Laboratory of Clinical Neurophysiology

Introduction
The Laboratory of Clinical Neurophysiology provides the full spectrum of diagnostic neurophysiologic testing (EEG, EMG/NCV, evoked potentials, sleep studies, and related clinical services) for adults and children undergoing neurologic evaluation.

Referrals to the Laboratory for routine or investigational diagnostic testing can be arranged through any of the members of the neurology group, as well as by neurologists and internists in the local community and the greater metropolitan area who desire routine or highly specialized neurophysiologic evaluations.

The Laboratory is conveniently located adjacent to the outpatient suite of the neurology group. Diagnostic studies are performed by highly-skilled technicians and interpreted by board-certified subspecialists. Examination results are generally available on the day of the examination. Most insurance and managed care plans are accepted.

Staff
The medical staff of the Laboratory consists of doctors who are full time academic members of the Department of Neurology and Neuroscience. The staff physicians are specially trained in areas of neurology and pediatrics related to epilepsy and seizures, neurologic monitoring, infant development, neuromuscular disease, and sensory physiology. In addition to performing diagnostic tests, the physicians contribute to medical progress and education through their research, lectures, and teaching activities.

Laboratory technicians are fully trained to serve you and to conduct the test your doctor has requested. They have had formal training in the tests they perform and maintain their professional abilities with ongoing training in electrodiagnosis.

Diagnostic Services
We perform several basic diagnostic tests that evaluate how specific parts of the nervous system work. They are:

• Electroencephalography (EEG). This is an examination of spontaneous brain activity.
• Electromyography and nerve conduction studies (EMG/NCS). These are examinations of nerve and muscle activity.

   

• Evoked potentials (EP's). These are examinations of brain activity related to sensory stimulation. Three common varieties are performed: sight (VEP's), hearing (BAEP's, and touch SSEP's.
• Polysomnography (PSG's). This is an examination of brain, eye movements, breathing, and other activity during sleep.

As a group, these studies evaluate the function (physiology, or how it works) of parts of the nervous system. In this respect, they differ from MRI, CT, and related tests, which examine the structure (anatomy, or what it looks like) of the nervous system. Conditions in which physiological testing is useful include (but are not limited to) epilepsy and seizures, sleep disorders, disorders of nerve, muscle, and movement, multiple sclerosis and related conditions.

Specialized Services
In addition to the basic diagnostic tests described above, the Laboratory provides highly specialized services to inpatients at NewYork-Presbyteriain Hospital/Weill Cornell Medical Center, the Hospital for Special Surgery, and Memorial Sloan-Kettering Cancer Center. These services are important to patients who may be undergoing neurosurgical procedures that place the brain, spinal cord, or nerves at risk.

Intraoperative neurological monitoring consists of EEG, EMG, or EP's (see above) performed during surgical procedures. These techniques provide an assessment of function of the nervous system during a surgical procedure, and help the surgeon minimize the risk of damage.

In collaboration with the Comprehensive Epilepsy Center, directed by Dr. Padmaja Kandula, we provide intensive monitoring to identify the source of seizures in epilepsy patients who are considering surgery.

In collaboration with the Functional Magnetic Resonance Imaging (fMRI) Laboratory at Memorial Sloan-Kettering Cancer Center, we provide a multimodal approach to neurosurgical planning. This technique, which consists of fMRI imaging prior to surgery and electrophysiological study during surgery, helps to identify identify important brain areas, and thus reduce the risk of impairment.

Fees, Billing, Managed Care, and Insurance
In order to help keep costs at a minimum, we expect payment in full at the time of service. There are two charges: one from NewYork-Presbyterian for the technician's services, and one from the Weill Cornell Faculty Practice Plan for the doctor's services. We will provide you with a receipt that you can send to your insurance company. Fees vary according to the complexity of the procedures, and the doctor and technician time required. For your convenience, we accept major credit cards.

Our physicians participate in a large number of managed care programs. Managed care approval requirements and fee arrangements vary widely and change rapidly, and it is wise to consult with your managed care provider to be sure that your visit will be covered. We also encourage you to speak with our Accounts Representative at (212) 746-2340 if you have questions on these matters.

Reports and Confidentiality
Your doctor will receive a written report of your test within a few days. He or she will also speak with your doctor if he requests us to call or if there are major or unexpected findings. Because it is important for your test to be reviewed with your complete medical record, we do not inform you directly of the test result. We maintain your record in a confidential manner to protect your privacy.