The University of Iowa's Regional Electroneurodiagnostic Forum

Since its almost Friday (but sadly it's not) we thought, maybe, you could use a few laughs today!!

Please join us in congratulating our graduating END Class of 2021 (And a special shout out to Dr. Yamada)! They are all graduating with full-time jobs!

Thank-you for allowing us to be apart of your journey in life; we look forward to seeing what your future brings!

Good afternoon everyone!! Man, it has been a while; we have been busy over here! We hope you all are doing well out there. We missed you all this year due to having to skip our annual meeting but hope Neurodiagnostic went well for you all!

Today we thought we would share a beautiful event. The patient is an 18 yo who has only had 4 known events. Starting a few years ago

Her first event included feeling hot, became unresponsive, started having whole body tensing, bilateral arms and legs stiffened followed by mild shaking, and eyes rolled back. The event lasted less than 5 minutes. This was followed by confusion, lethargy and slurred speech. After 15 to 20 minutes, she was fully oriented but still tired.

The second event included loss of consciousness at work. She had gone to lunch and after eating, felt dizzy and hot. The patient was recorded on the work camera to be spinning in circles, the pt reports seeing halos around lights, which was followed by LOC. She saw a neurologist at an OSH but it was thought to be vasovagal syncope not seizure.

The third event occurred while tubing behind a boat. Pt was upright for about 30 seconds, then they saw her eyes roll back and then slumped forward. Pt was reported to have been underwater for about 20 seconds. Pt was admitted at an OSH overnight for observation.

A routine EEG on was performed and it was reported that she had abnormal in wakefulness and sleep due to frequent brief bursts of 4-6 Hz generalized spike-wave/poly-spike-wave discharges lasting 1-1.5 seconds.

The pts most recent event is described as occurring while eating breakfast. Pt turned head to the right before losing tone and consciousness. Pt mom states pt became lethargic and she prevented pt from falling. Pt dad thought there may have had eye-brow raising/lowering then eyes rolling back.

Pt describes a sense of being "outside her body" during the events or hearing but it sounds like a "Adults talking in Charlie Brown." There was no posturing or extremity shaking with this event.

She was brought in for an extended EEG and throughout the EEG you can see multiple frequent spike and poly-spike waves occurring without correlates. She appropriately answers all questions, recalls word cues or phrases while events are occurring.

In the example, we are showing a period of her EEG where she continues to eat and text through the event.

Happy almost Friday! A little pick-me-up for the day! Always exciting to explain who we are and what we 'actually' do!

Sorry for our absence the last few months. As you all know its been a crazy busy year!

After some thought and given our hospital wide visitor restrictions, we are sad to announce that our plans for a 2021 Spring meeting have been cancelled.

We are looking into options for the future, likely the fall, which would include possible virtual meetings and online payment, if there is interest in this.

Please let us know your feedback and any topics you’d like covered. We look forward to hearing from you all.

Thank you all for your patience and understanding. Happy Holidays! We hope you all stay healthy and well.

If anyone is in the market for a cute, stylish new EEG machine, we've found the perfect addition to your lab 😉!

We are a little late BUT we wanted to be sure to congratulate our newest graduates of 2020; we know you will all do great things and hope you continue to find joy and compassion for the career you chose! We are so very sorry that your schooling ended the way it did but, at least, you will remember it forever!

We also know that we have been a little absent on our page in the last few months playing catch up at the hospital, getting all the patients re-scheduled/completed, and increasing our monitoring service in the OR but we hope you are all staying safe out there!

This week, is often a week we usually celebrate with all our wonderful co-workers. The people who know us best, next to our family, friends and significant others - all in all they really are family.

This year is a little sad for us, we are all working different shifts, off shifts, being moved to different areas of the hospital as help is needed, working in shifts remotely from home and the hospital attending to the patients on EEGs and the ones who still need surgery, we are broken up...

