Situated with physiological measurements on the ground floor at Grimsby hospital clinical neurophysiology is an allied specialty to neurology, with close associations with all neuroscience departments. The service is led by nationally renowned physiologists and is part of the Clinical Support Services directorate.
The department provides multimodality investigations for both outpatients and inpatients across the Trust in addition to teaching and training of trainee students to achieve examination success. The service is also supported by consultant neurophysiologists.
Referrals are received from a variety of medical specialties such as paediatrics, orthopaedics, rheumatology, general medicine and mental health.
It is primarily an investigative speciality; using computer, electrical, magnetic and electronic means of recording the function of the brain, spinal cord, spinal roots, peripheral nerves and muscle to diagnose disorders of the function of the nervous system. Investigations are also carried out as a measure of therapeutic monitoring and are carried out on patients of all ages, from neonates to the elderly. The specialty of Neurophysiology covers 3 main areas:
1. Electroencephalogram (EEG). This is a recording of the electrical activity of the brain. It is obtained by placing small discs on the scalp with paste and is used to investigate various conditions, including epilepsy, cerebrovascular disease (CVD), intracranial infections, metabolic disorders, dementia and other neurodegenerative disorders.
2. Evoked Potentials which encompasses 3 main sub-sections
(a) Visual evoked potential (VEP). This records the response from the visual pathway between the eye and the brain, in response to a pattern or flashing light. It is used to diagnose some neurological disorders such as MS or optic nerve disorders
(b) Brainstem auditory evoked potentials (BSAEP). This records the electrical activity of the brain in response to auditory stimuli such as clicks, which are presented from a set of headphones placed over the ears.
(c) Somatosensory evoked potentials (SSEP). This test records the response of the brain in response to short electrical impulses which are administered over a nerve in the arm or leg. Patients experience a tapping or pulsing sensation from these impulses. These tests will be used to aid the diagnosis of demyelinating disorders.
3. Nerve conduction studies (NCS) and Electromyography (EMG). Both of these tests assess the function of the sensory/motor nerve fibres and the muscles of the body. The NCS is obtained by placing small rings or pads on the skin which results in a tapping/tingling sensation or a twitch when a stimulus is introduced. The EMG is concerned with measuring the integrity of the muscles and the nerve-muscle junction. It is obtained by inserting a very fine needle into the muscle. These investigations are used to diagnose a variety of conditions including carpal tunnel syndrome, peripheral neuropathies, Bells’ palsy, motor neurone disease and myasthenia gravis.