Center for Clinical Neurophysiology
The Center for Clinical Neurophysiology (CCN) at UPMC was organized in 1981 as an interdepartmental resource serving, at that time, Presbyterian University Hospital, Montefiore Hospital and Children’s Hospital of Pittsburgh. At this time the CCN was composed of just a few clinicians providing diagnostic testing and intraoperative monitoring (IOM) services for only very specific surgeries in the neurosurgical and orthopedic disciplines.
The service has now grown to providing some 7,000 IOM cases per year at all UPMC pavilions as well as supporting UPP surgeons at non-UPMC hospitals. The CCN is the largest and busiest academic IOM program in the country providing services at 12 UPMC hospitals including UPMC Hamot. In addition, the CCN provides professional and technical coverage at Mon Valley and Jameson Hospitals.
The use of IOM at UPMC reaches across many surgical disciplines and has proven to be an invaluable adjunct not only in adult and pediatric neurosurgical procedures but also in orthopedic, ENT, vascular and cardiothoracic surgical procedures.
Intraoperative multimodality monitoring at UPMC includes expertise in somatosensory evoked potentials (SSEP), brainstem auditory evoked potentials (BAEP), motor evoked potentials (MEP) and electromyography (EMG).
Direct peripheral nerve recordings also are performed as well as single unit micro-electrode recordings performed during placement of DBS electrodes in various subcortical structures. EEG is also used to monitor cerebral function and ischemic risk during cerebral and peripheral vascular procedures including cerebral aneurysm treatment, carotid endarterectomy and a variety of cardiothoracic procedures.
EEG recorded directly from the pial surface of the brain, or Electrocorticography (ECOG) is used to help determine resection margins in epilepsy surgery, and to monitor for seizures during direct electrical stimulation of the brain surface carried out while mapping eloquent cortex in awake patients.
In addition to providing IOM services, the CCN also performs diagnostic evoked potential testing, continuous EEG services as well as transcranial Doppler studies.
Through our research efforts and publications we have shown that the application of multimodality intraoperative neurophysiological monitoring during a variety of peripheral and central nervous system operative procedures has a will continue to provide for an additional element of high-level care for our patients ultimately reducing morbidity thereby establishing a cost savings for the health system.
The Center for Clinical Neurophysiology, its highly trained and nationally renowned faculty and technical staff and the tools and techniques they utilize, bring yet another component of exemplary patient care to the UPMC patient population.
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