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.
