NEUROPHYSIOLOGY

 

I am an accredited Neurologist and Neurophysiologist.  Neurophysiology investigation encompasses electro-encephalography (EEG), nerve conduction studies and electro-myography (NCS and EMG), and also so-called evoked potential testing.  I would also include vestibular function tests measuring the balance mechanism within this range of tests. 

Whereas scanning looks at the nervous system from an anatomical perspective, neuro-physiology looks at the electrical functioning of the nervous system.  The brain, spinal cord, peripheral nerves and muscles work by a process of electrical discharges and so measuring the way the nervous system responds electrically is obviously going to pay dividends with regard to the diagnosis of different conditions.

If you have heard about a condition known as the carpal tunnel syndrome where the median nerve is crushed at the level of the wrist by a narrow canal and overuse of the wrist structures, then you may be amazed to hear that this diagnosis only became a reality in the 1950s with the development of nerve conduction studies.  Before that, anyone presenting with sensory symptoms in the hands was thought to have a problem arising in the neck.

Neurologists will order all of the neurophysiology tests as part of their armoury of investigation.  These tests can be incredibly helpful in medico-legal cases particularly when for instance there is a doubt about the veracity of neck or back pain or pain going into limbs which anatomical testing such as imaging has not yielded a dividend, that is an answer, whereas neurophysiology testing may well show an abnormality at an electrical or microscopic level.

Nerve conduction studies and electro-myography are carried out by a Medical Specialist, that is Consultant Practitioner trained in neurophysiology.  The other electrical tests and vestibular function tests are usually undertaken by a Technologist who is not medically qualified.  They often have to spend hours with the patient measuring tiny potentials in      a quiet and darkened room and we are very dependent on their skills for which they are seriously underpaid