ASET Webinar Schedule for 2012

Atypical Evoked Potential Testing

by Chris Slaymaker, R. EEG/EP T, CNIM Jan 18th (12 noon Central time, 1pm Eastern, 11am Mountain,10am Pacific)

About Chris: He has twenty five years of experience in neurodiagnostics. He earned a bachelor of science degree in biology from Mercer University in Macon, Georgia, and completed sixty-five hours in the graduate program in neurophysiology at the University of Tennessee. For eight years he worked with Ron Leppanen, Ph.D., a leading neurophysiologist who has published extensively on intraoperative neuromonitoring.

Chris has spoken on all aspects of neurodiagnostics, including intraoperative neuromonitoring and anatomy and physiology of the nervous system. He was an instructor of anatomy and physiology for four years at Alpha Institute of the Healing Arts. As an officer of the Tennessee Neurodiagnostic Society, he coordinated several seminars, which attracted ENT professionals as well as doctors and nurses from all over the eastern United States. He has extensive experience in EEGs, including LTME, ambulatory, brain mapping, and electrocorticography, EPs, particularly as it applies to the cranial nerves, and cortical mapping of SSEPs and Neuropsychological testing.

His presentation comes from the fact that EP testing seems to have taken a back seat to the current generation of imaging techniques. It has become difficult to get standard evoked potential testing pre-approved. It seems that doctors and insurance companies make this assumption:SSER, upper extremities (CPT 95925) is the same as a median nerve SSER SSER, lower extremities (CPT 95926) is the same as a posterior tibial nerve SSER

When you consider the peripheral nervous system, there are a multitude of peripheral nerves that lend themselves to evoked potential testing and there is more than just sensory signals that can be assessed. In this webinar Chris will describe techniques for performing evoked potentials from uncommon stimulation sites such as Trigeminal SSEP, Radial SSEP, Fermoral SSEP, Dermatomes, Pudendal, etc. and their usefulness in clinical studies as well as in IONM.

IONM in Anterior Cervical Disc and Fusion Case Presentations

by Brenda Bratton, R. EEG/EP T., CNIM

Feb 15th (12 noon Central time, 1pm Eastern, 11am Mountain,10am Pacific)

About Brenda: She has been working in the END field for 30 years.  She is currently the IOM Program Coordinator at St. Vincent Hospital.  She has been doing IOM for over 20 years.  She is on the ABRET Lab-NIOM board.  She is currently President of the Indiana Society of END Technologists (ISETT).

Case studies are always popular webinars so this lecture will focus on anterior cervical surgery cases with IONM changes, and outcomes. This will be a great webinar for IONM techs seeking recertification credits as well as an instructional webinar for those studying for board exams in IONM.

Atypical Absolute Change: Loss of TCeMEP and SSEP Case Studies

by MeChelle Vance, R. EEG/EP T., CNIM, CLTM

March 21st (12 noon Central time, 1pm Eastern, 11am Mountain,10am Pacific)

About MeChelle: She is an IONM Specialist with experience in a multitude of atypical cases as well as long term monitoring and clinical lab functions relating to neurodiagnsotics and complex intraoperative cases including but not limited to, craniotomies for tumors, aneurysm, AVMs, epilepsy, vascular surgeries, TAAA, thoracic endografts, endarterectomies, open and minimally invasive spine surgery.  She also participates in

corporate wellness and marketing and strategic planning for optimal health.  She has presented multiple topics at ASET, MSET, CSET, ISETT, and WSET, and is currently employed by Methodist Hospital in Indianapolis, performing a multitude of procedures which include.  Methodist Hospital is a level one trauma center, giving her a unique and fascinating opportunity to help some of the most challenging cases, in the OR, as well as the clinical lab.  Fortunately this allows the opportunity to present such cases, and provide education for those who may not have such opportunities.

Case presentations will illustrate this presentation of atypical changes seen in IONM.  A retrospective look at non-surgical related physiological events, which caused significant changes, as well as post operative deficits, this webinar will allow the novice as well as advanced practitioner to approach intraoperative neurophysilogic mointoring with a fresh perspective, as well as provide the surgeon with additional tools to provide optimal care to the patient.  

Unusual IONM Case Presentations

by Brenda Bratton, R. EEG/EP T., CNIM

April 18th (12 noon Central time, 1pm Eastern, 11am Mountain,10am Pacific)

About Brenda: She has been working in the END field for 30 years.  She is currently the IOM Program Coordinator at St. Vincent Hospital.  She has been doing IOM for over 20 years.  She is on the ABRET Lab-NIOM board.  She is currently President of the Indiana Society of END Technologists (ISETT).

Case studies are always popular webinars so this lecture will present some of the most unusual surgery cases with changes, and outcomes. This will be a great webinar for IONM techs seeking recertification credits as well as an instructional webinar for those studying for board exams in IONM.

May 10-11 Extended Webinar: ICU Pattern Recognition Basics and Trending for Nurses

This 2 day webinar will be gin at 10 am Central time each day with Part 1 (Basics) on Thursday May 10th and Part 2 (Somewhat more advanced topics) on Friday May 11th.

*A detailed schedule of speakers and topics to be announced.

Differentiating Nocturnal Epilepsy from Parasomnias

by Jennifer L. DeWolfe, DO

May 16th (12 noon Central time, 1pm Eastern, 11am Mountain,10am Pacificz)

About Dr Dewolfe: She is an assistant professor of neurology at the University of Alabama at Birmingham. She is the Director of Neurology Sleep Services at UAB and Director of the Sleep Center at the Birmingham VA Medical Center. She specializes in epilepsy and sleep medicine with research interests in women’s issues in epilepsy, the effects of sleep disorders on epilepsy, and the effects of surgical treatment of epilepsy on sleep.

