Neurophysiology

Union Hospital's Neurophysiology department performs diagnostic exams for patients ranging from neonatal to a geriatric level. The services we provide are:

EEG

EMG

Evokes Potentials

MSLT

These services are available on an outpatient basis as well as those who are inpatients and emergency room status.

Neurophysiology is staffed Monday through Friday 7:00 a.m. to 4:30 p.m. The department is closed on weekends and holidays. Staff members are on call for emergency or stat situations after hours, weekends, and holidays. Those situations include suspected brain death, status epilepticus (seizures not visibly seen), multiple seizures, and new onset of seizures in a pediatric patient.

Routine procedures are performed in a dark, quiet exam room. Those patients in intensive care are done at the bedside.

All exams are interpreted by our highly qualified neurologists who are board certified in neurology.

There are four expertly trained staff members in the department who perform exams.

EXAMS:

EEG

Routine EEG (electroencephalogram) - Twenty six cup electrodes are placed on the patient's head with conductive paste.  Hook-up takes 15-20 minutes.  Recording of the electrical activity lasts 20-30 minutes.  Patients are in the lab for approx. one hour total.  They are required to lay still and try to sleep.  Sedation is sometimes recommended for pediatric patients and those that are restless.

EEG's performed on patients checking for brain death require additional electrodes being applied, more documentation of the patient's surroundings and vital signs, and longer recording time.

We also offer 24 hour EEG recordings.  Those patients come to the lab and have a monitor with twenty electrodes applied with some special adhesive that holds them in place for the full twenty four hours.  The patient is allowed to go home and return the next day for removal.  Ambulatory EEG recordings allow patients to continue their normal activities while wearing the monitor. 

EMG

EMG (electromyogram) and nerve conduction studies are performed by our highly qualified physicians.    These are done on an outpatient basis on Monday, Tuesday, Thursday, and Friday mornings.  Those inpatients requiring evaluation are done at the physician's discretion.

EMG studies are performed on various muscle groups using tiny needle electrodes.  Those muscles tested are based on the patient's symptoms.

Nerve conduction studies are performed on various nerves using electrical stimulation.  Those nerves tested are also based on the patient's symptoms.

Results are interpreted by the physician performing the exam and given to the patient along with recommendations for treatment.  This exam lasts approx. thirty minutes to one hour.

Evoked Potentials

BSER (Brainstem-Auditory Evoked Response) is typically done during normal business hours in the lab.  Four electrodes are applied to the patient's head with conductive paste.  Headphones are placed over the ears.  A loud clicking noise is turned on, one side at a time.  This noise stimulates the brainstem and acoustic nerve.  Waveforms are produced and printed out for the neurologist to interpret.  This exam lasts approx. thirty minutes.

VER (Visual Evoked Response) is performed during normal business hours.  Five electrodes are applied to the patient's head with conductive paste.  Patients are instructed to look at the center of a video display with a checker board pattern on it.  The pattern shifts back and forth, stimulating the nerves in the back of the head.  Waveforms are produced and printed for the neurologist to interpret.  This exam lasts approx. thirty minutes.

SEP (Somatosensory Evoked Response) is performed during normal business hours.  Electrodes are taped on the surface of the skin at different locations (neck, back, and legs), along with three applied to the head.  After hook-up is completed, patients lie on their back in a relaxed position.

Nerves are stimulated in the wrists and ankles using electrical stimulation that is constant, producing a comfortable muscle twitch of the thumbs and great toes.

Waveforms are produced from the recording electrodes on the head and body.  Those are printed for the neurologist to interpret.  This exam takes one to two hours based on how well the patient relaxes and tolerates the stimulation.

MSLT

MSLT (Multiple Sleep Latency Test) is scheduled as an outpatient on Wednesdays.  Patients arrive at 6:15 a.m.   Twenty six cup electrodes are applied using special adhesive that will hold them on all day.

MSLT is a multiple-nap trial to assess the patient's sleepiness and determine the absence or presence of REM (rapid eye movement) sleep.  Timed naps (every two hours) are obtained throughout the day.  Patients are allowed to nap for twenty minutes, and then get up and do an activity to keep them awake (i.e. reading, knitting, etc.). Patients are not allowed to sleep in between naps. 

Breakfast and lunch are available in the hospital cafeteria.

After the final nap, the electrodes are removed using a special solution to dissolve the adhesive.  Patients are typically finished by 4:00 p.m.

One of the neurologists will interpret the exam and forward the results on to your physician.  This exam takes approx. 9.5 - 10 hours.  Patients are NOT allowed to leave the facility during that time.