Diagnostic Procedures in Neurological Disorders

Last week we discussed Hydrocephalus. Today, let us learn the different diagnostic procedures that our neurologists use to assess further neurological disorders.


The following procedures are the following:


1. Computerized Tomography (CT)
– this has become the procedure of choice in neurology because it defines intracranial structures and pathological lesions distinctly
– the amount of radiation is significantly less than other procedures

2. Magnetic Resonance Imaging (MRI)
– this is a more sensitive imaging technique than the CT scan
– its greatest advantage over Ct Scan is that radiation is not involved
– this gives an excellent delineation of the brain, spinal cord and of intra and extraparenchymatous lesions
– it gives a better definition of the posterior fossa and areas of demyelination

3. Cranial Ultrasonography
– this is the first line procedure in infants with open fontanels
– it is portable so it gives prompt and quite accurate information of the intracranial contents

4. Skull roentgenography
– they remain invaluable in the diagnosis of many neurologic disorders
– they are valuable in demonstrating congenital anomalies of the bone, fractures, fusions, enlargements of various foramina, sella expansion or destructions

5. Myelography
– rarely done in pediatrics
– suffice to know that this procedure is useful and indicated in delineating suspected lesions within the spinal canal such as tumors, herniated discs, hematomas and abscesses

6. Lumbar Puncture
– in pediatrics , the only absolute indication of performing a lumbar puncture  is the suspicion of central nervous infection
– in this procedure, the spinal fluid is collected aseptically and send to laboratory for cell count, differential count, protein and glucose determination. Gram staining and cultures are also done on the collected CSF.

7. Electroencephalography (EEG)
 – this is an important diagnostic tool in many neurologic disorders
– EEG records electrical activity of the brain
– this is useful in the evaluation of seizure disorders, sleep disorders  and in the diagnosis of brain death