Neurophysiology

• Routine EEG
• Sleep EEG
• Ambulatory EEG with/without video
• Multiple sleep latency testing 
• IP Video EEG long term monitoring
• Nerve conduction studies
• Electromyography
• Visual evoked potentials
• Electroretinography
• Somatosensory evoked potentials

The team includes:

• Kelly Bill, Clinical Service Manager (top row, far left)
• Dr. Sarah Green, Clinical Neurophysiology Consultant (top row, centre)
• Joanna Davis, Clinical Scientist (bottom row, far left)
• Zoe Braznell, Clinical Scientist (second row, far right)
• Paul Wright, Clinical Scientist (third row, far right)
• Heather Betteridge, Clinical Scientist (third row, far left)
• Sean Bennett, Clinical Scientist (top row, far right)
• Lydia Collins, Clinical Scientist (second row, far left)
• Georgie Davies, Clinical Physiologist (second row, centre)
• Julie Lock, Healthcare Scientist Assistant (bottom row, second from right)
• Ruth Coles, Medical Secretary, Neurophysiology (bottom row, second from left)
• Martha Shaw, Apprentice Clinical Physiologist (third row, centre)
• Cheryl Byrd, Epilepsy Clinical Nurse Specialist (bottom row, far right)

01905 733532

Department email address – [email protected]

Click on the title below to open each patient information leaflet:

• Ambulatory EEG
• Ambulatory EEG with video
• EEG (Electroencephalogram) Easy Read leaflet
• Melatonin sleep EEG (3 years old and under)
• Melatonin sleep EEG (3 years old and over)
• Multiple sleep latency test
• Natural Sleep EEG
• Natural Sleep EEG (3 years old and under)
• NCS and EMG Easy Read leaflet
• Nerve Conduction Studies
• Nerve Conduction Studies and EMG
• Nerve Conduction Studies (Outreach Clinics)
• Partially Sleep Deprived EEG
• Prolonged EEG with video
• Prolonged inpatient EEG with video (child)
• Routine EEG
• Somatosensory evoked potential
• VEP and ERG Easy Read leaflet
• Visual evoked potential and ERG

The information leaflet enclosed in your appointment letter will tell you what type of EEG test you have will have. 

How should I prepare for my EEG?

You should ensure that your hair is clean, dry and free of hair products to ensure that the electrodes (small metal discs) have the best contact with your scalp. It is also useful to wear a top that can be zipped or buttoned up at the front as we will apply a few electrodes to the top of your chest and your arm.

You should take your medicines as normal and bring a list of these with you. If you are bringing a small child for their EEG, it can be useful to bring along something to distract them, such as toys or snacks.

If you or your child are coming for a sleep EEG, try to ensure sleep will be achieved in the test by making yourself or your child more tired and avoiding any naps beforehand. 

How long will the test take?

Routine EEG tests will take up to 1 hour. Sleep EEG tests can vary depending on how long it takes to fall asleep but they generally take up to 2 hours. Prolonged EEGs with video in the department take between 2-6 hours. An ambulatory EEG test where you go home with the electrodes on can take between 18-72 hours. 

Can I eat before my test?

It is beneficial to eat and drink as usual before your EEG test. However, if you are having a sleep-deprived EEG, it is advised not to consume caffeine beforehand. 

Can I wear jewellery?

Yes – jewellery does not interfere with the test. 

What is melatonin?

Melatonin is a hormone produced by the body to regulate sleep cycles. Melatonin is not a sedative and there are no known side effects. It is used to encourage drowsiness/sleep. The effects are relatively short-lasting. If your child is prescribed melatonin at before bedtime at home, they can still have this as normal. 

Does my baby/child have to take the melatonin?

No – if your baby/child is relaxed and will fall asleep without the melatonin then they do not have to take it. 

Is the EEG painful?

The test is pain-free. You will feel us sticking on the electrodes which will feel slightly scratchy and cold.

Adults tolerate this fine, however some children, particularly those with sensory processing difficulties, may find this part of the test uncomfortable. It is therefore advised to bring something to distract your child, such as toys or snacks.

Once the electrodes are applied, the recording will begin and you will not feel anything.

Are there any risks?

There are few risks involved with EEG tests. During most EEG tests with your consent, we may show you a flashing light (photic stimulation) and ask you to take some quick, deep breaths (hyperventilation). These can increase the risk of having a seizure or episode in some people, however this is rare and you can ask to stop at any point.

