Neurological Diagnosis and Treatment for Learning Disabilities

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Tests That May be Prescribed for Your Child


After your first visit

After a thorough neurological evaluation, Dr. Fernando Miranda may recommend further testing. Based on the outcome of his initial evaluation there are several assessments that may be prescribed.

DEEP Assessment

BMI image is an EEG or electroencephalogram. It is much more specific than a traditional EEG using thirty two electrodes. The DEEP Assessment measures objectively the correlation between the brain function and the electrical activity of the neural tissue: at rest, through the circadian rhythm and during specific tasks. It may measure dysfunction, mild deviations from normal or definite abnormalities in the maturational process. Evoked responses (ERP) use stimuli in the visual and auditory domains to show objective links between perceptive-cognitive deficits and electrical maturational or structural damage to the brain.

BMI image Evoked responses may be altered by changes in the individual's psychological state, underlining the importance of differentiating between focused attention and non specific alertness. DEEP also offers an objective follow up to the improvement in the functional connectivity achieved when the right method is used in the treatment of a dysfunctional state.

The test takes place at our clinic and lasts between two and a half to three and a half hours. Up to approximately one hour of this time is used for placing the electrodes. During set up your child may participate in activities that distract him/her while encouraging him/her to "sit still" such as reading, playing video games, talking to/playing with staff and parents, or watching a DVD. Your child's hair will have some residual gel (used for conductivity of electrodes) left in it after the test and yourr child will most likely need to take a bath/shower that evening. (See Details about the EEG process.)

MRI

BMI image or Magnetic Resonance Imaging is a non-invasive procedure that allows us to look at the physical structure of the brain. The MRI rules out any possible structural abnormalities. The test takes between 45 and 60 minutes. If the child is apprehensive about enclosed spaces, a mild sedative may be prescribed. In some cases, outpatient anesthesia may be used. An "open MRI" is not an option as it is not specific enough for our purposes. Dr. Miranda strongly encourages the MRI be performed at a facility where the staff is familiar with the specificities of the examination, and where a Neuroradiologist is available for reading of the study.

MRI spectroscopy

is similar in patient experience to an MRI. It frequently takes place after the traditional MRI and lasts for approximately 15 additional minutes. Using a computer, technologists are able to measure specific neurotransmitter amounts in various areas of the brain. The outcome of this exam may help Dr. Miranda to make an accurate diagnosis. The findings often provide evidence to support the need for a specific pharmacologic intervention.

DTI (Diffusion Tensor Imaging)

is another form of MRI. The actual test follows the traditional MRI, and again takes an additional 15 minutes. The reading of the test is quite involved and requires a specialized technique and physics, all of which are not available but in major Medical Centers. Using the water absorption quality of myelin (sheath that surrounds nerve cells), the test is capable of detecting established and new pathways that have been formed in the brain. As new pathways are evidence of learning, this test is anatomical and physiological evidence of rewiring the brain through learning. DTI can be used as pre- and post measures to test the effectiveness of a particular pharmacologic agent, or specific tutorial and behavioral program or therapy.

 
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