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Syllabus Document Transcript

  • 1. Foundations of Clinical Neurophysiology Jeffrey R. Balzer, Ph.D.: Course Director balzerjr@upmc.edu 412-648-9779 Tuesday and Thursday, 3:30-5:00 pm Jannetta Conference Room: PUH 4th Floor, B Wing, Department Neurosurgery Text: “Intraoperative Neurophysiological Monitoring” 2nd Edition, Möller Lecture Topic Lecturer 1 Course Overview Dr. Balzer o What is Clinical Neurophysiology? (08/28/07) 2 Basic Electrical Concepts & Instrumentation Dr. Sclabassi o Conduction (08/30/07) o Impedance and Resistance o Capacitance and Inductance o Amplification and Filtering of Electrical Signals o Signal Averaging 3 Functional Neuroanatomy Dr. Habeych o Brain (09/04/07) o Brainstem o Spinal Cord o Cerebrovasculature o Cranial Nerves o Brachial Plexus/Peripheral Nerves 4 Functional Neurophysiology Dr. Balzer o Cerebral Metabolism (09/06/07) o Cerebral Blood Flow o AVD02 o Autoregulation o CSF Dynamics o Blood-Brain Barrier 5 Cerebral Electrical Activity Dr. Sclabassi o Electrical Activity of Neurons (09/11/07) o Synaptic Transmission o Electroencephalogram o Sensory Evoked Potentials o Motor Evoked Potentials 6 Neuropathophysiology Dr. Balzer o Injury and Neuronal Responses (09/13/07) o Cellular Homeostasis o Ischemia o Excitatory Amino Acids 7 Techniques for Electroencephalographic Recording Dr. Crammond o Electrodes (09/18/07)
  • 2. o International “Ten-Twenty” System o Equipment 8 Basic Scalp Electroencephalography Dr. Haybech o Origin of EEG (09/20/07) o Technical Considerations o EEG and Anesthesia o EEG and Surgical Procedures o Computer Processed EEG 9 Electrocorticography Dr. Balzer o Use in Epilepsy Surgery (09/25/07) o Technical Aspects of ECoG and Stimulation o Awake Craniotomy o Anesthetic Considerations 10 Intraoperative Evoked Potentials Dr. Balzer o Neurophysiologic Basis (09/27/07) o Instrumentation o Technical Standards 11 Somatosensory Evoked Potentials Dr. Crammond o Placement of Electrodes (10/02/07) o Sensory Tracts o Stimulating Electrodes o Phase Reversal o Clinical Indications for SSEP Recording 12 Brainstem Auditory Evoked Potentials Dr. Crammond o Placement of Electrodes (10/04/07) o Recording Parameters o Auditory Pathways/Obligate Waves o Clinical Indications for BAEP Recording 13 Visual Evoked Potentials Dr. Crammond o Stimulating and Recording (10/09/07) o Visual Pathways o Clinical Indications for VEP Recording o Electroretinogram (ERG) 14 Motor Evoked Potentials Dr. Balzer o Stimulating and Recording (10/11/07) o Neurogenic vs. Myogenic o Transcranial Electrical Stimulation o Motor Pathways o Clinical Indications for MEP Recording o Anesthetic Considerations October 16, 2007: MIDTERM EXAMINATION 15 Intraoperative Electromyography (EMG) Dr. Balzer o Basic Principles of EMG (10/18/07)
  • 3. o Recording EMG o Free-Running EMG o Stimulus-Evoked EMG o Alarm Criteria 16 Intraoperative Facial Nerve Monitoring Dr. Balzer o Monitoring Methods (10/23/07) o Electrode Placement o Discharge Patterns o Hemifacial Spasm o Clinical Indications 17 Other Cranial Nerve EMG Dr. Habeych o Extra-ocular Muscle EMG (10/25/07) o Trigeminal Nerve EMG o Lower Cranial Nerve EMG 18 Nerve Root Monitoring in the Spine Dr. Balzer o Free-Run vs. Stimulus-Evoked EMG (10/30/07) o Pedicle Screw EMG o Cervical EMG o Thoracic EMG o Lumbosacral EMG 19 Deep Brain Stimulation Dr. Crammond o Anatomy (11/01/07) o Physiology o Micro-Electrode Recording o Guiding the Surgical Placement 20 Anesthesia and Evoked Potentials Dr. Balzer o Halogenated Anesthesia (11/06/07) o Intravenous Anesthetics o Effects on Evoked Potentials o Effects on EMG 21 Transcranial Doppler Dr. Balzer o Cerebrovascular Anatomy (11/08/07) o Anatomical Anomalies o Techniques and Examination o Clinical Application 22 Magnetoencephalography (MEG) Dr. Sclabassi o Principles (11/13/07) o Techniques and Examination o Clinical Application 23 Cerebral Oximetry Dr. Balzer o Principles (11/15/07) o Techniques and Examination o Clinical Application 24 ICP/AVD02 and Closed Head Injury Dr. Okonkwo o Principles (11/20/07) o Pathophysiology
  • 4. o Evoked Potentials and Prediction of Outcome Thanksgiving Break: No Class 11/22/07 25 Quantification of Cerebral Blood Flow Dr. Balzer o Laser Doppler Techniques (11/27/07) o Bedside Xe133 o Xe-CT 26 Radiology and Imaging Dr. Horowitz o Reading a C-Spine X-Ray (11/29/07) o CT o MRI o Angiography 27 General Principles of Data Interpretation Dr. Balzer o Near-Field and Far-Field Potentials (12/04/07) o Potentials with Multiple Sources o Abnormalities During Monitoring o General Alarm Criteria 28 Intraoperative Monitoring: Case Reviews All Faculty o Spine (12/06/07) o Vascular o Cranial/Tumor o Awake Craniotomy o Cranial/Microvascular Decompression o Brachial Plexus/Peripheral Nerve o Deep Brain Stimulation/Microelectrode Recording December 15, 2007: FINAL PAPER DUE If you have a disability for which you are or may be requesting an accommodation, you are encouraged to contact both your instructor and Disability Resources and Services, 216 William Pitt Union, 412-648-7890 (412-383-7355 (TTY)), as early as possible in the term. DRS will verify your disability and determine reasonable accommodations for this course.