If we have asked you to come to your test sleep-deprived, this can also temporarily increase the risk of you having a seizure. If you are coming for an ambulatory or video EEG test, the electrodes are covered with a bandage to make one cable. It is possible that this could wrap around your neck at night when you take the EEG recorder home, therefore we have to warn you of the small risk of strangulation.

It is recommended that you have someone with you. There is also a small risk that the electrodes could cause sore spots to your head. Please let us know if you have particularly sensitive skin or are allergic to metal or micropore tape.  

Are there any side effects?

You will have some sticky hair after the EEG due to the paste used to stick electrodes on. Otherwise, there are no lasting side effects. During the test, we may show you a flashing light (photic stimulation) and ask you to take some quick, deep breaths (hyperventilation) with your consent.

The flashing lights can be uncomfortable for some people who are sensitive to bright lights. The deep breathing can make some people feel slightly light-headed and/or dizzy. These effects are short-lasting. The lights and breathing can increase the risk of having a seizure or episode in some people, however this is rare and you can ask to stop at any point.   

Is the test safe in pregnancy?

The test is safe in pregnancy, however please inform the person doing your test if you are pregnant because hyperventilation will not be performed. 

Is there anything I cannot do during an ambulatory or video EEG?

When we send you home with the wires glued on for a longer period, you will have a small bag with you at all times.

If we are performing a video EEG test, you will also have an iPad and video camera in a portable suitcase. Because of this, you are slightly restricted in what you can do. Excessive movement can also interfere with the test, therefore it is advised that you refrain from doing anything too strenuous while the recording is ongoing.

You will not be able to have a bath or shower as the equipment cannot get wet. We also ask that you do not use chewing gum as this can also interfere with the test.  

How do I remove the sticky paste?

A normal hair wash with shampoo, conditioner and a good scrub will remove the paste. If you have had an ambulatory EEG with glue applied to electrodes, you may wish to soak your hair in oil-based products first, such as olive oil or argan oil, and comb through to break down the adhesive. 

Will I be able to drive after my test?

The EEG test itself does not leave you unable to drive afterwards. However, if your neurologist or GP has advised you to stop driving due to your episodes, then you should not drive to or from your appointment.  

Can I go to work after my test?

Yes. 

When will I get my results?

Your test will be interpreted by the specialists in the neurophysiology department. A report will be written and sent to your referrer within 2 weeks. Your referrer should then discuss them with you.   

The information leaflet enclosed in your appointment letter will tell you whether you will have visual evoked potentials and ERG or somatosensory evoked potentials. 

What are evoked potentials?

Evoked potentials look at the pathway of nerve signals travelling from different parts of the body to the brain. There are different types of evoked potentials.

The information leaflet enclosed in your appointment letter will tell you which type of evoked potentials you will have. Visual evoked potentials (VEPs) look at the pathway of the nerve signals travelling from the eye to the brain.

An electroretinogram (ERG) is an additional test which may also be performed and it looks at the functioning of the retina (the layer of cells at the back of the eye). Somatosensory evoked potentials (SSEPs) look at the pathway of the nerve signals travelling from the hands or feet to the brain.

What is an ERG test?

An electroretinogram (ERG) looks at the functioning of the retina (the layer of cells at the back of the eye). You may or may not have this alongside a VEP test. 

How long will the test take?

The test is adapted depending on your symptoms, therefore the length of the test varies for everyone. It generally takes between 30-90 minutes depending on the type and number of tests being performed.  

How should I prepare for my visual evoked potentials?

You should ensure that your hair is clean, dry and free of hair products to ensure that the electrodes (small metal discs) have the best contact with your scalp.

You should take your medicines as normal and bring a list of these with you. Please bring any glasses you wear with you. 

How should I prepare for my somatosensory evoked potentials?

You should ensure that your hair is clean, dry and free of hair products to ensure that the electrodes (small metal discs) have the best contact with your scalp. You should take your medicines as normal and bring a list of these with you.

Please bring any glasses you wear with you. Please ensure you wear loose clothing so that your arms or legs are easily accessible as this is where we will place the electrical stimulus.

Your hands, arms, legs and feet need to be clean and free of creams/lotions, including tanning creams as these can interfere with the test. Keep your hands/feet as warm as possible prior to the test as cooler temperatures can give us false readings. Please remove any bracelets or watches. 

