How Are Central Nervous System Disorders Diagnosed
Nervous system disorders are diagnosed through a neurological examination and imaging techniques

The central nervous system (CNS) is a complex system that is made up of the brain, spinal cord, and nerves surrounding these structures.

Nervous system disorders are diagnosed through a neurological examination and imaging techniques that assess how well the brain and nerves are functioning.

What diagnostic tests are used to diagnose nervous system disorders?

Neurological examination

After discussing your symptoms, your doctor may perform a detailed examination to assess the nervous system. For example, they may use a pin or a thin filament to evaluate your sense of pain.

During a neurological exam, your doctor assesses several other aspects of the neurological system, such as muscular strength, autonomic nerve function, and the capacity to perceive different sensations (such as coolness and hotness).

Diagnostic tests

There are various diagnostic tests for nervous system disorders:

  • CT scan
    • Produces high-resolution images of the bones, muscles, and organs using X-rays and computer technology.
    • Provides more information than standard X-rays.
  • MRI
    • Generates comprehensive pictures of organs and structures within the body by using huge magnets, radio waves, and a computer.
  • Ultrasonography
    • Creates pictures of tissues and organs using high-frequency (ultrasonic) sound waves.
    • Used to visualize internal organs as they function.
    • Measures blood flow across different arteries.
  • Electrodiagnostic testing
    • A more extensive examination which may be performed if no clear findings are obtained from other diagnostic tests.
    • Commonly used to assess nerve and muscle activity based on the response to electrical stimuli and can assess the cause and extent of nerve injury.
    • Includes noninvasive neurological examinations, such as nerve conduction velocity (NCV) and electromyography (EMG).
    • Can be performed in conjunction with other diagnostic tests to provide a more complete picture of all elements of the neurological condition in question.
  • Electroencephalogram (EEG)
    • Records the electrical activity of the brain.
    • Involves placing about 20 tiny electrodes on the scalp to record brain activity.
  • Positron emission tomography (PET)
    • Uses a radioactive drug (called a tracer) to measure the metabolic activity of the cells.
  • Myelography
    • After a radiopaque, a contrast agent is introduced into the subarachnoid space through a spinal tap, and X-rays of the spinal cord are taken.
    • Has mostly been superseded by MRI, which generates more detailed pictures and is easier and safer to perform.
    • May be performed with CT scans when clinicians need more information about the spinal cord and surrounding structures than an MRI can offer.
  • Spinal tap
    • Involves withdrawing a sample of cerebrospinal fluid with a needle and sending it for lab analysis.
    • Looks for changes in the composition and appearance of cerebrospinal fluid, which is generally clear and colorless and contains a few red and white blood cells.
    • Changes in cerebrospinal fluid can indicate signs of infection, malignancies, or bleeding in the brain and spinal cord.
  • Neurosonography
    • An invasive study of the neonatal brain, used especially in preterm babies.
    • Can identify congenital conditions or malformations using ultrasound equipment.
  • Evoked potential
    • Measures the electrical response of the brain to visual, aural, and other sensory inputs.
  • Cerebral angiography
    • Examines arteries in the brain for anomalies such as aneurysms and disorders such as atherosclerosis, using contrast dye and X-ray imaging guidance.
    • Generates extremely precise, clear, and accurate images of blood vessels in the brain.
    • Images are electronically modified so that the skull bones, which would typically obscure the vessels, are removed from the image, revealing the blood vessels underneath.

What are common neurological disorders?

Diseases of the central and peripheral nervous systems are referred to as neurological disorders. Examples of neurological disorders include:

Many bacterial (Mycobacterium tuberculosis, Neisseria meningitides), viral (HIV, enteroviruses, West Nile virus, Zika), fungal (cryptococcus, aspergillus), and parasitic (malaria, Chagas) diseases can impact the nervous system.

Nervous system disorders are quite common. More than 6 million individuals die as a result of a stroke each year. Epilepsy affects more than 50 million individuals globally. It is estimated that there are about 7.7 million new cases per year of dementia each year, with Alzheimer's disease accounting for 60%-70% of cases. Migraines affect more than 10% of the world's population.

How are neurological disorders treated?

Early intervention can improve outcomes and reduce complications. 

Once the underlying cause of a nervous system disorder has been identified, addressing the cause and regaining function are the main objectives of treatment. To lower the risk of future issues, preventative measures should be implemented whenever possible.

Treatment for neurological disorders varies depending on the type, but most doctors use a multidisciplinary approach that may include drug and surgical therapy. Treatment options may be supplemented with nutritional support, physical therapy, and lifestyle changes, which can help to improve overall neurological function.

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Medically Reviewed on 11/8/2022
References
Image Source: iStock image

Neurological conditions. https://www.dignityhealth.org/conditions-and-treatments/neurology

Overview of Diagnostic Tests for Nervous System Disorders in Children. https://healthlibrary.brighamandwomens.org/Conditions/Neuroscience/90,P02597

Movement Disorders. https://www.radiologyinfo.org/en/info/movement-disorders