Foundations of Clinical Neurophysiology
Fall 2013
Neuroscience 1026
Jeffrey R. Balzer, Ph.D.: Course Director
Office Hours: By Appointment
balzerjr@upmc.edu
412-648-9779
Tuesday and Thursday, 4:00-5:15 pm
Room 116, Victoria Bldg.
Lecture
Topic
Lecturer
1
Course Overview
o What is Clinical Neurophysiology?
Dr. Balzer
(08/27/13)
2
Functional Neuroanatomy
o Brain
o Brainstem
o Spinal Cord
o Cerebrovasculature
o Cranial Nerves
o Brachial Plexus/Peripheral Nerves
Dr. Thirumala
(08/29/13)
3
Neuropathophysiology
o Injury and Neuronal Responses
o Cellular Homeostasis
o Ischemia
o Excitatory Amino Acids
Dr. Haybech
(09/03/13)
4
Functional Neurophysiology
o Cerebral Metabolism
o Cerebral Blood Flow
o AVD02
o Autoregulation
o CSF Dynamics
o Blood-Brain Barrier
Dr. Balzer
(09/05/13)
5
Cerebrovascular Anatomy and Physiology
o Circle of Willis
o Anterior Circulation
o Posterior Circulation
o Stroke
o Relationship to Evoked Potentials
Dr. Balzer
(09/10/13)
6
Techniques for Electroencephalographic Recording
o Electrodes
o International “Ten-Twenty” System
o Equipment
Dr. Crammond
(09/12/13)
7
Basic Scalp Electroencephalography
o Origin of EEG
o Technical Considerations
o EEG and Anesthesia
Dr. Thirumala
(09/17/13)
o
o
EEG and Surgical Procedures
Computer Processed EEG
8
Electrocorticography
o Use in Epilepsy Surgery
o Technical Aspects of ECoG and Stimulation
o Awake Craniotomy
o Anesthetic Considerations
Dr. Thirumala
(09/19/13)
9
Intraoperative Evoked Potentials
o Neurophysiologic Basis
o Instrumentation
o Technical Standards
Dr. Balzer
(09/24/13)
10
Somatosensory Evoked Potentials
o Placement of Electrodes
o Sensory Tracts
o Stimulating Electrodes
o Phase Reversal
o Clinical Indications for SSEP Recording
Dr. Crammond
(09/26/13)
11
Brainstem Auditory Evoked Potentials
o Placement of Electrodes
o Recording Parameters
o Auditory Pathways/Obligate Waves
o Clinical Indications for BAEP Recording
Dr. Crammond
(10/01/13)
12
Visual Evoked Potentials
o Stimulating and Recording
o Visual Pathways
o Clinical Indications for VEP Recording
o Electroretinogram (ERG)
Dr. Crammond
(10/03/13)
13
Motor Evoked Potentials
o Stimulating and Recording
o Neurogenic vs. Myogenic
o Transcranial Electrical Stimulation
o Motor Pathways
o Clinical Indications for MEP Recording
o Anesthetic Considerations
Dr. Balzer
(10/08/13)
MIDTERM EXAMINATION 10/10/13
October 15, 2013: NO CLASS
15
Intraoperative Electromyography (EMG)
o Basic Principles of EMG
o Recording EMG
o Free-Running EMG
o Stimulus-Evoked EMG
o Alarm Criteria
Dr. Balzer
(10/17/13)
16
Intraoperative Facial Nerve Monitoring
o Monitoring Methods
o Electrode Placement
o Discharge Patterns
o Hemifacial Spasm
o Clinical Indications
Dr. Habeych
(10/22/13)
17
Other Cranial Nerve EMG
o Extra-ocular Muscle EMG
o Trigeminal Nerve EMG
o Lower Cranial Nerve EMG
Dr. Habeych
(10/24/13)
18
Nerve Root Monitoring in the Spine
o Free-Run vs. Stimulus-Evoked EMG
o Pedicle Screw EMG
o Cervical EMG
o Thoracic EMG
o Lumbosacral EMG
Dr. Balzer
(10/29/13)
19
Deep Brain Stimulation
o Anatomy
o Physiology
o Micro-Electrode Recording
o Guiding the Surgical Placement
Dr. Crammond
(10/31/13)
20
Traumatic Brain Injury
o Principles
o Pathophysiology
o ICP
o Evoked Potentials and Prediction of Outcome
Dr. Okonkwo
(11/05/13)
21
Anesthesia and Evoked Potentials
o Halogenated Anesthesia
o Intravenous Anesthetics
o Effects on Evoked Potentials
o Effects on EMG
Dr. Balzer
(11/07/13)
22
Surgical Treatment of Epilepsy
o Epilepsy
o Conventional Treatment
o Surgery
o ECOG and Mapping
Dr. Richardson
(11/12/13)
23
Transcranial Doppler
o Cerebrovascular Anatomy
o Anatomical Anomalies
o Techniques and Examination
o Clinical Application
Dr. Balzer
(11/14/13)
24
Cerebral Oximetry
o Principles
o Techniques and Examination
o Clinical Application
Dr. Balzer
(11/19/13)
25
Brain Mapping Techniques
o Phase Reversal
o Direct Cortical Stimulation
o Awake Craniotomy
o Fourth Ventricle Mapping
Dr. Balzer
(11/21/13)
26
Interventional Radiology, Aneurysms and Stroke
o Endovascular Treatments
o Angiography
o Aneurysms
o Stroke
Dr. Ducreat
(11/26/13)
Thanksgiving Break: NO CLASS 11/28/13
27
Intraoperative Monitoring: Case Reviews
All Faculty
o Spine
(12/03/13)
o Vascular
o Cranial/Tumor
o Awake Craniotomy
o Cranial/Microvascular Decompression
o Brachial Plexus/Peripheral Nerve
o Deep Brain Stimulation/Microelectrode Recording
28
Paper Review
Dr. Balzer
(12/05/13)
December 14, 2013: FINAL PAPER DUE
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