Can I eat before my test?

It is beneficial to eat and drink as usual before your test.  

Is the test safe in pregnancy?

The test is safe in pregnancy. 

Is the test painful?

You will feel us sticking on the electrodes which will feel slightly scratchy and cold. Visual evoked potentials are not painful but some people find it difficult to concentrate on the screen during the test – you can ask for breaks.

For an ERG test, the physiologist/scientist will need to place a small fibre along the lower lid of your eye. This can feel slightly uncomfortable, similar to the feeling of a small hair in the eye, for a brief period of time.

Somatosensory evoked potentials are relatively pain-free, however some people may find it slightly uncomfortable for a few minutes when the electrical stimulus is applied; you will feel a tapping or twitching sensation in your hands/feet whilst the responses are recorded from your brain.  

Are there any risks?

Evoked potentials are considered a low risk, non-invasive test. There is a small risk of temporary minor skin irritation from the electrodes. If you are having visual evoked potentials or ERG, it is advised that you inform the person doing your test if you have epilepsy as flashing lights may be used. 

Are there any side effects?

You will have some sticky hair after the test due to the paste used to stick electrodes on. Otherwise, there are no lasting side effects.  

Will I be able to drive after my test?

Yes – there are no lasting side effects which will stop you from driving afterwards. 

Can I go to work after my test?

Yes. 

When will I get my results?

Your test will be interpreted by the specialists in the neurophysiology department. A report will be written and sent to your referrer within 2 weeks. Your referrer should then discuss them with you.   

The information leaflet enclosed in your appointment letter will tell you whether you will have nerve conduction studies (NCS), electromyography (EMG) or both. 

How should I prepare for my test?

You should take your medicines as normal and bring a list of these with you. Please ensure you wear loose clothing so that your arms or legs are easily accessible as this is where we will place the electrical stimulus.

We need to access the arm up to the shoulder, and the leg up to the thigh. Otherwise, you may be asked to change into a gown. Your hands, arms, legs and feet need to be clean and free of creams/lotions, including tanning creams as these can interfere with the test.

Keep your hands/feet as warm as possible prior to the test as cooler temperatures can give us false readings. If the tests are on your hands, you will need to take off jewellery and watches from both hands (you can leave your wedding ring on). 

If you have a pacemaker/defibrillator, please call the department on 01905 733532 to inform us. Cardiology may need to monitor the pacemaker during the procedure. 

If you are also having an EMG test, please notify us if you have a bleeding disorder or low blood platelets as you may need a blood test at your GP surgery 1 week before the test.

Please tell us if you are taking a blood thinner such as warfarin or apixaban prior to the test. If you take warfarin, please bring your record book and call us with your INR up to 1 week before the test.  

How long will the test take?

Nerve conduction studies alone can take anywhere between 20-45 minutes as the test is tailored to you. If you also need an EMG test, this can take an additional 20 minutes – again, this time differs for everyone. 

Can I eat before my test?

It is beneficial to eat and drink as usual before your test.  

Is the test safe in pregnancy?

The test is safe in pregnancy. 

Is the nerve conduction test painful?

You will feel a tapping or twitching sensation in your arms and/or legs. The sensations are brief and intermittent, however some people may find it a little uncomfortable.

Just let the person doing your test know if you would like a break or want to stop at any point. 

Is the EMG painful?

A fine needle electrode is inserted into a muscle. This feels like a small pinch and is well-tolerated by the majority of people. You can ask to stop the test at any time if it becomes uncomfortable. 

Are there any risks?

There are few risks involved with NCS. For EMG, very rarely, there is a risk of infection due to needle insertion. This occurs in less than 1 in 10,000 cases. Sterile needle electrodes are used and the skin is wiped with a disinfectant wipe prior to insertion to minimise this risk.

Needle insertion into a limb affected by lymphoedema is usually avoided. Very rarely, there is a risk of bleeding into the muscle requiring treatment. This occurs in less than 1 in 10,000 cases, and is usually seen in patients who take a blood thinner or have a bleeding disorder.

Pressure is applied to the puncture sites, to reduce bleeding.  

Are there any side effects?

There are no lasting side effects of NCS. For EMG, the most common side effect (more than 1 in 10 people) is mild discomfort or bruising after the test. This usually eases off after a couple of days. Less than 1 in 100 people may feel faint. 

Will I be able to drive after my test?

