Flash Player 9 (or above) is needed to view presentations.
We have detected that you do not have it on your computer. To install it, go here.

Like this document? Why not share!

Like this? Share it with your network








Total Views
Views on SlideShare
Embed Views



0 Embeds 0

No embeds



Upload Details

Uploaded via as Microsoft Word

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
Post Comment
Edit your comment

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.