Neurophysiology – Role of EMG and Nerve Conduction Studies

Neurophysiology

Neurophysiology is the study of the functioning of the nervous system. Clinical neurophysiology is the study of the functions of the nervous system for diagnostics, intensive care and intraoperative monitoring.

Techniques include

Electromyography (EMG)

Electroencephalography (EEG)

Somatosensory evoked potentials (SSEP)

Brainstem auditory evoked responses (BAER)

Motor evoked potentials (MEP)

Visual evoked potentials (VEP)

  1. Clinical EEG
    1. Basic EEG Patterns From Prematurity to Senescence
      1. Maturational changes
        1. Neonatal
        2. Other age related changes
      2. Normal variants
      3. Normal adult patterns-wake
      4. Activation procedures
    2. Clinical Correlation
      1. Seizures
      2. Other paroxysmal and transient conditions
      3. Brain death
      4. Focal lesions
      5. Diffuse and multifocal encephalopathies
      6. Coma
      7. Patterns of uncertain significance
      8. Drug and other treatment effects
      9. Disorders affecting sleep patterns
      10. Neonatal disorders
      11. Periodic patterns
    3. Sleep
      1. Physiology
      2. Instrumentation
      3. Clinical
  2. Clinical Evoked Potentials
    1. Visual
      1. Physiological parameters
      2. Stimulus and recording techniques
      3. Standard parameters of stimulation and recording
      4. Clinical correlation
      5. Criteria of abnormality
    2. Auditory
      1. Stimulus and recording techniques
      2. Physiological parameters
      3. Standard parameters of stimulation and recording
      4. Criteria of abnormality
    3. Somatosensory
      1. Stimulus and recording
      2. Physiological parameters
      3. Standard parameters of stimulation and recording
      4. Criteria of abnormality
      5. Clinical correlation
    4. Event related
      1. Stimulus and recording techniques
      2. Physiological parameters
      3. Standard parameters of stimulation and recording
      4. Criteria of abnormality
      5. Clinical correlation
  3. Sleep
    1. Technical, polysomnography
      1. Selection of appropriate recorded variables
        1. Neonates and children
        2. Adults
      2. Recording parameters for different variables
      3. Recording respiration
      4. Artifacts
    2. Physiology
      1. Sleep stage criteria
        1. Neonates and children
        2. Adults
      2. Patterns of drowsiness and sleep
        1. Neonates
        2. Children, adults, elderly
      3. Sleep indices criteria
      4. Normal sleep architecture
      5. Normal EEG patterns of drowsiness in children, adults and elderly
      6. Neural and neurochemical control of sleep patterns
      7. Circadian rhythms and sleep
      8. Effects of sleep deprivation, sleep needs
    3. Clinical aspects
      1. Effect on epileptiform activity and seizures
        1. Neonates and children
        2. Adults
      2. Effects of drugs on sleep architecture
      3. Common parasomnias
      4. Criteria of abnormal sleep architecture
      5. Disorders of excessive somnolence
        1. Multiple sleep latency testing in diagnosis
        2. Polysomnographic testing in diagnosis
      6. Indications for sleep monitoring
      7. Disorders of initiation and maintenance of sleep
      8. Abnormalities of sleep in CNS disease
  4. Intraoperative Monitoring
    1. Motor evoked potential monitoring for spinal cord surgery
    2. SEP monitoring for spinal cord, brainstem and cerebral surgery
    3. BAEP monitoring techniques for eighth nerve and brainstem surgery
    4. EEG monitoring for cerebral surgery
    5. Criteria for decision making
    6. Cranial nerve monitoring

VI. Epilepsy

    1. Applications and limitations of ambulatory EEG monitoring
    2. Applications and limitations of video/EEG monitoring
    3. Recognition of ictal patterns
    4. Correlation of EEG patterns with clinical syndromes