Marshall F Wilkinson, Joseph Silvaggio, Anthony Kaufmann
{"title":"Cathodal Genesis of Ipsilateral Hand (Crossover) Motor Evoked Potentials: Evidence from a Patient with Previous Stroke.","authors":"Marshall F Wilkinson, Joseph Silvaggio, Anthony Kaufmann","doi":"10.1080/21646821.2023.2178807","DOIUrl":"https://doi.org/10.1080/21646821.2023.2178807","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 2","pages":"149-155"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9636238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"<b>Kathleen Mears Memorial Lecture:</b> Telehealth - \"This Is the Way\".","authors":"Ryan R Lau","doi":"10.1080/21646821.2023.2210060","DOIUrl":"https://doi.org/10.1080/21646821.2023.2210060","url":null,"abstract":"I was surprised to be contacted last year by Linda Kelly to invite me to give the Kathleen Mears Memorial Lecture at the 2022 ASET meeting in Louisville, KY! I thought to myself, am I really that old or accomplished?! I did not initially think so; however, she felt my experience in telehealth would be of great education and benefit to ASET and the neurodiagnostic community, given the historic circumstances that occurred on March 11th, 2020. In case you forgot, that day changed everything. It was the day that the World Health Organization (WHO) declared that COVID-19 could be characterized as a pandemic (WHO 2020). Strangely, you may ask yourself, has it really been that long? Has it been over three years now that we remain in this pandemic? Yes! The reality is that what we lived and continue to endure is something out of a movie. We wore (and some continue to wear) N95 masks, dealt with toilet paper shortages, sweatpants living, and full-blown hospital and house lockups! Let me digress back to the importance of this article. I am truly humbled to be bestowed with the honor and privilege to present this lecture and write this article.","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 2","pages":"131-148"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9862127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neonate, Infant, Childhood, and Adolescent Epilepsy Syndromes.","authors":"Walt Banoczi","doi":"10.1080/21646821.2023.2172951","DOIUrl":"https://doi.org/10.1080/21646821.2023.2172951","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 1","pages":"58-93"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9269412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Technical Tips: Advocacy: A Cornerstone of Advancing the Interests of the Profession.","authors":"Jennifer Montgomery","doi":"10.1080/21646821.2023.2183013","DOIUrl":"https://doi.org/10.1080/21646821.2023.2183013","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 1","pages":"94-101"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9318005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jaime R López, Judy Ahn-Ewing, Ron Emerson, Carrie Ford, Clare Gale, Jeffery H Gertsch, Lillian Hewitt, Aatif Husain, Linda Kelly, John Kincaid, Meledy Kise, Adam Kornegay, Joseph J Moreira, Marc Nuwer, Anita Schneider, Mark Stecker, Lucy R Sullivan, J Richard Toleikis, Lois Wall, Susan Herman
{"title":"Guidelines for Qualifications of Neurodiagnostic Personnel: A Joint Position Statement of the American Clinical Neurophysiology Society, the American Association of Neuromuscular & Electrodiagnostic Medicine, the American Society of Neurophysiological Monitoring, and ASET - The Neurodiagnostic Society.","authors":"Jaime R López, Judy Ahn-Ewing, Ron Emerson, Carrie Ford, Clare Gale, Jeffery H Gertsch, Lillian Hewitt, Aatif Husain, Linda Kelly, John Kincaid, Meledy Kise, Adam Kornegay, Joseph J Moreira, Marc Nuwer, Anita Schneider, Mark Stecker, Lucy R Sullivan, J Richard Toleikis, Lois Wall, Susan Herman","doi":"10.1080/21646821.2023.2183008","DOIUrl":"10.1080/21646821.2023.2183008","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 1","pages":"14-46"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9318003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Justin W Silverstein, Harshal A Shah, Jason A Ellis, Randy S D'Amico
{"title":"Neuromonitoring Guided Vessel Identification in Iatrogenic Arterial Injury During Meningioma Resection.","authors":"Justin W Silverstein, Harshal A Shah, Jason A Ellis, Randy S D'Amico","doi":"10.1080/21646821.2023.2168971","DOIUrl":"https://doi.org/10.1080/21646821.2023.2168971","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 1","pages":"47-57"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9263022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"<b>Ellen R. Grass Lecture:</b> The Future of Neurodiagnostics and Emergence of a New Science.","authors":"William J Bosl","doi":"10.1080/21646821.2023.2183012","DOIUrl":"https://doi.org/10.1080/21646821.2023.2183012","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9618893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}