ABSTRACT
RICHARD MOBERG Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, and Moberg Medical, Inc., Ambler, Pennsylvania
21.1 INTRODUCTION In recent years there has been increased interest in observing brain electrical activity over extended periods of time. This is due, at least in part, to the modern aggressive approach to treating central nervous system (CNS) problems. Examples are seen in new surgical procedures affecting the brain vasculature, promising new techniques for the management of head and spinal cord trauma, and new pharmacotherapy that acts on the brain, such as anesthetics and psychoactive agents. The use of conventional monitoring equipment in these applications, however, has met with little success despite the clear need for these techniques.! This increased interest, but lack of suitable equipment, has prompted the development of a new class of instrument; the low-cost, dedicated monitor for observing brain electrophysiology. In this chapter we describe current monitoring systems and techniques and the processing algorithms now used and those that show promise. We include a description of current and future applications ofcontinuous neurophysiological monitoring. Since this is a new field, many techniques are still experimental. Accordingly, research issues will be described. Well-established neurophysiological monitoring applications such as sleep studies and seizure monitoring are reviewed elsewhere and are not being covered here except where new techniques have obvious application to these areas.
