Clinical Neurophysiology is primarily an investigative specialty using computer, magnetic and electronic means to record the function of the brain, spinal cord, spinal roots, peripheral nerves and muscle to diagnose disorders of the nervous system.
Most tests are performed across all age groups, adult and paediatric.
Key telephone numbers
01708 435 166
Clinic location
Neurophysiology Department
Ground floor, Orange zone
Queen’s Hospital
Rom Valley Way
Romford
Essex RM7 0AG
- Monday-Friday, 8am to 4.30pm
Key staff
Consultants in Clinical Neurophysiology: Dr Jacquie Deeb and Dr Nizar Muhammed
Senior chief physiologists: James Wall and Lesley O’Neill
Highly specialised physiologist: Cathy Jennings
Specialised physiologist: Prakriti Pyakurel
Secretaries: Helen Morgan and Julie Muller
Further information about our service
EMG (electromyography)
Used by clinicians to refer to both nerve conduction and EMG studies, which are usually carried out to diagnose disorders of the peripheral nerves or muscle. We also provide specialised tests like single fibre EMG study (voluntary and stimulation).
EEG (electroencephalography)
The recording of the electrical activity - measuring the brain waves. We provide routine EEG, sleep-deprived EEG, prolonged EEG and video-telemetry (for inpatients).
Sleep EEG
The entire test takes about two hours. This is a simple, painless procedure. It entails attaching several silver discs to the head with a special paste. We ask that you have four hours of sleep less than usual, and do not have any drinks to help keep you awake.
During the recording, (which takes about 60 minutes), you will be asked to relax - preferably lying down - and to close and open the eyes. For those unable to co-operate fully, we adapt this procedure as appropriate.
To obtain the best results we cannot have children in the examination room during this test.
In order to ensure the accuracy of the recording, please attend with your hair dry and washed within the previous 24 hours and do not apply any lacquer or other hair preparations.
You may eat and drink as normal and you should continue your medicines and tablets unless otherwise informed by your doctor. We will remove the paste from the hair at the end of the test but you may wish to wash the hair again later in the day. It would be helpful if you could bring your own comb or brush. There are no after effects. The results are not available immediately but will be sent to the doctor who requested the test.
EP (evoked potentials)
This records the responses of the brain to the stimulation of the senses. We perform the following studies:
- visual evoked potentials (VEP) where the patient is shown patterns or flashing lights
- auditory evoked potentials (AEP) where clicks are played through headphones
- Somato Sensory Evoked Potentials (SSEP) where small electrical pulses are applied to the arms and legs
VEP/AEP Evoked Potential Tests
These are simple painless procedures. They entail attaching a few silver discs to your head with a special paste. During the visual test (VEP) you will be asked to look at a checkerboard pattern. Please make sure you attend with any glasses you have, or contact lens if you wear them. During the auditory test (AEP) you will be wearing headphones and we will be playing loud clicks into one ear at a time, for five minutes. During these periods you will be asked to sit quietly with your eyes closed. We will check your hearing level to the clicks before starting. If you wear earrings, you will need to remove these prior to this examination.
In order to ensure the accuracy of the recording please attend with your hair dry and washed within the previous 24 hours and do not apply any lacquer or other hair preparations. We will remove the paste from the hair at the end of the test but you may wish to wash your hair again later in the day. There are no after effects. Your technician will explain the test more fully when you attend. The results will be sent to your referring consultant.
Somato Sensory Evoked Potentials (SSEP)
This involves applying small electrical impulses to one of the nerves in your arms and/or legs, while recording from electrodes on your head and limbs. Your hands/feet will twitch. Although this might be slightly uncomfortable, this is not a painful test. The procedure will be fully explained to you on the day by the technician. Please allow 30 minutes for this test if we are only testing your arms or legs, or 60 minutes if we test both. There are no after effects.
IOM (intraoperative monitoring)
We monitor neurophysiological function during surgical operations on the brain, spinal cord and peripheral nerves, and EMG-guided botulinum toxin treatment for patients with movement disorders (such as dystonia) and spasticity.
We accept referrals from specialists (neurologists, neurosurgeons, orthopaedic surgeons, rheumatologists, pain specialists etc.) but not directly from general practitioners.