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  • Training Matters
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How satisfactory are clinical neurophysiology training programs for neurologists?

Nature Clinical Practice Neurology volume 3, pages 114–115 (2007)Cite this article

A complete medical history and thorough neurological examination are often sufficient for a reasonable diagnostic orientation to be reached in patients with neurological disease; however, confirmation of the clinically suspected diagnosis usually requires the performance of ancillary tests. Such tests are frequently undertaken by experts, with specific knowledge and technical expertise, who know how to use the relatively complex and costly equipment associated with a particular procedure. In most instances, this knowledge and expertise has been gained as part of a specialty that stands separately from neurology, such as neuroradiology, neuropathology or neurogenetics. Neurologists, however, may also want to be able to perform laboratory tests themselves to diagnose their patients, and they are certainly prepared to make full use of the data gathered from such ancillary tests. This is particularly true in the case of clinical neurophysiology (CN), the results of which require accurate correlation with clinical findings. In this article, I focus on the identity of the specialists who should perform CN tests and the form of training they should receive.

CN is commonly used in the assessment of many neurological conditions, such as neuromuscular diseases,1 movement disorders,2 neuropathic pain,3 epilepsy,4 and sleep disorders;5 neurologists working in these fields may, therefore, wish to become proficient in CN. Moreover, although a well-prepared technician—and even an automated device—can help with nerve conduction studies,6 in my view, many electrophysiological tests such as needle and surface electromyography, evaluation of reflex responses, tests of cortical excitability, and assessment of risks in the operating room, should be performed by the neurologists themselves. Competence in the practice of CN, however, requires not only a thorough clinical knowledge, but also good technical skills. If an understanding of a patient's clinical condition is needed for a clinician to be able to gather useful and rewarding data, technical abilities are also necessary to obtain valid, artifact-free, documental support that allows confident conclusions to be drawn from the CN examination.

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References

  1. Tankisi H et al. (2005) Pathophysiology inferred from electrodiagnostic nerve tests and classification of polyneuropathies: suggested guidelines. Clin Neurophysiol 116: 1571–1580

    Article  Google Scholar 

  2. Valls-Solé J and Valldeoriola F (2002) Neurophysiological correlate of clinical signs in Parkinson's disease. Clin Neurophysiol 113: 792–805

    Article  Google Scholar 

  3. Garcia-Larrea L et al. (2002) Laser-evoked potential abnormalities in central pain patients: the influence of spontaneous and provoked pain. Brain 125: 2766–2781

    Article  Google Scholar 

  4. Nieuwenhuijs DJ (2006) Processed EEG in natural sleep. Best Pract Res Clin Anaesthesiol 20: 49–56

    Article  Google Scholar 

  5. Lobello K et al. (2006) Video/EEG monitoring in the evaluation of paroxysmal behavioral events: duration, effectiveness, and limitations. Epilepsy Behav 8: 261–266

    Article  Google Scholar 

  6. Kong X et al. (2006) NC-stat sensory nerve conduction studies in the median and ulnar nerves of symptomatic patients. Clin Neurophysiol 117: 405–413

    Article  Google Scholar 

  7. The American Board of Electrodiagnostic Medicine (ABEM) [http://www.abemexam.org/]

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  1. Department of Neurology, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain jvalls@clinic.ub.es

Authors and Affiliations

  1. J Valls-Solé is Senior Consultant at the Electromyography Unit in the Hospital Clinic of Barcelona, and Head of the Research Group on Neurophysiology in the Institut d'Investigació Biomèdica August Pi i Sunyer, Barcelona, Spain.,

    Josep Valls-Solé

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Valls-Solé, J. How satisfactory are clinical neurophysiology training programs for neurologists?. Nat Rev Neurol 3, 114–115 (2007). https://doi.org/10.1038/ncpneuro0406

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