Electroneurodiagnostic technology is the scientific field
devoted to the recording and study of electrical activity of the
brain and nervous system. Used for medical
evaluation and research, it includes procedures that access the
function of the nervous system.
Technologists record electrical activity arising from the brain,
spinal cord, peripheral nerves, or somatosensory systems using a
variety of techniques and equipment. Technologists also
prepare the patients for procedures, record electrical potentials,
obtain medical histories, calculate results, and maintain
equipment. They work with specially-trained physicians who
interpret the data and provide clinical impressions.
Electroencephalogram
(EEG)
An EEG records the electrical activity of the brain. Highly
sensitive monitoring equipment records the activity through
electrodes that are placed at measured intervals on a patient's
scalp. The test is not painful. The head is measured
and the electrodes are placed on the scalp with a paste-like
substance.
The test itself usually takes about 90 minutes, and the
principal role of the patient is simply to remain still, relaxed
and comfortable. During the test, the patient may be asked to
take repeated deep breaths (hyperventilate) and may be shown a
strobe light that flashes at different speeds. Both
activities can help reveal different brain patterns that are useful
for diagnosis. Sometimes, physicians also want to observe
brain patterns that occur during sleep.
For sleep tests, the patient may be asked to stay awake most of
the night prior to the EEG appointment or, in some cases, may be
given a mild sedative. EEGs assist physicians in the
diagnosis of a variety of neurological problems, from common
headaches and dizziness to seizure disorders, strokes, and
degenerative brain disease. The EEG is also used to look for
organic causes of psychiatric symptoms and disabilities in children
and can assist physicians in determining irreversible brain
death.
Intraoperative
Monitoring
Sometimes, patients having surgery on arteries in the neck or
around the heart will have EEG monitoring throughout the time they
are in the operating room. This provides the surgeon with
additional information about brain function during the surgery.
Long-Term Epilepsy
Monitoring
Long-term monitoring is the simultaneous recording of EEG and
videotaped behavior over extended periods of time. It is
useful in diagnosing patients with intermittent or infrequent
disturbances. These lengthy tests are performed in the lab,
using special computers.
Evoked Potentials
(EP)
The EP is a recording of electrical activity from the brain, spinal
nerves or sensory receptors in response to specific external
stimulation. Electrodes are applied to the scalp and other
areas of the body, a series of stimuli is introduced, and a
computer records the neurological responses.
Hundreds of responses are received, amplified and averaged by a
computer. The final response is plotted on a graph and
interpreted by a physician who looks for particular waveforms and
the time it takes them to occur.
Evoked potentials are helpful in evaluating a number of
different neurological problems, including spinal cord injuries,
acoustic neuroma and optic neuritis. Each type of EP looks at
a different neurological pathway. The most common types are
listed below:
- Auditory: The BAEP assists in evaluating the auditory
nerve pathways from the ears through the brainstem. Earphones
deliver a series of clicks or tones to each ear separately.
- Visual: VEPs evaluate the visual nervous system from
the eyes to the occipital (visual) cortex of the brain. The
patient is usually asked to stare at a pattern on a video screen
while remaining fully alert. Each eye is tested
separately.
- Somatosensory: SSEPs assess pathways from nerves in
the arms or legs, through the spinal cord, to the brainstem or
cerebral cortex. A small electrical current is applied to the
skin overlying nerves on the arms or legs. The current
creates a tingling sensation, but is not painful. Each leg or
arm is tested separately.
- Intraoperative Monitoring: Evoked potentials are
sometimes used to assess nerve function during surgical procedures
involving the spinal cord or brain. The technologist is
responsible for monitoring this information and providing a
technical description to the surgeon to allow him/her to make
changes to avert any permanent damage to the patient?s
function.
24-Hour Ambulatory
EEG
The ambulatory EEG records brain activity for 24 hours on
a small tape recorder that is worn around the waist.
Electrodes are applied to the scalp with a glue-like substance, and
the patient is sent home with a diary to record activities and any
symptoms during the next 24 hours.
Polysomnograms (PSG)
A PSG is a recording during sleep that
uses EEG and other physiologic measures to evaluate sleep
disorders. Patients usually spend one or two nights in the
lab being monitored. A technologist records various
information for interpretation by a special physician.
The test is used to help evaluate patients who experience
excessive sleepiness during the day or who have trouble falling
asleep or staying asleep at night. Three common sleep
disorders are sleep apnea, insomnia, and narcolepsy.
Nerve Conduction Studies
(NCS)
Nerve Conduction Studies are performed by placing surface
electrodes over a particular nerve, or a muscle innervated by that
nerve, and using electrical stimulation to activate the
nerve. When the nerve is stimulated, the patient feels a
tingling sensation.
The data collected is evaluated by a physician specializing in
electrodiagnostic medicine. Patients referred for NCS tests
suffer from nerve conditions which produce numbness, tingling, pain
or loss of sensation, or neurological diseases affecting primarily
the peripheral nervous system.