Neurology Center

Moodist Electrophysiology Laboratory

In addition to examinations, electrophysiological tests may be required to diagnose many neurological disorders. These tests include electroencephalography (EEG), electromyography (EMG) and polysomnography (recording of sleep and sleep-related breathing and movements). These tests are not just a group of laboratory tests but an extension of the neurology assessment. They not only confirm or refute clinical suspicion, but also reveal subtle, silent or previously unsuspected abnormalities and allow the precise location, type and degree of abnormality to be determined. In general, electrophysiologic tests measure and describe pathophysiologic changes and functions in the central and peripheral nervous and muscular systems.

EEG (Electroencephalography) 

Electroencephalography is the printing of electrical activity produced by nerve cells in the brain, both during wakefulness and sleep, as brain waves on paper. The electrical activity of the brain is measured by electrodes placed on the scalp. Examination methods such as computed tomography (CT) and magnetic resonance imaging (MRI), which were developed later than EEG, do not provide information about the electrical activity of the brain. They provide information about the function of the brain at the time of recording. If there is a problem in the brain that disrupts brain waves, it can also provide very limited information about the location and cause of this problem. However, it does not give any information about the appearance of brain damage.

It is mainly used in cases of suspected epilepsy and in the follow-up of epilepsy disease. The purpose of EEG in epilepsy is to support the diagnosis, decide on treatment, determine the types (classification), investigate focal brain lesions and monitor epilepsy patients. However, it can be used for differential diagnosis in many conditions (forgetfulness diseases, encephalitis, various systemic diseases and conditions with blurred consciousness due to drugs, etc.) that can disrupt brain waves by causing loss of function in brain cells.

EEG examination, which is used to examine patients with epilepsy and suspected seizure disorders, can also be performed in our electrophysiology laboratory.
The electrical activity of the brain is transmitted to the EEG machine via small metal electrodes placed on the patient's scalp and the data is recorded on a computer for an average of 20 minutes. No electricity is applied to the patient during the procedure and the patient does not feel any pain.

EMG (Electromyography)

It is used to assess central nervous system (brain, spinal cord), peripheral nervous system and muscle function. The EMG test is an electrophysiological test to measure disturbances in the connections between nerves and nerves-muscles and is performed by neurologists. EMG is used to obtain information about the location, degree, type and duration of the problem in these areas. Nerve conduction status and speed of sensory and motor nerve endings are measured.

The most common areas of use are entrapment neuropathies such as Carpal Tunnel Syndrome (CTS), demonstration of nerve damage in lumbar and cervical hernias, demonstration of nerve-muscle conduction disorders in muscle diseases, diagnosis and treatment of diseases such as facial paralysis, diayebete or various diseases, polyneuropathy due to drug-substance-alcohol use, motor neuron disease (ALS) or Guillain Barre Syndrome. EMG is a highly complex test and requires long-term training to perform.

Polysomnography (Sleep Test) (Hospital and Home)

It is a test in which sleep, breathing and movements of the arms and legs are recorded throughout the night. This test is most commonly used to detect sleep-apnea syndrome, sleep-related movement disorders and sleep-related disorders. At Moodist Hospital, the polysomnography test (sleep test) can be performed both in the hospital and at home.

Moodist Neuropsychology Laboratory

Neuropsychological assessment is one of the auxiliary examination methods that play an important role in neurology, psychiatry and neurosurgery, as well as in specialized fields such as epilepsy surgery and clinical psychology. This examination is carried out on the basis of the brain-behavior relationship with a number of psychometric tools called neuropsychological tests.

Complex behaviors and cognitive functions depend on the activity of large-scale, distributed, neurocognitive networks involving specific anatomical structures in the brain and the neural networks between them. Damage to any component of these systems can result in mild or severe impairment in the relevant cognitive domain. Neuropsychological tests allow us to assess our complex behaviors and cognitive functions that are the product of these neural systems. Neuropsychological tests are used for differential diagnosis, disease monitoring, treatment effectiveness monitoring, rehabilitation planning and research.

