro-diagnostic exam (i.e. NCV and/or EMG), who is continuing to treat with the ordering doctor, could have, if indicated, a follow-up study performed, 2-4 months (average) after initial testing, based on the presenting symptoms. Similar to all other forms of diagnostic tests, follow-up testing can be extremely useful because it will allow the treating physician to monitor concisely his patients’ progress, or lack of, objectively.
Clinically, the treating doctor should utilize the “Medical Necessity Form” provided by Neurolink to check off any suspected diagnoses and/or symptoms that are hallmark justifications for the NCV and/or EMG tests. The general rule of thumb is that if there is a suspected nerve damage associated with the patients’ complaints or injury then it is expected to rule such findings in or out by doing an objective study such as the NCV’s or EMG’s. Many complicated symptoms prompt the need for such diagnostic tests. Most common examples include:
Additional Indication and Diagnosis to qualify for a neuro-diagnostic test: