The intensive physical regimen followed by throwers and archers can impose stress on the elbow and hand in particular positions, which may increase the risk of developing peripheral nerve disorders and symptoms like pain...The intensive physical regimen followed by throwers and archers can impose stress on the elbow and hand in particular positions, which may increase the risk of developing peripheral nerve disorders and symptoms like pain and numbness. The purpose of the study is to investigate the effect of forearm and elbow joint positions on ulnar nerve conduction velocity in throwers, archers, and non-athletes. Total 34 subjects both males and females were included with body mass index (BMI) between 18.5 and 24.9 kg/m. Nerve conduction study (NeuroStim NS2 EMG/NCV/EP System) was used for measuring ulnar nerve conduction velocity (NCV) across elbow joint at different angles (0° elbow extension, 45°, 90°, and 120° elbow flexion) with different forearm positions. Repeated Measure Analysis of Variance (RMANOVA) revealed that there was a statistically significant difference in mean values of ulnar NCV at different angles, forearm positions & groups (p < .05). The forearm and elbow positions can have a significant impact on ulnar NCV, especially in athletes who perform repetitive upper limb motions. Results showed that the archers had significantly slower NCV than throwers and non-athletes at 90° of elbow flexion and forearm pronation.
Limited access to EEG services in rural areas creates health disparities in neurological care, including unnecessary transfers and delays in diagnosis and treatment. Rural facilities face several challenges to expanding...Limited access to EEG services in rural areas creates health disparities in neurological care, including unnecessary transfers and delays in diagnosis and treatment. Rural facilities face several challenges to expanding EEG resources, including a lack of neurologists, technologists, EEG equipment, and adequate IT infrastructure. Potential solutions include investment in innovative technology, expansion of the workforce, and development of hub-and-spoke EEG networks. Bridging the EEG gap requires collaboration between academic and community practices to advance practical technologies, train competent personnel and develop cost-effective resource-sharing strategies.
Advocacy should be thought of as a permanent part of recognition efforts during Neurodiagnostic Week (April 16-22, 2023) for Neurodiagnostic professionals. It is the perfect opportunity to engage in advocacy and educate...Advocacy should be thought of as a permanent part of recognition efforts during Neurodiagnostic Week (April 16-22, 2023) for Neurodiagnostic professionals. It is the perfect opportunity to engage in advocacy and educate others on the importance of using well qualified Neurodiagnostic Technologists to perform neurodiagnostic procedures. Why is advocacy important? Because there is strength in numbers and constituent voices matter. If Neurodiagnostic Technologists do not advocate for the profession and educate decision makers, legislators, and the public about the importance of professional competency in Neurodiagnostics, no one else will. Advocacy works and is a critical part of moving the profession forward to ensure that lawmakers and policy understand that those performing the procedures should be the best qualified professionals to do so.
López JR, Ahn-Ewing J, Emerson R
… +17 more, Ford C, Gale C, Gertsch JH, Hewitt L, Husain A, Kelly L, Kincaid J, Kise M, Kornegay A, Moreira JJ, Nuwer M, Schneider A, Stecker M, Sullivan LR, Toleikis JR, Wall L, Herman S
The Guidelines for Qualifications of Neurodiagnostic Personnel (QNP) document has been created through the collaboration of the American Clinical Neurophysiology Society (ACNS), the American Society of Neurophysiological...The Guidelines for Qualifications of Neurodiagnostic Personnel (QNP) document has been created through the collaboration of the American Clinical Neurophysiology Society (ACNS), the American Society of Neurophysiological Monitoring (ASNM), the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), and ASET - The Neurodiagnostic Society (ASET). The quality of patient care is optimized when neurophysiological procedures are performed and interpreted by appropriately trained and qualified practitioners at every level. These Societies recognize that Neurodiagnostics is a large field with practitioners who have entered the field through a variety of training paths. This document suggests job titles, associated job responsibilities, and the recommended levels of education, certification, experience, and ongoing education appropriate for each job. This is important because of the growth and development of standardized training programs, board certifications, and continuing education in recent years. This document matches training, education, and credentials to the various tasks required for performing and interpreting Neurodiagnostic procedures. This document does not intend to restrict the practice of those already working in Neurodiagnostics. It represents recommendations of these Societies with the understanding that federal, state, and local regulations, as well as individual hospital bylaws, supersede these recommendations. As Neurodiagnostics is a growing and dynamic field, we fully intend this document to change over time.
Electroencepholography (EEG) is the oldest and original brain measurement technology. Since EEG was first used in clinical settings, the role of neurodiagnostic professionals has focused on two principal tasks that requi...Electroencepholography (EEG) is the oldest and original brain measurement technology. Since EEG was first used in clinical settings, the role of neurodiagnostic professionals has focused on two principal tasks that require specialized training. These include collecting the EEG recording, performed primarily by EEG Technologists, and interpreting the recording, generally done by physicians with proper specialization. Emerging technology appears to enable non-specialists to contribute to these tasks. Neurotechnologists may feel vulnerable to being displaced by new technology. A similar shift occurred in the last century when human "computers," employed to perform repetitive calculations needed to solve complex mathematics for the Manhattan and Apollo Projects, were displaced by new electronic computing machines. Many human "computers" seized on the opportunity created by the new computing technology to become the first computer programmers and create the new field of computer science. That transition offers insights for the future of neurodiagnostics. From its inception, neurodiagnostics has been an information processing discipline. Advances in dynamical systems theory, cognitive neuroscience, and biomedical informatics have created an opportunity for neurodiagnostic professionals to help create a new science of functional brain monitoring. A new generation of advanced neurodiagnostic professionals that bring together knowledge and skills in clinical neuroscience and biomedical informatics will benefit psychiatry, neurology, and precision healthcare, lead to preventive brain health through the lifespan, and lead the establishment of a new science of clinical neuroinformatics.
