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Neurophysiology Diagnostics for Health Care Providers

Neurophysiology diagnosticcare an integral part of many clinical pathways for patients with problems and conditions that affect the functioning of the brain ,nervous system and muscles .The contribution of clinical neurophysiology services in end –to-end patient pathways is immensely significant

Clinical applications of Neurophysiological investigations

Nerve conduction studies (NCS) :

Involve electrical stimulation of peripheral nerves with recording of responses from nerves and muscles .It is used to investigate ,for example facal neuropathies such as carpet tunnel syndrome and other causes of numbness, tingling and pain in the limbs

Electromyography (EMG) :

Investigate the causes of muscle weakness and a variety of disorders affecting the nervous system .Combining the EMG and NCS often improves the diagnostic accuracy

Evoked Potential Studies (EPS) –Visual (VEP), Auditory (AEP), Somatosensory (SSEP):

are potentials produced by the brain in response to specific stimuli, for example, a flashing light, sound Chemodenervation with Botulinum toxin under EMG guidance for blepharospasm, hemifacial spasm, spasmodic torticollis, writer’s cramp etc...

Respective nerve stimulation study and single fiber EMG :

for myasthenia gravis and Eaton –lambert and other paraneoplastic syndrome

EVOKED Potential Studies:

Visual (VEP), Auditory (AEP), Somatosensory (SSEP) for pathologies in vision, hearing and spinal cord pathways.
  • VEP –Optic atrophy, Pituitary tumor, Blindness, Demyelinative disease (e.g. Multiple Sclerosis), temporal lobe lesions
  • AEP –Acoustic Schwannoma and other cerebellopontine tumors (e.g. Multiple Sclerosis )temporal lobe lessions
  • SSEP- Spinal cord pathologies, specifically degenerative and demyelinative disease

Electro Retinography (ERG):

evaluation of various retinopathies

Video-Electroencephalogram (EEG) :

electrophysiological assessment of epilepsy ,consideration of non-epileptic episodes (e.g. breath-holding spells , synope , inattention etc.)Acute symptomatic causes for seizures (stroke, CNS infection, head trauma, metabolic disturbance etc.)Addition of online artifac elimination and spike –detection application enhances the elimination and spike-detection application enhances the diagnostic accuracy of the EEG interpretation and helps in eluting epileptiform activity from the background rhythm