Neurophysiology Diagnostics for Health Care Providers
Neurophysiology diagnostics play a crucial role in various clinical pathways for patients dealing with issues affecting the brain, nervous system, and muscles. The significant contribution of clinical neurophysiology services is evident throughout end-to-end patient pathways.
Clinical Applications of Neurophysiological Investigations
Nerve Conduction Studies (NCS):
- These studies involve the electrical stimulation of peripheral nerves, recording responses from nerves and muscles.
- They are utilized to investigate conditions such as focal neuropathies (e.g., carpal tunnel syndrome) causing numbness, tingling, and pain in the limbs.
Electromyography (EMG):
- EMG is employed to explore the causes of muscle weakness and various disorders affecting the nervous system. Combining EMG and NCS enhances diagnostic accuracy.
Evoked Potential Studies (EPS) – Visual (VEP), Auditory (AEP), Somatosensory (SSEP):
- Evoked potentials are brain responses to specific stimuli like flashing lights or sounds.
- Chemodenervation with Botulinum toxin under EMG guidance is used for conditions like blepharospasm, hemifacial spasm, spasmodic torticollis, and writer’s cramp.
Repetitive Nerve Stimulation Study and Single Fiber EMG:
- These are conducted for myasthenia gravis and Eaton–Lambert syndrome, along with other paraneoplastic syndromes.
- Electro Retinography (ERG):
- ERG evaluates various retinopathies.
Video-Electroencephalogram (EEG):
- EEG provides an electrophysiological assessment of epilepsy and consideration of non-epileptic episodes (e.g., breath-holding spells, syncope, inattention). It also aids in identifying acute symptomatic causes for seizures (stroke, CNS infection, head trauma, metabolic disturbances). The addition of online artifact elimination and spike-detection applications enhances diagnostic accuracy by isolating epileptiform activity from the background rhythm.