Neuro-Electro-Diagnostic Laboratories and Epilepsy Center

Scope of Service

Neuro-Electro-Diagnostic Laboratories and Epilepsy Center are performing the following services:

Electroencephalography (EEG) test is a record of fluctuations of electrical activity in the brain recorded from the surface of the scalp. It is used foremost for diagnosis of cerebral dysfunction caused by epilepsy, cerebral inflammatory processes, cerebrovascular disorders, dementia, degenerative disorders of the central nervous system (CNS), infantile brain damage and cerebral palsy, craniocerebral trauma, metabolic CNS disorders, cerebral anoxia. This test is also used in diagnosis of coma and brain death.

Electromyography (EMG) test, in which a small needle is inserted into a muscle to record its electrical activity, is employed to evaluate suspected neuromuscular disorders and to provide an objective measure of pathophysiological changes. The nerve conduction velocity (NCV) test is usually associated with the EMG test. EMG tests are widely used for diagnosis of peripheral neuropathies associated with muscular dystrophies, diabetes, diseases of the autonomic nervous system, etc.

Evoked potentials (EP) tests investigate the integrity of neural pathways carrying electrical signals from the sensory organs to the brain and are used in the diagnosis of disorders of the nervous system to locate the site of nerve damage. Evoked Potentials Laboratory performs three following major EP tests: brainstem auditory evoked potentials (BAEP), visual evoked potentials (VEP), and somatosensory evoked potentials (SEP) of upper (SUEP) and lower (SLEP) extremities.
 

Auditory evoked potentials (BAEP) is a method of non-invasive investigation of cochlea-auditory nerve-brain stem pathways. It is clinically useful for diagnosing of cerebellopontine angle tumors and diseases affecting the brain stem.   Visual evoked potential method allows electrophysiological study of visual system by recording surface evoked potentials from the eye or scalp. Retinal potentials evoked by visual stimuli constitute the electroretinograms (ERGs), whereas potentials recorded from scalp comprise the visual evoked potentials (VEPs). VEPs are a useful tool helping in diagnosis of multiple sclerosis, Parkinson's disease, chiasmic compression, optic atrophy, etc.   Somatosensory evoked potentials (SEP) study the response elicited by electrical stimulation of mixed motor or sensory peripheral nerves. SEP assist in neurological diagnosis by identifying lesions(s) in the somatosensory pathways and useful for diagnosis of multiple sclerosis, leukodystrophies, peripheral nerve disorders, brachial plexopathy, cervical spondylosis. SEPs are used in evaluation of spinal cord traumas and head injuries.
 
Transcranial Doppler (TCD) is a diagnostic procedure designed to test of integrity of the blood circulation in the brain. This technique allows the ultrasound observation of the function of brain arteries.

Video-EEG monitoring is the prolonged monitoring of EEG activity combined with simultaneous video recording of clinical behavior under conditions that can approximate normal daily activities of the patient. It helps in management of neurological patients, aiding in the differential diagnosis of types of "attacks"(physical or psychological in origin); seizure types; neurological and behavioral disorders in children and adults; evaluation of sleep disorders including sleep apnea, which may lead to sudden death syndrome.

Intraoperative Monitoring of EEG, EMG and EPs during the surgery provides objective information about anesthetized patient. It gives the surgeon immediate feedback of signs of impending risk. The intra-operative monitoring of peripheral nerves, spinal cord, brainstem, optic nerves and cerebral cortex helps to identify new neurological impairment and allows prompt correction of the cause. It helps the surgeon during the course of the operation to feel comfortable with a greater degree of surgical intervention than he/she would in the absence of monitoring. It also provides prompt identification of new systemic impairment such as anoxia or hypotension.

  Locations: University Hospital G-118, G-120, G-122,
Hours:         Inpatient: 8:00 a.m. - 4:30 p.m., Monday - Friday
                     Last appointment, 1.5 hr. prior to closing Outpatient: 9:30 a.m. - 4:30 p.m., last appointment at 2:00 p.m. Contact: Department Manager 972-6494

Scheduling/Referral procedure

EEG Senior Neurophysiology Technologist 972-6465
Evoked Potentials Neurophysiology Technologist 972-6467
EMG Neurophysiology Technologist 972-5863
Video-EEG Nurse Clinician 972-0570
TCD Clinical Nurse Specialist 972-0571
Intraoperative monitoring Department Manager 972-6494
FAX: 972-7440

Inpatient: EEG orders written on the Neurology Electroencephalogram request form (#UH-6523, available on the nursing unit) are sent to the Neuro-Electro-Diagnostic Laboratories by fax, delivered to the UH G-118, or called in. Requests received in the morning are usually scheduled in the afternoon. Request received in the afternoon are usually scheduled for the next working day.

