AANN Core Curriculum, 7th Edition, Ch. 6 Neurodiagnostic Tests: Digital Version-Chapter 6

Chapter 6

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Neurodiagnostic testing combines imaging, electrophysiology, laboratory analysis, ultrasound, biopsy, and cognitive assessment to identify neurological disease and guide treatment. Nurses help patients understand procedures, verify safety requirements, coordinate care, and monitor for complications.

<strong>Imaging:</strong> Plain X-rays assess bones, alignment, fractures, and hardware. CT provides rapid images useful for acute hemorrhage, fractures, edema, and stroke; contrast studies can visualize arteries, veins, and tissue perfusion but require assessment of allergies and renal function. MRI offers detailed soft-tissue and brain imaging without radiation, but requires screening for metal and incompatible devices and may be difficult for patients with claustrophobia or agitation. PET and SPECT assess brain metabolism or blood flow. Cerebral angiography provides detailed vascular images but is invasive and carries bleeding, embolic, and contrast-related risks. Myelography and cisternography examine spinal structures and cerebrospinal fluid (CSF) flow.

<strong>Electrodiagnostic tests:</strong> EEG records brain electrical activity and helps assess seizures, sleep disorders, and brain function; video EEG correlates behavior with electrical patterns. Evoked potentials assess sensory pathways. Electromyography (EMG) and nerve conduction studies evaluate muscle and peripheral nerve function, including neuropathy, nerve injury, and neuromuscular disorders. Repetitive nerve stimulation helps investigate neuromuscular-junction conditions such as myasthenia gravis.

<strong>Ultrasound:</strong> Carotid Doppler evaluates blood flow and stenosis in neck arteries. Transcranial Doppler assesses intracranial circulation, including vasospasm, emboli, and stroke-related flow changes. Optic nerve sheath ultrasound can help detect elevated intracranial pressure, but is operator-dependent and must be interpreted with other clinical findings.

<strong>Lumbar puncture</strong> collects CSF, measures its pressure, or delivers medication or imaging tracers. Nursing considerations include reviewing medications, allergies, coagulation status, and indications for imaging before the procedure; elevated intracranial pressure is a contraindication. Afterward, monitor neurological status, puncture site, and symptoms such as headache, bleeding, or infection. CSF testing assesses cells, glucose, protein, pressure, and infectious or other disease markers.

<strong>Biopsies</strong> of brain, nerve, muscle, or temporal artery help confirm tumors, neuropathies, muscle disease, or vasculitis when results will guide diagnosis and treatment. <strong>Neuropsychological assessments</strong> evaluate memory, intelligence, visuospatial and executive function, mood, dementia, and concussion; testing requires alert participation and may take several hours.

Keywords

neurodiagnostic testing

electroencephalography

magnetic resonance imaging

lumbar puncture

cerebrospinal fluid

nerve conduction studies

electromyography

transcranial Doppler

brain biopsy

neuropsychological assessment