Neurology With Epilepsy Clinic

The department of Neurology is the first of its kind in Thrissur. A full fledged Neuro Intensive Care Unit with 10 beds deals with neurological emergencies the clock Ventilators and other life support systems function smoothly at the Neuro Intensive Care Unit.

Protocols for stroke and epilepsy have been established and swing into action automatically. No time lag is experienced in treating these disorder. The radio-diagnosis department with CT scan and MRI work round the clock as well.

Out Patient department functions daily from Monday to Saturday. Prior bookings are available up to a month earlier.

Emergencies are admitted Via the Casualty.

Some of the diseases being managed at Neurology Clinic

• Epilepsy and seizure disorders
• Stroke
• Encephaltis, Meningits and other Neurological infections
• Polymyostis, Muscular dystrophies and other disorders of muscles
• Myaesthenia gravis
• Parkinson d disease and other Movement disorders
• Myaesthenia gravis
• Multiple sclerosis and other demyelinating disorders
• Gulillain Barre Syndrome and other Neuropahies
• Migraine and other headaches
• Dementia
• Paediatric Neurology cases

Electroencephalography is a simple, non-invasive and essential investigation for the evaluation of seizure disorders. It picks up the electrical activity of brain from different regions as recorded from electrodes placed on scalp.

Equipments

• Neurology Clinic has a most modern 16 Channel Digital EEG machine which does simultaneous video recording of all the activities of the patient during the procedure.
• Hard copy of representative pages of EEG recording are given along with the report.
• EEG recording on CD
• EEG recording of patients can be given on a CD and it can be reviewed by other neurophysicians on any computer and is also useful for future reference.
• Photo recording time is approximately 30 minutes

Indications

• Basic investigation for evaluation of seizure disorders
• Pseudo seizure
• Prognostication of seizure
• Helpful in differentiating between seizure and syncope
• Helps to find out the type of seizure which may guide the drug of choice
• Non-convulsive status
• Diagnostic for certain conditions like SSPE, CJD

Patient Preparation for EEG

• Head should be shampooed; no hair-oil should be applied
• No need to discontinue anti-epileptic drugs before EEG]
• Normal meals are allowed before test
• Preferable to remove metallic ornaments like necklace, ear-rings etc

Motor and sensory nerve conduction study (MNCV and SNAP ) - test the electrical conduction of motor / sensory impulse by that nerve. EMG (electromyography) tests the electrical contractile properties of a muscle.

Equipments

EMG, MNCV and SNAP are recorded on the same machine which is computer based. The data of patients are stored on hard disk of computer for analysis and future reference.

Indications

• All types of neuropathies (diseases of nerves)
• Myopathies ( diseases of muscles)
• Myaesthenia gravis and other myo-neural junction disorders
• Systemic disorders like diabetes mellitus affecting the nerves

Patient Preparation for EMG & Nerve conduction studies

• No restriction on meals
• Limbs should be cleaned thoroughly with soap and water
• Rings and bangles should be removed if possible
• Recording time : 60 minutes (approx)
• Evoked potential Studies

VEP are electrical potential differences recorded from scalp produced in response to visual stimuli. For normal responses the entire visual system should be intact and disturbances anywhere can produce abnormal VEP's.

BAER are the potentials recorded from ear and vertex produced in response to a brief auditory stimulation to assess the conduction through the auditory pathway upto mid-brain.

For normal responses the entire auditory pathway should be intact and disturbances anywhere can produce abnormal BAER.

SSEP are the electrical potentials produced by the large diameter sensory fibres in the peripheral and central portion of the nervous system produced in response to a sensory stimulus.

A digital ECG machine is also available in the clinic.

• Neuro I.C.U. with respirators
• Thrombolytic therapy for stroke.
• 16 channel digital EEG.
• Video EEG Monitoring Unit.
• Polysomonography
• Evoked potential (visual, auditory & Somatosensory)
• Well established Physiotherapy Unit
• Pre Epilepsy Surgery Evaluation.