What is Neurophysiology?
Neurophysiology is a branch of neuroscience and physiology that is interested in studying the function of the nervous system through the use of electrophysiological recordings. Within the NHS, Neurophysiological Scientists perform a range of diagnostic tests to assess the functioning and integrity of the brain and nervous system. The most commonly performed tests are Electroencephalography (EEG), Nerve Conduction Studies (NCS), Evoked-Potentials (EPs) and Electromyography (EMG). These tests are performed on patients of all ages and are performed in a range of clinical settings including outpatient, intensive care, wards, and during surgical interventions.
What Clinical Conditions or Disorders are Typically seen in the Neurophysiology Department?
The Neurophysiology department sees patients with a range of neurological disorders. Each of the diagnostic tests performed within the department are tailored towards diagnosing specific neurological conditions. EEG is typically used to investigate conditions such as epilepsy, and encephalopathy. NCS and EMG are used to assess the function of nerves and muscles and are commonly used to diagnose conditions such as Carpal Tunnel Syndrome, Myasthenia Gravis, Peripheral Neuropathy, and Motor Neurone Disease. Auditory, Visual and Somatosensory EPs can be used for the diagnosis of conditions such as Multiple Sclerosis, and Optic Neuritis. Somatosensory EPs and Motor EPs are also performed intraoperatively as a method of monitoring the sensory and motor nerve pathways during corrective spinal surgery (e.g., Scoliosis or Tumour resection) in order to prevent post-surgical neurological deficits.
What day-to-day activities do Neurophysiologists perform?
The thing I like the most about Neurophysiology is that no two days are the same. In my department we have a team briefing each morning where we are assigned our workload for the day. As a trainee Clinical Scientist my day-to-day activities might involve assisting the Consultant Clinical Neurophysiologist in an EMG Clinic, performing NCS, EPs and EEGs under the supervision of a qualified Neurophysiological Scientist, analysing and interpreting test results, and writing up clinical reports to send to the Consultant for reviewing. While most of our time is spent working within the local hospitals, portable EEG testing is also performed at hospitals outside of the local Trust. Specialist Neurophysiologists may also spend time working in Theatres performing intra-operative monitoring for Neurosurgery and Orthopaedic surgery.
What does the Scientist Training Programme involve for Neurophysiology?
The first year of the STP is spent undertaking rotational modules. For me this involved completing rotations in Audiology, Vision Sciences, Pathology and MRI. However, following the curriculum review earlier this year, Neurophysiology STP trainees will now undertake rotational modules in Cardiac Science, Sleep and Respiratory Sciences, Pathology and MRI. Along with rotational modules, first year trainees complete an introductory module focused on the basics of Neurophysiology. This module consisted of learning the basics of EPs, including how to perform, interpret and report an EP, clinical history taking, and the clinical presentations of commonly encountered disorders. Alongside of the clinical teaching, Neurophysiology trainees attend a three-week University teaching block. The University teaching was focused primarily on the anatomy and physiology of the eye, ear, and central and peripheral nervous system, and was delivered via lectures and practical sessions. In addition to the scientific content, trainees also attended lectures focused on Professional Practice and Good Scientific Practice, which form a key portion of the competencies required by all STP trainees.
The second and third year of the STP are focused on specialist Neurophysiology modules, and involve teaching in NCS, EMG, EPs, Paediatric EEG, EEG in the Intensive Care Unit, and Sleep and Long-Term Monitoring. During the third year of the STP you are also required to complete a research project, and a 4–6-week Elective module in an area of Healthcare Science that is different from your usual training environment. As I am in my second year of the STP, I am currently writing up my research proposal and planning to complete my Elective module within the Cardiology department over the summer.
The STP offers graduate students an incredible opportunity to start a career within healthcare science, providing you with invaluable skills to help you succeed as a qualified Clinical Scientist. Neurophysiology is a fascinating and dynamic profession, that allows you to work directly with patients, and provides many opportunities for personal and professional development.