Services Offered by Colorado Center for Neuroscience

• Routine EEG/cEEG
• Stat EEG
• IONM
• cEEG
• LTME
• Expert Consultation
• File Review

Remote EEG Interpretation

This includes routine EEGs, both inpatient and outpatient, and ambulatory EEGs. All that is needed is access to the raw EEG data to read, patient information for billing, and access to the dictation system to complete the report. Alternatively, a report can be generated independently and faxed or emailed to the appropriate location. Turnaround time for routine studies is usually 24 hours or less on weekdays, 48 hours on weekends and holidays.

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Remote Stat EEG Interpretation

Dr. Spillers does not have a typical office practice. He is available at any time during the day to read a STAT EEG remotely. This requires that the EEG machine have internet access so that he can view the EEG in real time. Otherwise, he can review it as soon as it is available if there is no real time access. STATs are typically read in an hour or less and a preliminary report can be sent to the ordering physician by text, fax, or email (direct number must be provided).

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Intraoperative Neuromonitoring

Intraoperative monitoring (IONM) tests the function of the nervous system repeatedly during surgical and other procedures that involve risk to the nervous system. The goal is to identify changes in nervous system function in a timely fashion and report these changes to the surgeon. The surgeon can then make adjustments to reduce or eliminate any risk and prevent the patient awakening from surgery with a permanent deficit. The most common tests include somatosensory evoked potentials (SSEP), trans-cranial motor evoked potentials (TCMEP), free-running EMG, pedicle screw testing, and EEG. Less common testing includes brainstem evoked potentials (BAEP), and cranial nerve monitoring. IONM is most commonly requested for spine and brain surgery, but is also appropriate during other surgical procedures that place the central nervous system at risk.

See the list of Surgeries Monitored in the blue box to the right.

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Remote cEEG Interpretation

Continuous EEG (sometimes referred to as ICU-EEG) is continuous monitoring of EEG of patients, typically in the ICU. This method of monitoring is becoming available nationwide in hospitals of all sizes and locations. Over 90% of seizures in the ICU are nonconvulsive and therefore, not clinically obvious. The purpose of cEEG is to identify subclinical seizures, non-convulsive status epilepticus, or other changes in EEG pattern that might reflect a neurologic change that is unrecognizable clinically. cEEG monitoring can be beneficial for both evaluating treatment approaches, and establishing a prognosis for these patients. There are a number of indications for cEEG:

• Status Epilepticus
• Ischemic Stroke
• Subarachnoid Hemorrhage
• Intracranial Hemorrhage
• Encephalitis and other CNS infections
• Traumatic Brain Injury
• Therapeutic Hypothermia (Adults)
  • Coma post-Cardiac Arrest
  • Ischemic stroke
  • Severe Traumatic Brain Injury
  • Fulminant Hepatic Failure
  • Therapeutic Hypothermia (Neonates/Pediatrics)

There are a multiple models for cEEG, depending on the availability of technologists and the volume of cases in a particular facility. cEEG is reviewed by Dr. Spillers and a professional report is dictated for each 12 to 24 hours of recording time.

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Long Term Monitoring for Epilepsy (LTME)

LTME refers to simultaneous recording of EEG and clinical behavior (by video) over extended periods of time to evaluate patients with paroxysmal disturbances of cerebral function. LTME is used when it is important to correlate clinical behavior with EEG events. EEG recordings of long duration may be helpful in circumstances in which patients have intermittent disturbances that are difficult to record during routine EEG testing. LTME is typically limited to patients with epileptic seizure disorders or suspected epileptic seizure disorders. This includes ruling out epileptic seizure disorders in patients with non-epileptic events. LTME does not involve real time analysis of the data.

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Expert Consultation

Expert consultation for legal cases available upon request.  Please contact Dr. Spillers.

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File Review

File review available upon request.  Please contact Dr. Spillers.

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