Frequently Asked Questions
Q: What is an EEG?
A: An EEG is also known as an electroencephalogram. This is a test where wires and electrodes are
temporarily pasted to your head/scalp to monitor your brain wave activity. EEG's are routinely used to evaluate
patients who have seizures, convulsions, blackout spells, or spells of unusual behavior. It is a painless,
non-invasive test which evaluates your brainwaves, much like an EKG which evaluates your heart's electrical
activity.
Q: What is a NCS (Nerve Conduction Study)?
A: An NCS is an electrical test of your nerves in your face, arms, and legs. It is used to help evaluate
symptoms such as numbness, tingling, pins/needles sensation, burning pain, and sharp/shooting pains of
the hands, feet, or face. The test uses electrodes placed on the skin overlying the nerves. A very tiny electrical
current is then passed through the nerve to assess its function. There is minimal discomfort due to a feeling
of a tiny electrical shock, but most patients tolerate this without much difficulty.
Q: What is an EMG?
A: An EMG is also known as an electromyogram. This is a test where muscle and nerve function are
evaluated using a very thin needle. There is no electrical stimulation or "shock" as in NCS's. However, a very
thin, sterile needle is inserted into various muscles of the arm, leg, and paraspinal areas to determine if they
are functioning normally. A microscopic microphone is located in the tip of the needle, which listens to
muscle activity. Healthy muscles give off a healthy sound, however, unhealthy muscles give off abnormal
sounds. Every muscle in the body is connected to nerves coming off of the spinal cord in the neck and the
back. Depending on which muscles sound unhealthy, an EMG may determine which nerves in the neck or
back are irritated or injured. This is often seen in radiculopathies, otherwise known as "pinched nerves."
Various muscle disorders and neurodegenerative disorders are also evaluated with EMG.
Q: Who performs the NCS and EMG studies?
A: At Northlake Neurology, Dr. Jung personally performs all the NCS and EMG testing. The actual
performance and interpretation of NCS and EMG studies require specialized training during the years of
residency and fellowship. These tests should only be interpreted by experienced neurologists or physiatrists
(physicians trained in rehabilitative medicine), because they require a high degree of skill, clinical knowledge
of neuroanatomy, and the ability to treat potential, but rare, complications. Some NCS tests may be
performed by a technician under the supervision of a physician trained in neurodiagnostic medicine, but never
should these tests be interpreted by a technician or a computer.
Q: Why do some doctors' offices perform NCS and EMG studies if they are not neurologists or physiatrists?
A: There are "mobile electrodiagnostic units" (mobile EDX units) that contract with offices to perform these
tests, but they are not recognized by the major governing bodies of neurophysiology and electrodiagnostic
medicine. These mobile EDX units often consist of an unsupervised technician who utilizes a
"one-size-fits-all" arm or leg brace and hand-held device that generates nerve conduction data of questionable
accuracy. Furthermore, the great majority of these tests are then interpreted by a central computer located in
another state...not by a specially trained physician. Medicare/Medicaid and most major insurance carriers have
now denied any coverage of such testing with hand-held devices.
Other offices contract a physical therapist to perform NCS and EMG studies in their offices. North Carolina
Medical Laws do not prohibit physical therapists from performing these studies. However, therapists are NOT
allowed to provide an interpretation of these studies. Unfortunately, some offices have these physical
therapists give interpretations that a physician simply signs off on as agreeing with the therapist's
interpretation. This is like having an x-ray, then having the x-ray technician give an interpretation of the x-ray
results. Would you want medical decisions being made based on test results not rendered by a physician
trained in that kind of testing?
Q: Is it safe to have NCS and EMG testing done by one of these "mobile EDX units"?
A: The American Academy of Neurology has several guidelines and position statements regarding the safety
of NCS/EMG testing by mobile EDX units. Please click here to access this information. The American
Association of Neuromuscular and Electrodiagnostic Medicine also has an EMG/NCS Position Statement.
Q: How do I know if I have migraines?
A: Do you get nauseated with your headaches? Do you have sensitivity to bright lights during your
headaches? Do you have to stop what you are doing when you get a headache? If you answered "yes" to 2 of
these 3 questions, there is a >90% chance that you have migraines.* If so, you should ask your doctor for a
referral to a neurologist. (*The ID Migraine Validation Study, Neurology 2003; 61: 375-382)
Q: How do I know if I had a seizure?
A: If you have ever blacked out and cannot remember what happened, or if you have ever had uncontrollable
jerking/twitching with or without losing consciousness, you may have had a seizure. Only your doctor can
determine if you really had a seizure. If so, your doctor may refer you to a neurologist.
Q: Does Dr. Jung speak English that I can understand?
A: Yes. Dr. Jung speaks perfect English without any accent.
Q: Do I need a referral to see Dr. Jung?
A: Yes. You will need a consultation request from your primary care provider.