Yes – there are no lasting side effects that will stop you from driving afterwards. 

Can I go to work after my test?

Yes. 

When will I get my results?

Your test will be interpreted by the specialists in the neurophysiology department. A report will be written and sent to your referrer within 2 weeks. Your referrer should then discuss them with you. 

What is involved in an MSLT?

There are two parts to the test, therefore you will need to attend on two consecutive days. On the first day, you will attend the department to have electrodes applied for an overnight EEG (encephalogram) recording. The EEG records the electrical activity of your brain. You will not feel anything from the EEG.

You will be asked to fill in a diary sheet when you take the EEG recorder home. Please remember to bring this with you on day two. On the second day, have a light breakfast in the morning of the test. You will participate in up to 5 ‘nap trials’ at 2 hour intervals where you will lie down to sleep in a quiet, darkened room.

You should wear comfortable clothes that you can sleep in. In between nap trials, you will be able to walk around the hospital and should try to avoid sleep. Some people like to bring something to cover their head to disguise the wires while out of the department.

You should avoid heavy exercise, caffeine, stimulating activities and bright sunlight. If you must smoke, please avoid this 30 minutes before the start of a nap trial.  

How long will the MSLT take?

The appointment on day 1 will take up to 1 hour. The MSLT on day 2 will take up to 9 hours. 

How should I prepare for my MSLT?

Please complete the questionnaire and sleep diary enclosed with your letter. You should aim to have sufficient sleep for the 2 weeks leading up to the test as sleep deprivation will lead to inaccurate results.

You should ensure that your hair is clean, dry and free of hair products to ensure that the electrodes (small metal discs) have the best contact with your scalp. It is also useful to wear a top that can be zipped or buttoned up at the front as we will apply a few electrodes to the top of your chest and your arm.

Certain medications can affect the test. Please ensure you have had a discussion with your referrer about whether you need to reduce or stop taking any medication in the 2 weeks before your appointment. Please bring a list of your medications with you.

You will need to have a minimum of 6 hours sleep overnight before the second part of the test. You should expect to be in the hospital for up to 9 hours on day 2 of the test. Due to the length of the test, you will be offered lunch and are advised to bring something to occupy yourself, such as a book.  

Can I eat before/during my test?

It is beneficial to eat and drink as usual before and during your MSLT test. However, caffeine must be avoided on the day of the test so you may need to consider reducing the amount you consume slowly in the 2 weeks leading up to the test if you usually drink a lot. 

Is the test safe in pregnancy?

The test is safe in pregnancy. 

Is the MSLT painful?

The test is pain-free. You will feel us sticking on the electrodes which will feel slightly scratchy and cold. Once the electrodes are applied, the recording will begin and you will not feel anything.  

Are there any risks?

There are few risks involved with an EEG and MSLT test. During the first part of the test when you go home with equipment, the electrodes are covered with a bandage to make one cable.

It is possible that this could wrap around your neck at night when you take the EEG recorder home, therefore we have to warn you of the small risk of strangulation. It is recommended that you have someone with you.

There is also a small risk that the electrodes could cause sore spots to your head. Please let us know if you have particularly sensitive skin or are allergic to metal or micropore tape.  

Are there any side effects?

You will have some sticky hair after the EEG due to the paste and glue used to stick electrodes on. Otherwise, there are no lasting side effects.  

Is there anything I cannot do during EEG when I go home with the electrodes on?

When we send you home with the wires glued on, you will have a small bag with you at all times. Because of this, you are slightly restricted in what you can do.

Excessive movement can also interfere with the test, therefore it is advised that you refrain from doing anything too strenuous while the recording is ongoing.

You will not be able to have a bath or shower as the equipment cannot get wet. We also ask that you do not use chewing gum as this can also interfere with the test. 

How do I remove the sticky paste and glue?

A normal hair wash with shampoo, conditioner and a good scrub will remove the paste. You may also wish to soak your hair in oil-based products first, such as olive oil or argan oil, and comb through to break down the adhesive.

Will I be able to drive after my test?

The EEG/MSLT test itself does not leave you unable to drive afterwards. However, if your neurologist or GP has advised you to stop driving due to your sleepiness or episodes, then you should not drive to or from your appointment.

When will I get my results?

Your test will be interpreted by the specialists in the neurophysiology department. A report will be written and sent to your referrer within 2 weeks. Your referrer should then discuss them with you.