Services and laboratories » Unità Operativa Semplice – (U.O.S ) Servizio di Neurofisiopatologia » Diagnostic activities

• EMG
• Single Fiber EMG
• EMG with analysis of the motor units
• Pelvic floor muscles EMG
• Laringeal muscles EMG
• Motor conduction studies
• Sensory conduction studies
• Test for Spasmophilia
• Ischemic test
• Ripetitive stimulation
• Periodic paralysis test
• Sacral latency
• F wave
• H reflex
• Long-loop reflexes
• Blink reflex
• Cortical silent period
• Mixed nerve silent period
• Maseterine exteroceptive silent period
• Tremor studies
• EMG guided botulinum toxin injection
• Visual evoked potentials
• Brainstem auditory evoked potentials
• Somatosensory evoked potentials
• Pudendal nerve evoked potentials
• Dermatomeric (cranio-bulbar district included) evoked potentials
• Motor evoked potentials (cranio-bulbar district included)

Access modality: tests are performed both for the National Health Service and for paying patients.

Monitoring activity

EEG during carotid tromboendoarterectomy.

Registration from and stimulation of various cerebral areas and basal ganglia during deep brain stimulators implants in parkinsonian and dystonic patients.

Centre  for Parkinson disease and movement disorders
(Directors Prof. Alberto Priori, Dr. Mario Rango)

Beside the physicians of the Neurophysiology Unit, the following professionals contribute to the activity of the Centre:

- Dr. Mario Rango, Senior Neurologist (Tel. 02/55033841)
- Dr. Alberto Castelli, Electronic Engineer-Bioengineer PhD, Telemedicine MS
- Dr. Alessio Di Fonzo, Neurology Resident
- Dr. Isabella Ghione, MD

• Movement disorder clinic
  The clinic follows patients with dystonia, corea, myoclonus, Parkinson’s disease, Parkinsonism, tremor. There is also a special clinic for occupational disorders in performing artists (musician’s cramps). Apomorphine tests are available and digital video recordings are performed when necessary for diagnostic and treatment follow-up purposes.
  

The following procedures and tests are also available:

• Magnetic resonance spectroscopy: reference center-Lombardia network of excellence for Parkinson’ s disease care and assistance
• Proton spectroscopy
• Phosphorus spectroscopy
• Dynamic spectroscopy-activation studies

  Genetics:

• a-synuclein
• parkin
• mithocondrial haplotypes
• haplotypes locus APO E
  
  
  
• Botulinum toxin clinic
  The clinic follows patients with cervical distonia, blepharospasm, facial hemispasm, writers cramp, spasmodic dysphonia (in collaboration with Dr. Giovanna Cantarella of the ENT department) tremor, spasticity, bruxism, Meige syndrome etc. Hyperidrosis and syalorrea are also treated.
  
  

Deep Brain Stimulation Unit
(Director Prof. Alberto Priori)
Deep Brain Stimulation is the latest advance in the treatment of movement disorders, especially Parkinson’s disease and dystonia. Very thin electrodes are stereotactically implanted by neurosurgeons in the basal ganglia and connected to an extracranial stimulator generating high-frequency train of stimuli able to modulate the abnormal pattern of discharge found in Parkinson’s disease and in torsion dystonia.
The physician working in these unit belong to the Neurophysiology Unit (Prof. Priori, Prof. Barbieri, Dr. Pesenti, Dr. Ardolino, Dr. Bossi) and to the Neurosurgery Department (Dr. Rampini, Dr. Egidi, Dr. Locatelli) They collaborate with the Department of Bioengeneering of the Politecnico di Milano and with the Neurology Department of Ospedale San Paolo. The unit selects, treats, and follows up patients with movement disorders (Parkinson’s disease, generalized torsion dystonia etc.) undergoing deep brain stimulation. About hundred implants have been done in patients with Parkinson’s disease and dystonia.

Centre for the Diagnosis and Treatment of Epilepsy
(Director Dr. Alberto Cappellari)

• Epilepsy Clinic
  The clinic follows juvenile and adult patients with epilepsy. A detailed history is taken from the patient to establish the possible occurrence of epileptic crisis. Based on the clinical picture and the results of EEG and neuroradiologic investigations too, the specific epileptic crisis and epileptic syndromes are defined for the individual patient. The most appropriate pharmacological therapy in then started, and the patient underogoes serial clinical and paraclinical follow-ups.
  
  
  
• Epilepsy Unit
  Our Centre actively cooperates with other national Centers (IRCCS E. Medea , Bosisio Parini; IRCCS Stella Maris, Pisa; Ospedale Fatebenefratelli e Oftalmico Milano; IRCCS C. Mondino Pavia; Dipartimento di Neuroscienze, Universita’ di Milano Bicocca; Dipartimento di Neuroscienze Sezione di Farmacologia, Universita’ Federico II Napoli) in a project aiming to study the familiar epilepsies. The aim of this project is to define those factors - beside the already known genetic mutations – involved in the complexity of the phenotype of the familiar epilepsies, including the possible multidrug resistance.

Access modality: Consults are performed both for the National Health Service and also for paying patients.Research Activity.