Epilepsy syndromes are defined either by a specific set of symptoms or by the area of the brain where the seizures originate. Some of the symptoms include types of seizures and age of seizure onset. Other symptoms includ...Epilepsy syndromes are defined either by a specific set of symptoms or by the area of the brain where the seizures originate. Some of the symptoms include types of seizures and age of seizure onset. Other symptoms include the frequency and severity of the seizures and the time of day in which they occur. Epilepsy syndromes are likely to be present at birth or appear during childhood. The treatment for childhood epilepsy syndromes may include medication, diet therapy, nerve stimulation, or surgery.
Neuromonitoring is commonly used in neurosurgery and allows intraoperative assessment of functional pathways in the brain during surgery. Monitoring alerts can guide surgical decision making in real-time allowing surgeon...Neuromonitoring is commonly used in neurosurgery and allows intraoperative assessment of functional pathways in the brain during surgery. Monitoring alerts can guide surgical decision making in real-time allowing surgeons to mitigate or avoid potential iatrogenic injury and subsequent postoperative neurologic sequelae that may result from cerebral ischemia or malperfusion. Here we present a case of a patient undergoing a right pterional craniotomy for the resection of a tumor which crosses midline with multimodal intraoperative neuromonitoring including somatosensory evoked potentials, transcranial motor evoked potentials, and visual evoked potentials. During the final portion of tumor resection, arterial bleeding was noted of unknown origin shortly followed by loss of right lower extremity motor evoked potential recordings. Motor evoked potential recordings in the right upper, and left upper and lower extremities were stable, as well as all somatosensory evoked potentials and visual evoked potentials. This distinct pattern of right lower extremity motor-evoked potential loss suggested compromise of the contralateral anterior cerebral artery and guided the surgeons to a rapid intervention. The patient awoke from surgery with moderate postoperative weakness in the affected limb that resolved to preoperative status by postoperative day 2, and back to normal strength prior to three-month follow-up. In this case the neuromonitoring data suggested compromise to the contralateral anterior cerebral artery which guided the surgeons to investigate and identify the site of vascular injury. The present case reinforces the utility of neuromonitoring in emergent surgical situations to guide surgical decision making.
A case is described where baseline transcranial electrical motor evoked potentials (TcMEP) and somatosensory evoked potentials (SSEP) results were unilaterally absent in a patient with previous hemispheric stroke undergo...A case is described where baseline transcranial electrical motor evoked potentials (TcMEP) and somatosensory evoked potentials (SSEP) results were unilaterally absent in a patient with previous hemispheric stroke undergoing a right-sided carotid endarterectomy. SSEP data confirmed right cortical pathology and excluded a technical rationale for absent motor evoked responses. Attempts at generating left-hand (contralateral) TcMEP from right cortical anodal stimulation failed despite high stimulus intensities. However, TcMEP responses from anodal stimulation of the right cortex were recorded from the right-hand (ipsilateral) which were attributed to "crossover." Ipsilateral TcMEP onset latencies derived from the stimulus-response data supports the idea that crossover is a product of cathodal stimulation initially acting on pericortical motor pathways.
Medically refractory seizures affect one-third of patients with epilepsy (PwE), for whom epilepsy surgery is considered. Video electroencephalography (vEEG) monitoring is a fundamental tool for pre-operative seizure loca...Medically refractory seizures affect one-third of patients with epilepsy (PwE), for whom epilepsy surgery is considered. Video electroencephalography (vEEG) monitoring is a fundamental tool for pre-operative seizure localization. Facial and cranial myogenic artifacts can obscure vEEG findings, thus interfering with seizure localization. Studies have shown the beneficial effects of botulinum toxin type A (BTX-A) injection into cranial muscles for reducing myogenic artifacts. This longitudinal study aimed to assess the effects of BTX-A injection on these artifacts. Twenty-two patients with medically refractory hypermotor seizures with daily seizure frequency and undetermined epilepsy localization were included in this study and underwent Dysport® injection (200 units) into the frontotemporal region. vEEG recordings were performed at baseline (one week before the injection), and at three days and six days post-injection. Before and after the injection, the amplitudes of myogenic artifacts were compared during various states (ictal, blinking, chewing, bruxism, head lateralization, scowling, talking, and yawning). BTX-A injection significantly reduced the amplitudes of EEG myogenic artifacts, except during blinking (day three) and talking (days three and six). On day six, significant reduction in EEG myogenic artifacts were noted during blinking, chewing, and bruxism for the greatest number of patients (95.5%, 90.9%, 81.8%), while significant reductions in EEG myogenic artifacts during talking, head lateralization, and ictal phase were associated with the least number of patients (22.7%, 36.3%, and 40.9%). Therefore, BTX-A injection could be a convenient method for filtering myogenic contamination, improving EEG interpretation, and facilitating seizure localization in patients with medically refractory seizures.