What do we provide physicians?

IntraNerve Neuroscience (INN) is dedicated to meeting the specific needs of each physician we support across the United States.

IONM for Physicians

Over the years, we have built strong clinical partnerships and retained our surgeon network by providing a highly competent, consistent level of neuromonitoring with local staff. We provide regular in-service presentations to surgeons and hospital staff to ensure continuity of services and tailor our monitoring based on surgeon preferences.

Peripheral nerve injury is a significant perioperative problem, being the second most common cause of professional liability and patient injury in the practice of anesthesiology (Ihab et al. 2006). IONM is proven to help minimize this occurrence with SSEP monitoring. This modality has a recognized role in detecting impending nerve injury related to patient positioning and external pressure (e.g., stretching of brachial plexus) (Eager, et al. 2011, Ihab et al. 2006).

It takes only one adverse surgical event to yield devastating consequences. IONM has proven to significantly reduce the chances of this one adverse surgical event, resulting in improved patient care and quality of life, which is the primary purpose of surgical intervention.

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What IONM modalities do we offer?

Assess the functional integrity of the dorsal column sensory pathways from the peripheral nerve to the sensory cortex.

Assess the functional Integrity of descending motor pathways, from the motor cortex to peripheral muscles.

EMG activity is recorded using needle electrodes placed subdermally (under the skin and near a muscle), or directly in the belly of the muscle(s) of interest.

Provides real-time feedback whenever a motor nerve is activated or irritated by surgical manipulation such as pulling, stretching, and/or compression of nerves.

Response to direct or indirect electrical stimulation of nerves. A hand-held probe is used to deliver electrical current to the site of interest. When a functional nerve is depolarized, a response is recorded in the form of a compound muscle action potential (CMAP).

The test is designed to evaluate pedicle screw placement, specifically focusing on medial pedicle screw breaches.

Records electrical activity from the cerebral cortex.

Assess the neuromuscular junction to assess the reliability of modalities that record from peripheral muscles (i.e. EMG, TceMEP).

Monitors the auditory brainstem function (hearing) in response to auditory (click) stimuli.

Performed by asking the patient various tasks while they are awake to identify eloquent areas.

Cortical Stimulation: Allows for functional mapping of the primary motor cortex.

Allows surgeon to functionally assess proximity to descending corticospinal tracts during deep tumor resection.

Allows for functional identification and mapping of motor and/or mixed cranial nerves. CN-EMG provides real-time feedback regarding mechanical irritation of motor and/or mixed cranial nerves.

Assess the function of the entire visual pathway in response to light stimuli.

Identify the location of Central Sulcus by recording SSEP responses from a grid placed on the exposed surface of the brain by the surgeon.

Assesses the motor pathway by recording electrical responses (D-Waves) from an epidural electrode placed by the surgeon.

Aids in identifying structures in the spinal cord during intramedullary tumor resection. Involves the direct stimulation of the dorsal columns with a handheld probe and recording the corresponding sensory evoked potential from the scalp.

Electrodes placed directly on the exposed surface of the brain to record electrical activity from the cerebral cortex.

Identify and preserve critical non-visible somatic nerves.

Measure conduction velocity and integrity of sections of peripheral nerves during peripheral nerve surgeries, i.e. tumor resection.

Neurotelemetry/ cEEG for Physicians

INN provides a real-time assessment of cerebral function and electrical activity, 24/7/365 for your patients. Patients that benefit from cEEG/Neurotelemetry, Routine/STAT, and Ambulatory EEG services include:

  • Acute severe head injury
  • Acute stroke
  • Altered mental status
  • Central nervous system infections
  • Central nervous system tumor
  • Critically ill
  • Neonates
  • Post-anoxic injury
  • Sepsis
  • Status post-cardiac arrest/hypothermia protocol
  • Suspected status epilepticus
  • Toxic or metabolic encephalopathy
  • Traumatic brain injury
  • Unexplained coma
  • Vasospasm

We monitor and guide management for patients with brain ischemia from vasospasm after subarachnoid hemorrhage, which can sometimes be hard to detect in mentally altered neurological patients or those with nonspecific, nonlateralizing clinical findings, such as lethargy. We monitor for convulsive and nonconvulsive seizures. Nonconvulsive status epilepticus and patients with subarachnoid hemorrhage are at a higher risk for having different kinds of seizure activity. Our monitoring helps to titrate anticonvulsant drugs, especially in sedated and paralyzed patients, as well as help display trends in brain function and possible prognosis.

Yes! Columbia University in New York found that 44% of 117 children undergoing cEEG had seizures. 39% had non-convulsive seizures and 75% of those patients had purely non-convulsive seizures. Jette N et al, Arch Neurol 2006.
A study with 300 patients who underwent non-elective cEEG over a 27 month period, with 189 studies performed in an ICU resulted in change in AED prescribing in 52% of all studies with initiation of an AED therapy in 14%, modification of AED therapy in 33%, and discontinuation of AED therapy in 5% of all studies. Kilbride et al. Arch Neurol 2009
Accredited by The Joint Commission in Ambulatory Care

What is our High-Performance Difference?

Through our tightly integrated, comprehensive neuroscience service offerings, innovation, and highly skilled technologists, we are able to provide the highest quality services for our customers and ultimately the patients we serve. Learn more about INN’s High-Performance Difference in Neuroscience by clicking the button below.