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The University of Maryland Medical Center can handle your care whether you're seeking peripheral neuropathy diagnosis or treatment.

Nerve Conduction Study and Electromyography

A Nerve Conduction Study (NCS) and electromyography is a two-part test that a trained professional completes. Your health care provider may recommend this procedure to understand your neuropathy further.

The NCS involves the nerves in a patient's arms and legs. A tiny pulse of electricity is sent through the arm or leg to stimulate nerve response, which a computer captures to show how fast or slow nerves react.

Electromyography (EMG) provides important information about a patient's muscles. During this test, a very small needle is inserted into a specific muscle. Patients may then be asked to relax or contract their muscles. During this test, you might hear cracks, pops or static, which is the sound of your muscle working in response to the test. A computer then captures muscle activity. This test helps identify normal and abnormal muscle function.

Neuromuscular Ultrasound

Neuromuscular ultrasounds can help better diagnose and potentially treat a neurological disease. For example, the technique can diagnose carpal tunnel and other nerve compressions, as well as nerve and muscle diseases. The ultrasound may help determine the best spot for a nerve or muscle biopsy and where to inject therapeutics.

An operator will apply gel and a probe to the skin for the ultrasound. Testing is non-invasive and usually painless.

Diagnosis at Our Autonomic Laboratory

At the autonomic laboratory, patients receive tests that measure the stimulated responses of organs that the autonomic nerves have control over. Test data will indicate whether the autonomic nervous system is functioning normally.

Your body's autonomic system manages essential functions, such as blood pressure, blood flow and sweating. Caregivers study test results to understand how well a patient's autonomic nervous system functions. Detailed testing performed at the Maryland Autonomic Laboratory strives to uncover the reasons behind the symptoms that patients experience. For instance, the lab examines whether an autonomic nerve disease or an autonomic system problem could be behind a patient's symptoms.

To see if a disease is affecting the autonomic nervous system, tests monitor blood pressure, blood flow, heart rate and sweat responses. By measuring these involuntarily regulated bodily functions, health care professionals can understand whether a patient's complications could be because of a problem with their autonomic nervous system.

Blood Pressure And Heart Rate Tests Include:

  • A deep breathing test to assess the patient's heart response. The deep breathing test requires several minutes of deep breathing.
  • A test called the Valsalva maneuver that requires the patient to blow into a tube to increase their chest pressure. During testing, a provider monitors changes in a patient's blood pressure and heart rate.
  • A tilt table test, which requires the patient to lie on a table that's then raised for at least five minutes. During testing, a provider monitors changes in a patient's blood pressure and heart rate.
  • The Quantitative Sudomotor Axon Reflex Test (QSART) is another autonomic test that measures sweating and skin temperature. Acetylcholine and a small electric current are applied to the skin. The test measures the patient's sweat production at the lower and upper limbs.

All testing is non-invasive and usually painless.

Biopsies

Skin Biopsy

A skin biopsy is a 30-minute outpatient procedure that a trained professional performs. Your health care provider may recommend this procedure to understand your neuropathy further and gain information about the small nerves in your skin.

What to Expect:

  • A health care professional will use a local anesthetic to numb your biopsy site.
  • The professional will take a small piece of skin, no bigger than the tip of a ballpoint pen, from just above the ankle and just above the knee. They will then apply a bandage, and the sample will receive further processing at a lab.
  • After your procedure, you can return to normal activities but should keep the area of your biopsy clean and dry.

Infusion Services

Your health care provider may recommend an infusion or intravenous (IV) medication for your neuropathy treatment. At our Peripheral Neuropathy Center, the Department of Neurology organizes and facilitates the outpatient infusion center.

The infusion center provides patient monitoring in a calm and relaxing environment. Infusions can be given through a small peripheral IV catheter. Patients are encouraged to bring personal entertainment to occupy themselves while they receive their medication. But in case you forget, we have a large selection of movies at the clinic.

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