Evoked Potentials orders written on the request form (#UH-5982, available on the nursing unit) are sent to the Neuro-Electro-Diagnostic Laboratories by fax, delivered to the UH G-118, or called in. Requests received in the morning are usually scheduled in the afternoon. Request received in the afternoon are usually scheduled for the next working day.

EMG orders written on the request form (#UH-2608, available on the nursing unit) are sent to the Neuro-Electro-Diagnostic Laboratories by fax, delivered to the UH G-118, or called in.

Video-EEG orders written on the chart should be approved by physician epileptologist and are called in.

TCD orders written on the chart are called in.

Intraoperative monitoring orders are called in.

Outpatient: EEG orders written on the Electroencephalogram request form (#UH-6523, available through general stores) are sent to the Neuro-Electro-Diagnostic Laboratories by fax, delivered to the UH G-118, or called in. The request form should include: patient name, phone number and/or address, diagnosis, prescribed pharmaceuticals, referring physician’s name and phone number and/or address. Patients are generally scheduled within one-week time from referral. Please indicate on the referral if scheduling is required immediately.

Evoked Potentials orders written on the request form (#UH-5982, available through general stores) are sent to the Neuro-Electro-Diagnostic Laboratories by fax, delivered to the UH G-118, or called in. The request form should include: patient name, phone number and/or address, diagnosis, prescribed pharmaceuticals, referring physician’s name and phone number and/or address. Patients are generally scheduled within one-week time from referral. Please indicate on the referral if scheduling is required immediately.

EMG orders written on the request form (#UH-2608, available through general stores) are sent to the Neuro-Electro-Diagnostic Laboratories by fax, delivered to the UH G-118, or called in. The request form should include: patient name, phone number and/or address, diagnosis, prescribed pharmaceuticals, referring physician’s name and phone number and/or address. Patients are generally scheduled within one-week time from referral. Please indicate on the referral if scheduling is required immediately.

Video-EEG orders are called in.

TCD orders are called in.

Intraoperative monitoring orders are called in.

Patients referred for neurodiagnostic tests should receive following information:

Electroencephalography (EEG)

The EEG is a time consuming test; the average procedure usually takes about 1.5 hour, but may run longer.   We recommend that patients be advised to wash their hair night prior to the test, use of hair oils and hair sprays should be avoided, braids and other types of elaborate hairdo should be undone before the test. Patient’s hair should not be wet before this test. Additionally, a patient should bring a comb, and a hat or a scarf, since their hair will be messed up after the test. Furthermore, patients should be advised that the EEG test could take considerable amount of time, for children test’ duration may be up to three hours, or more.

 

Evoked Potentials We recommend that patients be advised to wash their hair prior to the test, use of hair oils and hair sprays should be avoided, braids and other types of elaborate hairdo should be undone before the test. Patient’s hair should not be wet before this test. Additionally, a patient should bring a comb, and a hat or a scarf, since their hair will be messed up after the test. Furthermore, patients should be advised that this test could take considerable amount of time, for children test’ duration may be up to three hours, or more. Electromyography (EMG) The EMG test may be painful for a patient; light doses of sedative could be prescribed before or during the test. In these cases a family member should accompany a patient. Video-EEG The Video-EEG monitoring may be requested only after a patient was evaluated by an epileptologist. A patient should be advised that this test could take considerable amount of time up to 24 hours or longer. Transcranial Doppler (TCD)

Intra-Operative Monitoring

Only a surgeon may request intraoperative monitoring.

Result Reporting

Inpatient: Test reports signed by a physician are send to Medical Records within week after a test is performed. Oral report of test results is available on the same day, if necessary.

Outpatient: Copies of test reports, signed by a physician, are faxed or mailed to the referring physician within week after a test is performed. The original reports are sent to Medical Records.