This presentation will review the differential diagnoses of nocturnal behaviors, focusing on parasomnias in more detail. NonREM and REM sleep parasomnias will be discussed, including pathophysiology, clinical manifestations, EEG and polysomnographic findings. Nonpharmacologic and pharmacologic treatments will be reviewed along with suggested protocols for technologists performing clinical neurophysiologic monitoring procedures on patients with parasomnias.

Comparison of MEG Source Localization Techniques

by Susan Bowyer, PhD.

Sept 19th (12 noon Central time, 1pm Eastern, 11am Mountain,10am Pacific)

About Dr. Bowyer: Currently the Senior Staff Investigator in the Neuromagnetism Lab and assistant professor at Wayne State University in Detroit, she has worked in the Biomagnetism field for the past 15 years.  She is an experienced researcher with extensive training and expertise in Magnetoencephalography

(MEG), computer applications and image analysis. She possesses a solid understanding of neuroimaging tools and their use in exploring normal and abnormal functioning of the brain. Her experience includes MEG study design, implementation, data collection and data analysis. She has developed MEG Protocols for studies of migraine, language cognition, spreading cortical depression, and epilepsy.  She is a dedicated scientist with exceptional organizational, troubleshooting, and problem-solving skills. She has authored 30 articles in peer reviewed scientific journals.

The presentation will include Dr Bowyer’s research:

Objective: To compare the MEG data source localization techniques (ECD, Current Distribution, Beamformer, and Coherence) for evaluating a potential epilepsy surgery patient’s focus. Background: Determining the site of ictal onset can be difficult in some patients with refractory partial epilepsy. MEG is a diagnostic tool with excellent spatial and temporal resolution that can provide non-invasive interictal localizing information not available from other imaging methods. Several MEG analytical methods are used to localize epileptiform activity. We wish to determine if techniques, beyond the standard ECD technique, can provide more accurate localizing information prior to surgical resection.

Methods: Fifty-four patients with refractory epilepsy were monitored with MEG. Visually identified epileptic spike activity was analyzed with four separate MEG techniques: Single Equivalent Current Dipole (ECD), Current Distribution (MR-FOCUSS), Beamformer (Borgiotti-Kaplan (BK-BEAM)), and Coherence (ICA-minimum norm). The ECD was performed with 4D Neuroimaging software and the others were all performed in MEG_TOOLS software. Results will be compared to surgical resection if available.

Results: Seven of 103 patients have very noisy data that could not be used. Forty-three of 96 patients had 5 or more spikes each identified during MEG analysis. Of the patients who had detectable spikes, all 43 had ECD source localizations. Twenty-seven of 43 patients also had current distribution, and beamformer localizations performed on the interictal spikes as well as Coherence imaging on 10 minutes of spontaneous resting state brain activity. Agreement among three techniques (ECD, BK BEAM and MR-FOCUSS) was found in 19/27 (70%), determined by the localization results having an overlapping component within a region encompassing a 1 cm sphere. Coherence imaging results from this same group of 27 patients that found: concordance in 22/27

(82%) with ECD; concordance in 24/27 (89%) with MR-FOCUSS; concordance in 21/27 (78%) with BK BEAM.

Conclusions: Advanced MEG techniques (Current distribution, Beamformer, and Coherence) may provide additional interictal epileptiform data, which may be helpful in the decision making process for surgical intervention.

Algorithmic Approach to IONM with Case Presentations Where Changes Occurred

by Jeff Balzer, PhD, DABNM, FASNM

Oct 17th (12 noon Central time, 1pm Eastern, 11am Mountain,10am Pacific)

About Jeff: He is an Associate Professor of Neurological Surgery and Neuroscience, Director of the Cerebral Blood Flow Laboratory and Associate Director of Clinical Services, Center for Clinical Neurophysiology at the

University of Pittsburgh Medical Center.  He is a member of ASET and past President of the American Board of Neurophysiolgocial Monitoring and the current Secretary/Treasurer of the Amercian Board of Neurophysiologic Monitoring.

Jeff’s presentation will describe an algorithmic approach to IONM describing the paradigm and approach we used for every case performed at our institution.   It will include the key questions that need to be asked before every case, how every case is approached a number of different case presentations that include significant changes to elucidate how the algorithm is key to the differential diagnosis and interpretation of the data. 

Fall Extended Webinar topic: Neurofeedback

*(October, date and schedule of speakers and topics to be announced)

Digital Analysis and Trending in EEG

by Marco Moreno, R. EEG T.

November 14th (12 noon Central time, 1pm Eastern, 11am Mountain,10am Pacific)

About Marco: Marco Moreno graduated from St. John’s Hospital END program in Springfield, IL in 1985, and worked as a technologist at Memorial Medical Center and as a researcher at Southern Illinois University School of Medicine in Springfield. He completed his B.A. in Biology at Southern Illinois University in Carbondale, IL. Through the 1990s he managed EEG and Epilepsy

Monitoring Units at Saint Francis Hospital in Tulsa, OK and at St. Louis Children’s Hospital in St. Louis, MO. He completed his M.A. in Health Services Management at Webster University in St. Louis, MO. In 1997 he went into sales for NCI and then in 2001 for Nicolet, and for the last 5 years has been a clinical specialist for Nicolet (Carefusion). The presentation “Digital Analysis and Trending of the EEG” addresses the different ways we try to use digital technology to help us to read EEG more efficiently and accurately. Used properly, spike and seizure detection and EEG trending makes long term EEG easier and faster to digest, and helps you to see not just the minute detail, but the “big picture” as well.