You’ve spent months, maybe years, trying to get answers. You’ve seen specialists. You’ve done the standard tests. And you keep hearing some version of the same thing: “Everything looks normal.”

But you don’t feel normal.

If that’s what brought you to Nexus Neuro, you’re in the right place. Our approach to care is fundamentally different from what you’ve likely experienced before, and that starts from the very first time you walk through our doors in Carmel, Indiana.

Here’s a look at what your first appointment actually involves, why we do each piece of testing, and what we’re looking for along the way.

It Starts with a Real Conversation

Before any testing begins, we sit down with you.

Your first appointment opens with a comprehensive consultation. We review your full medical history, any past diagnostics you’ve had done, previous nerve studies, lab work, imaging, and any other relevant records. This isn’t a five-minute intake form review. It’s a thorough conversation designed to help us understand not just your symptoms, but the full picture of your health history and how you got to where you are today.

This step matters because it shapes everything that comes next. The specific assessments we run and the order in which we run them are built around your individual case. Whether you’re dealing with a brain-based condition, peripheral neuropathy, post-concussion symptoms, chronic pain, balance issues, or something you haven’t been able to categorize yet, your evaluation is tailored to you.

One thing we hear often from new patients: they came in thinking their issue was purely physical, like a balance problem or chronic pain, and had no idea the brain was involved. That’s actually very common. Part of what we do in your first appointment is help you understand how all the pieces connect.

From there, we run our Brain-Body-Gut assessment and the appropriate diagnostics for your case. Here’s a closer look at the core testing tools we use.

Sensory Testing and Sensory Motor Integration

Your nervous system is constantly receiving information from the world around you and from your own body. It takes in signals about where you are in space, what you’re touching, how your joints are positioned, and how your muscles are moving. Then it has to process all of that information and coordinate an appropriate response.

When any part of that loop breaks down, the effects can show up in ways that seem completely unrelated: clumsiness, difficulty with balance, chronic pain, heightened sensitivity, numbness, tingling, or a general sense that your body isn’t doing what your brain tells it to.

Sensory testing at Nexus Neuro examines how well your sensory and motor systems are communicating. We assess range of motion alongside sensory-motor integration, looking at how your nervous system processes incoming signals and translates them into movement and coordination.

This testing helps us identify whether there are specific pathways in your nervous system that are underperforming, overreacting, or failing to integrate properly. For many patients, this is where we find answers that explain symptoms they’ve had for years without a clear cause.

Videooculography (VOG)

Your eyes tell us an enormous amount about your brain and nervous system.

Eye movements are controlled by multiple regions of the brain, including the cerebellum, brainstem, and cortex, and they require precise coordination between many different neurological pathways. Because of this, the way your eyes move is one of the most sensitive windows into neurological function available to us.

Videoculography (VOG) is a technology that tracks and records your eye movements with high precision using specialized goggles equipped with infrared cameras. During testing, we guide your eyes through a series of controlled movements and observe how your brain and nervous system respond.

We’re looking at things like how smoothly your eyes track a moving target, how quickly and accurately they jump between two fixed points, how they respond to head movement, and whether there is any involuntary movement (called nystagmus) that shouldn’t be there.

For patients dealing with post-concussion symptoms, dizziness, vertigo, visual disturbances, migraines, or balance problems, VOG testing is often one of the most revealing parts of the evaluation. It can identify dysfunction in specific parts of the brain or inner ear that conventional imaging simply doesn’t show.

VOG is also a powerful tool for tracking progress. Because the data is objective and measurable, we can compare your results across appointments and see clearly how your neurological function is changing with care.

Cervical and Neck Assessment

The neck is far more neurologically significant than most people realize.

Your cervical spine houses critical neurological structures and is packed with specialized receptors that constantly feed information to your brain about head position, movement, and spatial orientation. When the cervical spine is injured, restricted, or not functioning properly, it can disrupt those signals in ways that produce symptoms that seem to have nothing to do with your neck: headaches, dizziness, brain fog, difficulty concentrating, visual disturbances, and problems with balance and coordination.

This is especially relevant for patients who have a history of whiplash, concussion, or repetitive strain injuries, but cervical dysfunction is more common than most people expect even without a clear traumatic event.

Our cervical assessment evaluates the structural and neurological function of the neck, looking at range of motion, joint mobility, muscle function, and how well the cervical receptors are integrating with the brain’s other sensory systems.

For many patients, addressing cervical dysfunction is a foundational part of their care plan because the neck is often an upstream driver of symptoms they never connected to that region of their body.

Autonomic Nervous System Testing with the Nerve Express

Your autonomic nervous system (ANS) controls the functions that run in the background of your daily life: heart rate, circulation, breathing rate, digestion, temperature regulation, and the balance between your body’s “go” state and its “rest and recover” state.

When the ANS is dysregulated, the symptoms can feel overwhelming and often defy explanation through standard testing. Fatigue that doesn’t improve with sleep. Heart palpitations. Lightheadedness when you stand. Chronic anxiety. Brain fog. Digestive issues. These are all common presentations of autonomic dysfunction.

At Nexus Neuro, we use the Nerve Express system to objectively measure how your autonomic nervous system is functioning. The Nerve Express is a non-invasive, computer-based tool that analyzes heart rate variability (the variation in timing between your heartbeats) to quantify the balance between your sympathetic and parasympathetic nervous systems.

The assessment involves three components:

The Orthostatic Test measures how your ANS responds when you move from lying down to standing. A healthy nervous system makes that transition smoothly. When it doesn’t, that breakdown is often at the root of dizziness, fatigue, and cardiovascular symptoms.

The Valsalva Maneuver Combined with Deep Breathing challenges your nervous system in a controlled way to reveal how well your autonomic function holds up under demand. This test is particularly valuable for distinguishing between temporary dysfunction and more established, chronic imbalances.

Together, these tests give us precise, quantifiable data about the state of your autonomic nervous system, something that conventional lab work and imaging simply can’t provide.

Putting It All Together

After your testing is complete, we take everything we’ve gathered and synthesize it into a clear picture of what is actually happening in your nervous system. We explain what we found, what it means for your specific symptoms, and what a targeted care plan looks like for you.

This is where things start to make sense for most patients. For the first time, there’s an explanation. There’s a map. And there’s a path forward.

Nexus Neuro serves patients from Carmel, Westfield, Zionsville, Fishers, Noblesville, and throughout the Indianapolis metro area. If you’ve been looking for answers and haven’t found them yet, we’d love to be your next step.

Ready to get started? Contact Nexus Neuro today to schedule your first appointment.

Please note: The testing described above represents the range of diagnostic tools we use at Nexus Neuro. Not every patient will undergo every assessment. Your evaluation is individualized based on your specific case, history, and symptoms. Dr. Schulke will determine which combination of testing is most appropriate for you during your consultation.