Revive Centers

Leaders in Neurological Recovery

Diagnostic Testing

Videonystagmography (VNG)

The Videonystagmography (VNG), or testing of eye movement, gives us a representation of the function of eye muscles, cranial nerves, brainstem nuclei, cerebellum, and cortical regions. By measuring things like gaze stabilization, smooth pursuits, saccades, and optokinetics, we can differentiate the areas of weakness to inform our treatment programs. Since different eye movements are controlled by different parts of the brain and brain stem, these VNG findings provide our clinical team with a non-invasive snapshot of the identify with precision the areas of the neuraxis that are underfunctioning.

Difficulty performing these movements is associated with: concussion, traumatic brain injury, stroke, neurodegenerative disorders, anxiety, vertigo, and more.

The results will be thoroughly discussed with you. It is important that you have an understanding of how your eye movements are impacting your symptoms and function. During your last day of treatment, you will be retested to evaluate progress. The results will be used to create a program you will perform at home for the next 3 months.

The SMART EquiTest® system utilizes a dynamic force plate with rotation and translation capabilities to quantify the vertical forces exerted through the patient’s feet to measure center of gravity position and postural control; and a dynamic visual surround to measure the patient’s use of visual information to maintain balance. It provides assessment and retraining capabilities with visual biofeedback on either a stable or unstable support surface and in a stable or dynamic visual environment
The ears allow for interacting with the environment through sound and movement.  In the inner ear is a system for reflexogenic balance called the vestibular system.  The vestibular system is stimulated by any motion.  Improper function of the vestibular system will impact balance, walking, and eye movements.
Information sent from the joints and muscles of the leg and feet are sent to the brain.  Damage to the joints, muscles, or part of the brain that receives the information can occur from injuries, neuropathy, diabetes, stroke, traumatic brain injury, cerebral palsy, or concussions will impact balance.  The lack of information from the joints and muscles is one reason you will see patients will neuropathy use a wide-based stance.
The visual system is dominant for most people and usually, compensates for decreased function of the others.  Problems arise though when it is dark or the visual system is no longer able to process environment as quickly.  There are many causes for a disturbance in the visual system, but here are a few: concussion, multiple sclerosis, diabetes, Parkinson’s, cerebral palsy, vertigo, dizziness, migraines, traumatic brain injury, and stroke.

Cognitrax is powered by CNS Vital Signs neurocognitive assessment technologies; the leader in clinical use with over 7000 clinical users and over 2000 clinical investigators and researchers in 52 countries. Cognitrax enables an objective longitudinal assessment of a patient’s “CORE” neurocognitive function using computerized neuropsychological tests. It can assist in the recognition and evaluation of Neurodegenerative Disorders.

Cognitrax automates the precise psychometric (speed and accuracy of responses with no rater bias) measurement of a patient’s neurocognitive function. Cognitrax domain scores are presented as Subject (raw) Scores, Standard Scores, and Percentile Ranks computed from calculations using the data values of individual subtests and are simply the number of correct responses, incorrect responses, and reaction times. Cognitrax grades the severity of impairment based on an age-matched normative comparison database with lifespan norms from ages 8 to 90.

Functional Movement & Physical Exam- There are specific observational tests that can help your doctor figure out what is causing your neurological disturbance. A functional neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine where the nervous system is impaired.

Lab Testing & Blood work – Often we will need thorough lab work to identify underlying causes or comorbidities to neurologic impairment. This could include one or some of the following: comprehensive blood panel (Including specific food allergy testing, detailed hormone panels, or in-depth thyroid panels) genetic test, a saliva sample, stool sample.

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