Epilepsy, Neuromuscular and Autonomic Disorders Specialist in Nepal at MEDHARMA CliniX:

The Medharma Clinix  is a world-class, research-driven neurology practice located in Kathmandu, Nepal led by Dr. Ishan Adhikari, MD MS-HCM with a broad range of specialties and decades of collective experience from the USA.  The CliniX provides only the highest quality medical care to patients from communities throughout Nepal and bordering regions. 

The Medharma CliniX offers a complete menu of diagnostic, management, and treatment services for disorders that affect the central and peripheral nervous systems. This includes disorders of the Brain, Spinal Cord, Nerves, and Muscles. 

At Medharma CliniX, highly-trained and experienced Dr. Ishan Adhikari (Board Certified Specialist from USA) specializes in stroke treatment and post-stroke rehabilitation,headache and migraine care, and neurology-related sports medicine.

We are trying to establish ourselves as leaders in the neurology field when it comes to providing cutting-edge treatment and compassionate care for patients affected by chronic neurological diseases, including Intractable Epilepsy, Multiple Sclerosis, Parkinson’s Disease, and debilitating Neuromuscular Disorders such as Myasthenia gravis and Amyotrophic Lateral Sclerosis (ALS). 

We are proud to offer state-of-the-art treatment approaches, including Behavioral Psychotherapy, Botox® therapy, Inpatient/Outpatient Rehabilitation, Physical therapy, Speech therapy, and Chronic pain treatment while working collaboratively with trusted partners and allied health professionals. We ensure holistic treatment to uplift quality of life for both patients and families suffering from neurological disorders. 



An electroencephalogram (EEG) is a test that detects electrical activity in your brain using small, metal discs (electrodes) attached to your scalp. Your brain cells communicate via electrical impulses and are active all the time, even when you’re asleep. This activity shows up as wavy lines on an EEG recording. An EEG is one of the main diagnostic tests for epilepsy and seizure disorders. An EEG can also play a role in diagnosing other brain disorders.

Why EEG?

An EEG can determine changes in brain activity that might be useful in diagnosing brain disorders, especially epilepsy or another seizure disorder. An EEG might also be helpful for diagnosing or treating the following disorders:

  • Brain tumor
  • Brain damage from head injury
  • Brain dysfunction that can have a variety of causes (encephalopathy)
  • Inflammation of the brain (encephalitis)
  • Stroke
  • Sleep disorders


None: EEGs are safe and painless. Sometimes seizures are triggered in people with epilepsy during the test, but appropriate medical care is provided if needed.

How do you prepare?

Food and medications

  • Avoid anything with caffeine on the day of the test because it can affect the test results.
  • Take your usual medications unless instructed otherwise.

 Other Precautions

  • Wash your hair the night before or the day of the test, but don’t use conditioners, hair creams ,sprays or styling gels.Hair products can make it harder for the sticky patches that hold the   electrodes to adhere to your scalp.
  • If you’re supposed to sleep during your EEG test, your doctor might ask you to sleep less or avoid sleep the night before your test.

What can you expect?

During the test

You’ll feel little or no discomfort during an EEG. The electrodes don’t transmit any sensations. They just record your brain waves. Here are some things you can expect to happen during an EEG:

A technician measures your head and marks your scalp with a special pencil to indicate where to attach the electrodes. Those spots on your scalp might be scrubbed with a gritty cream to improve the quality of the recording.

A technician attaches discs (electrodes) to your scalp using a special adhesive. The electrodes are connected with wires to an instrument that amplifies the brain waves and records them on computer equipment. Once the electrodes are in place, an EEG typically takes up to 60 minutes. Testing for certain conditions requires you to sleep during the test. In that case, the test can be longer.

You relax in a comfortable position with your eyes closed during the test. At various times, the technician might ask you to open and close your eyes, perform a few simple calculations, read a paragraph, look at a picture, breathe deeply for a few minutes, or look at a flashing light.

Video is routinely recorded during the EEG. Your body motions are captured by a video camera while the EEG records your brain waves. This combined recording can help your doctor diagnose and treat your condition.

After the test

The technician removes the electrodes and you can return to your normal routine.


Dr. Ishan Adhikari who is a trained Clinical Neurophysiologist & Neurologist will analyze EEGs and interpret the recording. Dr. Adhikari will schedule an office appointment to discuss the results of the test. If possible, bring along a family member or friend to the appointment to help you remember the information you’re given.

Information for Nerve Conduction Studies (NCS) and Electromyography (EMG) 

Nerve and muscle disorders cause the muscles to react in abnormal ways. Measuring the electrical activity in muscles and nerves can help find diseases that damage muscle tissue (such as myopathy or muscular dystrophy) or nerves (such as peripheral neuropathies). EMG and nerve conduction studies are often done together to give more complete information.


Nerve conduction studies measure how well and how fast the nerves can send electrical signals. Nerves control the muscles in the body by electrical signals, and these impulses make the muscles react in specific ways. NCS can aid in locating damage to the nervous system, which includes all the nerves that lead away from the brain and spinal cord and the smaller nerves that branch out from those nerves as well as junctions between the nerves and muscles. NCS study is performed by placing the electrode on the affected arm or leg. Then a small amount of current is applied to measure the electric signals. You may feel a little shock. NCS study is performed by a doctor or trained technologist.


An electromyography (EMG) measures the electrical activity of muscles at rest and during contraction. For this part of the test, a small, thin needle electrode is put into several muscles to look for diseases that damage muscle tissue or nerves. EMG is performed by a doctor who is specialized in this field. The doctor will look at and listen to the signals that travel from the electrode to the EMG machine.

 How to prepare for the EMG/NCS?

• Do not wear any lotion or makeup on the day of the exam, as oils can interfere with results. Take a bath or shower to remove oil from your skin.

 • If you are taking blood thinners or have a history of bleeding problems, talk to your Neurologist.

 • Certain medicines such as anticholinesterase inhibitors (i.e. Mestinon) can alter results. Thus, these medications should be held on the morning of the exam, after consultation with your Neurologist.

 • Please inform the clinic nurse and/or physicians if you have a pacemaker, as it could be affected by the small electrical impulses sent during the NCS.

 What to expect? 

 The test usually takes from 1 to 2 hours. You can do any of your normal activities, like eating, driving and exercising, before or after the test. There are no lasting side effects. You may feel some discomfort or minor bleeding around the electrode insertion points during the test.

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