What is Clinical Neurophysiology

Clinical Neurophysiology is an allied specialty to Neurology and it involves the diagnosis of a wide range of conditions affecting central and peripheral nervous system. It is concerned with the testing of the electrical function of the brain, spinal cord, and nerves in the limbs and muscles.

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Neurophysiology tests are being utilised in patient pathways and management decisions within the hospitals for a variety of specialties including neurology, neurosurgery, orthopaedics, paediatrics, ophthalmology, rheumatology and ICU.

The common tests performed in neurophysiology lab involves electroencephalogram (EEG), nerve conduction studies (NCS), electromyography (EMG). Specialized tests include:

Video telemetry: It is a specialised study comprising of EEG and video recording and this is essential for epileptic work up. The need for complete evaluation of interictal and ictal EEG abnormalities and matching with clinical semiology and the focal lesion is absolutely essential for the success of the epilepsy surgery.

Evoked potentials: It is used to test central pathways, e.g. Multiple Sclerosis

Sleep studies: It is a very important tool in the diagnosis of sleep disorders including Obstructive sleep apnea (OSA).

Repetitive stimulation & Single fibre EMG: Essential for diagnosis of Myasthenia Gravis which is a neuromuscular junction transmission dysfunction.

Intra-operative monitoring: Tests performed during spinal cord surgeries to help assess the integrity of the cord during the operation and augments safety during spinal cord surgeries

Electrocorticography (ECOG): Electrophysiological monitoring that uses electrodes placed directly on the exposed surface of the brain to record electrical activity from the cerebral cortex during epilepsy surgeries. Useful for identification of lesion and effective resection

Patients with the following conditions will most likely require clinical neurophysiology tests,

  • Neuropathy in patients with Diabetes Mellitus
  • Epilepsies
  • Neuromuscular disorders
  • Connective tissue diseases
  • Sleep disorders
  • Carpal Tunnel Syndrome
  • Radiculopathy

Our department is a comprehensive diagnostic centre offering routine and specialised neurophysiology services for early detection, prompt diagnosis, and treatment to maximise the quality of life and wellbeing. We cater to adult and paediatric age groups. The workforce includes highly skilled doctors and technicians who offer world class diagnostic procedures which are essential in the management of various neurological conditions.Our mission is patient centred high-quality services resulting in a better experience and accurate diagnosis for patients.

Article by Dr Bhuvaneshwari Rajendran
Consultant, Clinical Neurophysiology and Neurosciences
Kauvery Hospital

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