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Become a patient of ours.Thank you for being a patient of ours.Thank you.Answers to your questions.


We hope your office visit has been productive.  Please feel free to email or call with questions or comments.  Or write down questions or concerns to discuss at your next visit.

Following an office visit, additional testing may be ordered. A little insight on what those tests might include:


Magnetic Resonance Imaging (MRI):  A noninvasive way of  imaging your insides.  MRI technology has revolutionized neurology.  The initial MRI’s were called NMR’s, Nuclear Magnetic Resonance images.  The nuclear part had to do with how magnetic fields affect Hydrogen atoms.  MRI’s utilize powerful magnetic fields to change the tilt angle of Hydrogen atoms.   When that magnetic field is turned off, Hydrogen atoms return to their normal position, and in turn, release energy.  An MRI image is then generated by recording the energy signature released by the hydrogen atoms.  Fascinating.

MRI procedures may be done with contrast.  MRI Contrast is made from Gadolinium, and is quite safe except in patients with significant kidney problems.  Gadolinium is not Iodine based and is therefore very different from the contrast used in CT scanning.  An MRI contrast injection may be used during your scan in order to help  detect certain types of problems. 

MRI procedures cannot be done in patients with magnetic parts:  That would include patients with pacemakers, internal defibrillators (AICD’s) or embedded shrapnel. Metal workers may also be excluded if small pieces of metal are embedded in the eye.

MRI procedures are very noisy, but not very long.  Most scans are completed in less than 30 minutes.  In a conventional, horizontal MRI, the body part to be imaged is placed in a tube, surrounded by a magnet.  Patients with claustrophobia may need a mild sedative medication taken 45 minutes prior to the procedure.


Electromyogram (EMG) is an electrical recording of nerve and muscle activity.  This routine test is performed by Dr. Stein in our office. 

There are two parts to the EMG.  The Nerve Conduction Study and the Electrode Examination.  During the nerve conduction study an electrical stimulus is applied to specific nerves in the arms or legs resulting in a muscle twitch.  During the electrode examination, we use a small pin to record electrical muscle activity generated by the patient.  EMG is very helpful when diagnosing problems with the nerves and muscles in the neck, back, arms and legs. 

Although the EMG test may sound ominous, most patients do very well, with only minor discomfort.  I have been performing this procedure for over 20 years and routinely hear patients say “it wasn’t as bad as I thought”. 
If possible, wear loose fitting clothing and avoid applying skin lotions prior to the EMG.  No other preparation is necessary.  Take all of your regular medications and feel free to eat a regular diet.  The entire test lasts 30-45 minutes.  Following the EMG I will analyze the results and discuss the findings with you at your follow up visit or with your referring physician.

The nervous system is like an electrical circuit in your home; problems with wiring, switches or bulbs can all result in darkness.  EMG helps us shed light on where the problem originates.  Interestingly, the use of electrical impulses to test muscles dates back to 1792 with the work of Luigi Galvani.  Naturally, we have refined the procedure since that time.

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