Problems in the brain can be hard to diagnose. Many times the symptoms of a brain condition show up in another part of the body because of the complex pathway of your nervous system. When an issue with your brain health is suspected, your doctor will begin with an initial evaluation and then move on to more complex neurological diagnostic tests.

An initial evaluation will typically include a complete medical history and a neurological exam. During a neurological exam your doctor will check for alertness, muscle strength, coordination, reflexes and your response to pain. Your doctor will also check your eyes for swelling of the optic nerve, which connects the eye to the brain. You may also be asked to complete some basic memory tests. If this initial exam shows any signs of a brain health issue, your doctor will order more advanced tests.

Advanced Diagnostic Tests for Brain Health Conditions

Advanced diagnostics may include:

  • Balance tests — These may include posturography, otolith tests, EquiTest and rotary chair tests.
  • Biopsy — The removal of tissue to look for abnormal cells. A biopsy may be done on a suspected cancerous tumor, or on muscle tissue to help diagnose conditions like muscular dystrophy.
  • Blood tests — Blood testing can indicate abnormal levels of hormones, blood cells and other indications of disease. Blood testing may include genetic and DNA testing for inherited conditions.
  • CT scan and CT angiography — A CT scan is an x-ray machine linked to a computer in order to take a series of detailed pictures of the head. During a CT angiography, an injection of a special dye is used to directly image the vessels in the neck and head more clearly.
  • Diagnostic angiogram — During this procedure a catheter is used to look for abnormalities in the blood vessels using a rapid set of x-rays and time lapsed photography.
  • Electroencephalography (EEG)
    • Ambulatory EEG — This helps to measure the electrical activity of the brain over a 48-hour period. The patient wears the EEG electrodes home for 2 days, which allows for the capture of the patient’s typical spells/seizures to aid in diagnosis of epilepsy.
    • Inpatient Video EEG — This type of EEG is used to measure the electrical activity of the brain while patients are hospitalized for 2-5 days in Emory’s Epilepsy Monitoring Unit (EMU). During hospitalization on the EMU, EEG is recorded 24 hours a day, along with concurrent video.
    • Routine EEG — This type of EEG is used to measure the electrical activity of the brain. EEGs are performed to determine whether abnormal brainwaves are present, which can aid in the diagnosis of seizures as well as other neurologic disorders, including epilepsy.
  • Electromyography — A special test that records the electrical activity of your muscle tissue in order to help diagnose muscular dystrophy.
  • Evoked-potential study — This test measures the brain’s response to sight, hearing and touch stimuli.
  • Gait mapping — During gait mapping, a patient walks on a mat with multiple sensors which can identify the speed, spatial resolution and other elements of a person’s walking pattern in order to detect movement disorders.
  • Memory screening test — Patients who exhibit symptoms of dementia can undergo a memory screening test to determine the level of cognitive impairment.
  • Motion analysis — This procedure is used to help evaluate movement disorders, such as tremor and gait (walking). During motion analysis the patient wears a suit that uses sensors linked to a computer, which can interpret the body’s motion in three dimensions.
  • MRA — A magnetic resonance angiography is an MRI study that provides images of blood vessels supplying blood to the brain in order to help diagnose stroke.
  • MRI — A powerful magnet linked to a computer makes detailed pictures of your brain. These pictures are viewed on a monitor and can also be printed. Sometimes a special dye is injected to help show differences in the tissues of the brain. Special scanning called magnetic resonance spectroscopy can determine metabolism of brain abnormalities giving extra diagnostic information.
  • Multiple sleep latency test — This test is used to quantify sleepiness and diagnose disorders of excessive sleepiness.
  • Multiple wakefulness test — This polysomnogram is used to evaluate the ability to stay awake during the day.
  • Myelogram — A spinal tap is performed to inject a special dye into the cerebrospinal fluid and an x-ray of the spine is taken. The patient is tilted to allow the dye to mix with the fluid.
  • Neuropsychological testing — This type of testing is used to measure the severity of memory and other cognitive dysfunction that can occur in many individuals with brain conditions such as epilepsy.
  • Neurovascular ultrasound — This test uses high-frequency sound waves to detect and diagnose thickening of the walls of arteries that could indicate risk of stroke.
  • Polysomnogram — This test helps diagnose sleep disorders by recording information including brain waves, eye movements, muscle tone, and oxygen levels in the blood, heart rate and rhythm, leg and body movements, sounds made while sleeping, breathing effort, and airflow through the nose and mouth while a patient sleeps.
  • Positive Airway Pressure (PAP) titration study — During a titration study, the patient sleeps using the CPAP machine while the sleep technologist records data including the patient’s breathing. This information helps determine the level of air pressure that keeps the airway open and helps the patient to breathe easily during sleep.
  • Positron emission tomography — Imaging of the brain's use of the sugar glucose in a scanner that works much like a CT scan, but detects signals from a radioactive dye that is injected at the beginning of the scan.
  • Single Photon Emission Computed Tomography (SPECT) — This test produces 3-D images of brain activity and blood flow and then translates the images into a "map" that shows brain function in detail.
  • Sleep studies — We offer sleep studies both at home and overnight in our sleep lab to help diagnose sleep disorders.
  • Stereotactic needle biopsy – Using an imaging device for guidance, such as CT or MRI, the surgeon makes a small incision in the scalp and drills a small hole into the skull, called a burr hole. The doctor passes a needle through the burr hole and removes a sample of brain tumor tissue.