This week is Neurodiagnostic Technologist week. For most people you will have no idea who we are, for those that do know, you're likely family, a friend of ours, know of us from your own specialty in the medical field, or sadly, have needed is at one point in your life. For others, we have seen you but you will never know we were a part of your care.

Unfortunately, we are among one of many under-recognized healthcare workers in the medical field.

We are often mistaken for nurses, and though we are so thankful for nurses, we are not nurses. We are the ones often behind the scene, we arrive at the patients bedside, hooking them up, maintaining test quality, reporting to the doctors when there is abnormal firing of neurons within your brain causing it to seize; making sure you get adequate treatment to avoid neuronal death. Though you or your family often don't see us, we are of vital importance to hospital treatments and diagnoses.

We are the ones who they will call when you deliver your baby that was born with poor oxygen stats, when your infant has concerning spasms, causing damage to the brain and if they aren't treated - they may be delayed in everything they do.

They will call us for your child that has a fever causing seizures, children who once got great scores in school but now are declining academically because their brain isn't functioning properly and the only indication is staring off in space.

We are the ones they call when your loved one gets into an accident, has a stroke or hemorrhage and won't wake up even when the sedation has worn off.

They will call us when you have nerve damage, neuropathies, when they think you have multiple sclerosis, spastic ‘plegias’, to aid in diagnosing ALS, surgical manipulations when placing screws in the lumbar spine so that you don’t wake with shooting pain into your lower back and legs, to stimulate your nerves with lumbar tumors, tethered cords to identify what nerve correlates to certain muscles so that you don’t wake with life altering deficits.

They will call us when you or a loved one needs emergency surgery, requiring our skills in neurophysiology and intraoperative monitoring to monitor their sensory and motor pathways so they don't wake with numbness or become paralyzed, they will call us for the tumor they just found on your spine for the same reasons, the tumor in your brain if it's near the motor or sensory cortex, they will call us to aid in mapping your brain for epilepsy surgery, so that you can wake without deficits and hopefully be seizure free from the seizures that were once intractable. They will call us for any possible brain dysfunction you can think of and we will show up.

I hope most of you will never need to see us but if you do we will always greet you with a smile. Though this is only a small idea of what we do; we want to say thank-you to all the awesome people in this field of Neurodiagnostics – We at the University of Iowa, are proud to be one with all you.

Happy Neurodiagnostics Week - Even though we wont be celebrating our normal style we wanted to send a shout out to all of our fellow Technologists this week because you are all awesome! We hope to celebrate in style at a later date!

We have some pretty awesome doctors that leave little treats for us here and there as well. Thanks for the Neurodiagnostic Gifts and for our random treats through out the year - our doctors are the best!

Hope all our fellow EEG, LTM, ICU, EMG and IOM Techs are safe and healthy out there! It's crazy to actually be living history in the making! We're trying to make the best of these uncertain times; if you are too - we would love to see your pictures!

We often filter through many EEGs when scanning, clipping, and archiving - working to preserve data and to save it for recall and student learning later. Sometimes you come across the most beautiful examples of EEG waveforms. Today we wanted to share with you this beautiful example of BIPDs (Bilateral Independent Periodic Discharges).

BIPDs are defined as periodic discharges that are independently and simultaneously present in both hemispheres. They are far less common than LPDs and are associated with higher risk for seizures, depressed consciousness, and mortality.

The difference between interictal and ictal states is the same as for LPDs and depends on whether the BIPD activity evolves, including faster activity within the BIPDs. If the activity evolves and spreads the interpreter can call this an ictal pattern; however, if there is no evolution within the BIPDs the viewer should only call the activity ictal if there is a clinical correlate. BIPDs, otherwise, should be named as an interictal pattern.

We hope that you are all staying safe!

END Forum Certificates were emailed today. If you requested one and did not receive it, please check your junk email, otherwise feel free to contact us and we will get one sent to you. Thanks again!