Neurophysiology

The Department of Clinical Neurophysiology at the NHNN is responsible for a wide range of neurophysiological procedures, principally electromyography (EMG) and nerve conduction studies, EMG-guided botulinum toxin (BoTox) injections, electroencephalography (EEG), evoked potentials  (EPs) and intra-operative monitoring (IOM), amounting to a total of approximately 8,000 investigations per annum. It provides neurophysiological services for the NHNN and other hospitals in the South-East in addition to receiving referrals from elsewhere in the UK and abroad.  The department is recognised as a centre of excellence, with an international reputation for pioneering new techniques to investigate nervous system function, and has a major role in the training of neurophysiologists, neurologists, clinical physiologists and researchers.

The department offers a number of specialised techniques, including investigation of ion channel disorders affecting peripheral nerve and muscle, examination of small fibre properties using quantitative sensory testing, laser Doppler Imaging and skin biopsies. A dedicated telemetry unit provides a 24/7 round the clock possibility of EEG monitoring for the investigation of paroxysmal neurological disorders, altered consciousness and assessment for epilepsy surgery. The combination of EEG and EMG investigations are used for the analysis of movement disorders.

Principal areas of current research interest within the department are nerve excitability testing of peripheral nerve and muscle in neuromuscular diseases and evaluation of these techniques as biomarkers for monitoring therapy and in drug discovery studies; the development of effective EEG investigation tools in complex epilepsy and epilepsy surgery; development of instrumentation for simultaneous EEG and functional MRI; development of new neurophysiological techniques in combination with fMRI in the study of facial pain and headache.