Neuropsychological testing is thus an effective way of determining whether a person's complaints are due to a real impairment or weakness in memory or other mental functions, i.e. whether they are really due to a disturbance in brain functioning or more likely to be due to a condition such as mental tension. These tests also provide clues as to the type of disorder (i.e. the diagnosis of the disease) and the course of the disease by looking at the pattern of impairment in mental functioning.

In addition, the effectiveness of the treatment can be determined by detailed neuropsychological assessment before and after treatment. The neuropsychological profile of the individual, i.e. the impaired and preserved processes of the patient, is of great importance in determining the strategies to be used to compensate for the resulting impairments, in other words, in the programming of rehabilitation. Mental functions assessed by neuropsychological tests can be listed as follows:

• Alertness and Attention
• Complex Attention and Executive Functions, Perseverance,
• Interference resistance, Response inhibition, Category switching
• Planning
• Abstraction, Reasoning
• Memory
• Language Skills
• Arithmetic
• Spatial orientation of attention - Complex visual perceptual functions (visuo-spatial/visual-spatial skills)
• Configuration (Visuo-constructive skill)
• Praksi

In the Moodist neuropsychology laboratory, standard and computerized neuropsychological tests are performed and interpreted by experienced clinical psychologists. As a result of all these mental skills evaluated, the causes of the patient's complaints and the real problems can be revealed by the specialist and physician applying the test. As a result, a treatment program suitable for the patient is determined and the necessary rehabilitation techniques are applied. The cognitive rehabilitation program is aimed at the patient's cognitive skills that are determined to be weak in the light of neurological and neuropsychological evaluations.

Moodist Difference in Diagnosis and Treatment

Private Moodist Hospital Neurology Department provides outpatient diagnosis, treatment and follow-up services for a wide range of neurological diseases.

Research and study programs on new techniques and treatment options are successfully carried out in our hospital. In this way, we are able to produce knowledge and offer newly emerging treatment options to our patients.

Within the scope of treatment; the treatment program of various diseases is created specifically for our patients. Thus, we adopt a much more effective treatment approach for our patients with multifaceted, complementary treatment options; medications, cognitive rehabilitation, brain stimulation methods and many techniques for reorganizing activities of daily living. We have a multidisciplinary team with the competence level to apply all these treatment approaches.

What happens if neurological diseases are not treated?

Neurological disorders are among the disease groups that pose the highest health burden for patients, their relatives and healthcare professionals, and this is increasing with the aging world population. Neurological diseases account for approximately 16.8 percent of deaths worldwide and 9.4 million people die each year.

In brain and nerve diseases, as in other diseases, a number of physical pains or negative complaints are encountered. In this sense, to make an assessment of the symptoms of neurological diseases, patients usually consider seeking help from neurologists with the following symptoms and complaints:

• Ligament pain
• Dizziness
• Fainting
• Sleep disorders
• Tremors and involuntary movements of the hands
• Movement disorders
• Disorders of consciousness
• Forgetfulness
• Low back, neck and back pain
• Loss of balance

When such symptoms occur, a neurologist should be consulted as soon as possible and evaluated with a number of tests. Rapid and early diagnosis is very important for neurological diseases that occur due to problems in the autonomic, central and peripheral nervous systems, which constitute the most sensitive structures of our body in terms of life.

Early diagnosis and initiation of treatment is also very valuable for recovery. If there is a delay in examinations and diagnosis, irreversible damage and even life risks may occur. For this reason, people with neurological disorders should urgently contact the nearest neurologist and start the treatment process urgently after early diagnosis.

