Clinical neurophysiology Flashcards

1
Q

what is clinical neurophysiology

A

diagnostic specialty - like radiology but look a nerves

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2
Q

what studies are involved in neurophysiology

A

electromyography (EMG) - nerve conduction studies

EEG - electrical activity within the brain

evoked potential

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3
Q

what does EMG investigate

A

problems in the peripheral nerve and muscle

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4
Q

what does EEG investigate

A

electrical activity within the brain, epilepsy and states of altered consciousness

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5
Q

what do evoked potentials investigate

A

visual and somatosensory -problems in the pathway

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6
Q

what two aspects of nerve conduction are measured in nerve conduction studies

A

conduction velocity

amplitude

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7
Q

what does stimulating the sensory nerve fibres in the fingers allow

A

measurement of sensory function

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8
Q

where does ulnar neuropathy most commonly present

A

mostly at the elbow sometimes at the wrist

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9
Q

what are signs of ulnar neuropathy

A

ulnar distribution numbness

wasting of small muscles

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10
Q

what would you be looking for on electrophysiology of ulnar neuropathy

A

conduction block/slowing due to demyelination

nerve root damage

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11
Q

what would the electrophysiology results show for ulnar neuropathy from conduction block

A

slowing of motor response across elbow

small sensory response from ulnar nerve

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12
Q

what would the electrophysiology results show for ulnar neuropathy from nerve root damage

A

small but not slowed motor response

normal sensory response

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13
Q

what causes myasthenia gravis

A

antibodies to post-synaptic ACh receptors

decrease the effectiveness of released ACh

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14
Q

what is the presentation of myasthenia gravis

A

present with weakness, fatigue, normal sensation

often affects the eyes - diplopia, ptosis

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15
Q

how can myasthenia gravis be diagnosed

A

Detect Antibodies (takes some weeks, only +ve in 70%)

Neurophysiology

  • Repetitive stimulation - for fatigue
  • Single fibre EMG - for jitters
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16
Q

what does routine EMG look at

A

action potential from whole motor units

17
Q

how can EMG be useful in diagnosis of myasthenia gravis

A

the needle can be positioned to record from two fibres within the same motor unit - if variation in time of firing between the two fibres = jitters

can be a sign of myasthenia gravis before presenting symptoms

18
Q

what do EEGs record

A

electrical activity generated by cortical neurons across multiple points on the scalp

19
Q

what can be seen on EEG readings

A

epileptic activity
states of consciousness - sleep, stages of sleep
encephalopathy

20
Q

what can EMGs and EEGs help facilitate

A

medical or surgical treatment