A: An EEG is also known as an electroencephalogram. This is a test where wires and electrodes are
temporarily pasted to your head/scalp to monitor your brain wave activity. EEG's are routinely used to evaluate
patients who have seizures, convulsions, blackout spells, or spells of unusual behavior. It is a painless,
non-invasive test which evaluates your brainwaves, much like an EKG which evaluates your heart's electrical
activity.
Q: What is a NCS (Nerve Conduction Study)?
A: An NCS is an electrical test of your nerves in your face, arms, and legs. It is used to help evaluate
symptoms such as numbness, tingling, pins/needles sensation, burning pain, and sharp/shooting pains of
the hands, feet, or face. The test uses electrodes placed on the skin overlying the nerves. A very tiny electrical
current is then passed through the nerve to assess its function. There is minimal discomfort due to a feeling
of a tiny electrical shock, but most patients tolerate this without much difficulty.
Q: What is an EMG?
A: An EMG is also known as an electromyogram. This is a test where muscle and nerve function are
evaluated using a very thin needle. There is no electrical stimulation or "shock" as in NCS's. However, a very
thin, sterile needle is inserted into various muscles of the arm, leg, and paraspinal areas to determine if they
are functioning normally. A microscopic microphone is located in the tip of the needle, which listens to
muscle activity. Healthy muscles give off a healthy sound, however, unhealthy muscles give off abnormal
sounds. Every muscle in the body is connected to nerves coming off of the spinal cord in the neck and the
back. Depending on which muscles sound unhealthy, an EMG may determine which nerves in the neck or
back are irritated or injured. This is often seen in radiculopathies, otherwise known as "pinched nerves."
Various muscle disorders and neurodegenerative disorders are also evaluated with EMG.
Q: Who performs the NCS and EMG studies?
A: At Northlake Neurology, Dr. Jung personally performs all the NCS and EMG testing. The actual
performance and interpretation of NCS and EMG studies require specialized training during the years of
residency and fellowship. These tests should only be interpreted by experienced neurologists or physiatrists
(physicians trained in rehabilitative medicine), because they require a high degree of skill, clinical knowledge
of neuroanatomy, and the ability to treat potential, but rare, complications. Some NCS tests may be
performed by a technician under the supervision of a physician trained in neurodiagnostic medicine, but never
should these tests be interpreted by a technician or a computer.
Q: Why do some doctors' offices perform NCS and EMG studies if they are not neurologists or physiatrists?
A: There are "mobile electrodiagnostic units" (mobile EDX units) that contract with offices to perform these
tests, but they are not recognized by the major governing bodies of neurophysiology and electrodiagnostic
medicine. These mobile EDX units often consist of an unsupervised technician who utilizes a
"one-size-fits-all" arm or leg brace and hand-held device that generates nerve conduction data of questionable
accuracy. Furthermore, the great majority of these tests are then interpreted by a central computer located in
another state...not by a specially trained physician. Medicare/Medicaid and most major insurance carriers have
now denied any coverage of such testing with hand-held devices.
Other offices contract a physical therapist to perform NCS and EMG studies in their offices. North Carolina
Medical Laws do not prohibit physical therapists from performing these studies. However, therapists are NOT
allowed to provide an interpretation of these studies. Unfortunately, some offices have these physical
therapists give interpretations that a physician simply signs off on as agreeing with the therapist's
interpretation. This is like having an x-ray, then having the x-ray technician give an interpretation of the x-ray
results. Would you want medical decisions being made based on test results not rendered by a physician
trained in that kind of testing?
Q: Is it safe to have NCS and EMG testing done by one of these "mobile EDX units"?
A: The American Academy of Neurology has several guidelines and position statements regarding the safety
of NCS/EMG testing by mobile EDX units. Please click here to access this information. The American
Association of Neuromuscular and Electrodiagnostic Medicine also has an EMG/NCS Position Statement.
Q: How do I know if I have migraines?
A: Do you get nauseated with your headaches? Do you have sensitivity to bright lights during your
headaches? Do you have to stop what you are doing when you get a headache? If you answered "yes" to 2 of
these 3 questions, there is a >90% chance that you have migraines.* If so, you should ask your doctor for a
referral to a neurologist. (*The ID Migraine Validation Study, Neurology 2003; 61: 375-382)
Q: How do I know if I had a seizure?
A: If you have ever blacked out and cannot remember what happened, or if you have ever had uncontrollable
jerking/twitching with or without losing consciousness, you may have had a seizure. Only your doctor can
determine if you really had a seizure. If so, your doctor may refer you to a neurologist.
Q: Does Dr. Jung speak English that I can understand?
A: Yes. Dr. Jung speaks perfect English without any accent.
Q: Do I need a referral to see Dr. Jung?
A: Yes. You will need a consultation request from your primary care provider.
| Copyright 2006 Northlake Neurology. All rights reserved. |
Northlake Neurology
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