Neuromodulation (TMS) Laboratory

Transcranial Magnetic Stimulation (TMS) is a new tool and method used in the treatment of a number of neuropsychiatric disorders. TMS application is performed in Moodist Hospital Neuromodulation Laboratory. The basic working principle of TMS is the magnetic stimulation of key areas in the brain that are inactive in the patient by applying the electromagnetic coil through the scalp. Beforehand, certain points on the head (nasion and preauricular regions (right and left) are marked and sound wave emitting markers are fixed and the desired brain region is localized. TMS works very similar to the MRI devices we normally use and generates magnetic field pulses of that power (1.5-2 Tesla).

TMS is an FDA-approved, safe noninvasive treatment for depression and migraine. In addition, in our laboratory, we perform TMS for research on its effectiveness in tinnitus (ringing in the ears), dementia, epilepsy, Parkinson's and Alzheimer's diseases.

Transcranial Magnetic Stimulation (TMS) in Migraine

It is a treatment method that is more commonly known as TMS treatment by migraine patients and is frequently researched for its effectiveness in migraine treatment. TMS procedure in migraine is applied from the back of the head (occipital region). It can be performed as a repetitive or single application. It is thought to affect the release of some neurotransmitters by affecting the electrical fields in the cerebral cortex with magnetic impulses. It can also affect the polarization of the nerve tissue in the area where it is applied. Data on its effectiveness in the treatment of chronic migraine are not yet ‘sufficient’. However, it has been approved by the FDA (US Food and Drug Administration) for the ‘treatment of acute attacks of migraine with aura’.

What kind of treatment method is followed in the Neurology Clinic for forgetfulness?

We determine the patient's cognitive impairment, the form and characteristics of the forgetfulness of the patient with known classical methods (CBCT-MR, EEG, Blood tests) and Neuropsychometric evaluations and plan treatment after diagnosis. The most classical treatment method is medication, but medications are not effective in all cases. Many supportive treatments are also needed. One of the main approaches we use for this is Cognitive Rehabilitation. It is a method that can be useful in progressive degenerative diseases such as Alzheimer's disease.

Another treatment method is brain stimulation techniques called noninvasive neuromodulation techniques (TMS), which have developed in recent years. TMS is a treatment method applied externally to the brain without any intervention to the body. With this device, a high-powered magnetic field is directed through the skull to the damaged areas of the brain, with the aim of reactivating these areas that are not working well.

What can be done to cope with neurological diseases?

In order to make diagnosis and treatment more effective in the field of neurological diseases, very promising results are being obtained in ongoing studies all over the world. Many neurological diseases, which used to be considered incurable, have been included in the group of treatable diseases. Technological developments accelerate developments in the diagnosis and treatment of brain diseases, and the possibilities brought by the age are applied to the diagnosis and treatment of neurological diseases. At Moodist Hospital, efforts to increase the diagnostic and treatment opportunities specific to neurological diseases and to make new arrangements for the care and rehabilitation of neurological patients are being carried out with great care.

It is becoming increasingly important to educate and inform our society about brain and nerve diseases. Especially starting from schools, proper eating habits that include enough fruits and vegetables should be adopted. In addition, information on preventing smoking and alcohol use, providing environments that will increase physical activity, regular control and appropriate treatment of hypertension, diabetes, heart diseases, strategies to prevent obesity should be addressed not only with health centers but also with schools, parks, sports centers and public education strategies as a whole.

How Can I Help My Relative with Neurological Disease?

Considering the increasingly aging population, the rate of neurological diseases and emergencies is increasing day by day. Neurologic emergencies are more common than other emergencies, especially in the elderly. The importance of rapid diagnosis and treatment has increased thanks to recently changing and developing treatment protocols. If not treated quickly, neurologic emergencies are an important cause of death and disability in elderly patients. Because of physiologic changes and comorbidities in the elderly, diagnosis can sometimes be difficult and confusing, requiring additional attention and skill.

Symptoms of neurological diseases may include headache, dizziness, loss of strength in the body, coordination problems such as inability to move, confusion, numbness or dizziness. Therefore, people experiencing such symptoms should be urgently evaluated by the nearest neurologist.