American Intraoperative Monitoring covers your patients 24/7 with our industry leading Technologists, Neurologists, and Epileptologists.
American Intraoperative Monitoring ' Electroencephalography (EEG) and Evoked Potential (EP) Lab is accredited by the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET), and continues to evolve while remaining the most stringent and competitive in the industry. Our Certification in Long Term Monitoring (CLTM) accreditation is currently pending. Contact us today to find out how our accredited lab can customize a program tailored to your hospital's specific EEG/EMU/LTM needs.
An Electroencephalogram records the electrical activity of the brain.
EEG is used to assist in the diagnosis of epilepsy and a variety of neurological symptoms. EEGs also are used to evaluate the effects of head trauma or the consequences of infections diseases.
During EEG, highly sensitive monitoring equipment records the activity through surface electrodes that are placed at measured intervals on the patient's scalp.
AEEG allows prolonged EEG recording in a residential setting. The ability to record continuously for up to 72 hours increases the changes of recording an ictal event or inter-ictal epileptiform discharges. AEEG is an alternative option to inpatient monitoring. However, can still confirm a clinical suspicion of epilepsy by capturing seizure on the recording.
Uses simultaneous recording of EEG and video recorded clinical correlations over extended periods of time. LTM is useful in diagnosing patients with intermittent or infrequent disturbances as well as in the diagnosis of seizures and other neurological disorders, such as unexplained coma. LTM studies can be performed in Intensive Care Units (ICU) - CEEG and also in an Epilepsy Monitoring Unit (EMU).
Widely used in the critical care setting due to the recognition that a large variety of conditions that are associated with the risk of developing seizures. As most seizure that develop alongside the conditions are non-convulsive, EEG is the only reliable means to detect them and monitor response to treatment. CEEG can be applied in either structural disorders, such as potentially expanding mass lesions, metabolic or physiological disorders, seizures, metabolic encephalopathies and post-anoxic injuries. Additionally, CEEG may also be used in the management of metabolic coma and also a helpful tool in decision making regarding prognosis for cerebral recovery after severe brain injury.
EMU is a specialized unit designed to evaluate, diagnose, and treat seizures in patients of all ages. Recording equipment is used to monitor the brain activity while also recording video and audio to capture clinical changes that are correlating with the changes in brain activity during seizures. The combined approach gives us a greater understanding of the captured seizures than using one technique alone. In the EMU patients are monitored throughout the day and night. The patients stay and length of study may vary, however it usually ranges from three to seven days. The monitoring of these patients by a technologist can be done on-site for quick easy access to the patient, allowing for cognitive testing during events. Or monitoring can be done remotely (off-site) with the assistance and cooperation from the nursing staff.
SEEG is an invasive surgical procedure used to record from and better localize the area of which an already diagnosed epileptic seizure disorder originates. With SEEG depth electrodes are placed within the brain tissue and grid electrodes are placed directly on the cortex. Once the SEEG electrodes are placed in the OR, the patient is then monitored in an ICU or Critical Care setting. EEG recording is monitored in combination with video and audio recordings for best outcomes. The length of study can vary from patient to patient. Following a successful EEG recording of several seizures, language and motor mapping are often performed to help with the prognosis of resection outcomes.
EPs are recordings of electrical activity from the brain, spinal nerves, or sensory receptors in response to specific external stimulation. EPs are helpful in the evaluating a number of different neurological problems, including spinal cord injuries, hearing loss, blurred vision and blind spots. This test can be performed clinically in a laboratory using either earphone stimulation to stimulate the hearing pathway (BAEP), a checkerboard pattern on a television screen to stimulate the visual pathway (VEP), or a small electrical current to stimulate a nerve in the arms and legs (SSEP). Visual Evoked Potentials (VEP): The VEP is a standardized and reproducible test of the optic nerve function. It is more sensitive compare to MRI in detecting lesions affecting the visual pathway in front of the optic chiasm. Even with negative results, VEPs can be useful in excluding certain disorders. Brainstem Auditory Evoked Potential (BAEP): BAEP testing can be used to accurately assess conduction through the brainstem and auditory nerve pathways. BAEPs can also be helpful in the diagnosis of hearing loss, acoustic neuroma, multiple sclerosis, Friedreich's ataxia, hereditary cerebellar ataxia, B2 deficiency and subarachnoid inflammation. Somatosensory Evoked Potential (SSEP): An SSEP test can inform about the presence and extent of a particular disease or injury affecting the somatosensory nerve system. It can also be used to monitor the progression of a neurological disorder.
NCS is used in the evaluation of electrical potentials from peripheral nerves. The technologist stimulates the nerve with an electrical current and then records the amount of time it takes the nerve impulse to actually reach the muscle. The NCS is typically used in conjunction with and EMG study that is performed by a physician.
Autonomic Testing is a series of tests used to help in the diagnosing of autonomic failures and dysfunctions. These tests are a non-invasive procedure that measures the response of the autonomic nervous systems to control and maintain blood pressure, heart rate and sweating. Modalities commonly performed: Quantitative Sudomotor Axon Reflex Test (QSART): QSART evaluates the postganglionic sympathetic cholinergic functions by eliciting both spontaneous and evoked sweat responses. Tilt Table Study: Head-up tilt testing is one of the most important tools used in the evaluation of autonomic dysfunction. The tilting mechanisms promote blood pooling in the splanchnic and lower extremity circulation and stimulates the autonomic nervous system with orthostatic stress, allowing both parasympathetic and sympathetic interventions to be tested with one maneuver. Heart Rate Deep Breathing (HRDB): Tests functions that are mediated mainly by the vagal nerve and is commonly used to evaluate cardiac parasympathetic functions. Valsalva Maneuver: This non-invasive test is most sensitive in testing sympathetic adrenergic failure but is also useful in the evaluation of sympathetic functions and failures. Infant hearing screening programs are designed to identify hearing loss in infants shortly after birth. Prior to discharge after birth, each newborn has his/her hearing tested. If for some reason the newborn does not pass the screening, a rescreen is usually done. If the infant does not pass the second hearing test, he/she is referred to a specialist for further testing.
TCD is a non-invasive ultrasound method used clinically to examine the blood circulation within the brain. During TCD, sound waves that are inaudible to the human ear, are transmitted through the tissues of the skull. These sounds waves reflect off blood cells moving within the blood vessels. This allows for a calculation of speed. The sound waves are recorded and displayed on a computer screen. TCD ultrasound images help in the diagnosis of a wide range of brain conditions affecting blood flow to the brain and within the brain.