The subspecialty of Clinical Neurophysiology involves the assessment of function of
the central, peripheral, and autonomic nervous systems as well as skeletal muscle
using both clinical evaluation and electrophysiologic testing. The latter includes
electroencephalography (EEG), magnetoencephalography (MEG), electromyography (EMG),
nerve conduction studies (NCS), polysomnography (PSG), evoked potentials, and autonomic
testing. Practicing in clinical neurophysiology requires a sound understanding of
clinical neurology, normal neurophysiology, and the wide array of abnormal neurophysiologic
findings that may be associated with different neurologic disorders.
It is often challenging for neurology trainees to acquire optimal knowledge in neurophysiology
during residency given its high clinical demand coupled with the multitude of subspecialties
within neurology. Similarly, trainees may not have the opportunity to be exposed to
all facets of clinical neurophysiology thereby narrowing their experience as budding
neurologists. In light of these system-based constraints, the Arquivos de Neuro-Psiquiatria recognizes the need for a new journal subsection exclusively focused on the field
of clinical neurophysiology. We hope this subsection will expand trainees’ learning
experience and ultimately improve patient care as well as potentially encourage some
trainees to pursue further training in neurophysiology.
Images in Clinical Neurophysiology welcomes manuscripts with highly educational value related to the subspecialty of
neurophysiology. Neurophysiologic content (educational images and/or videos of EEG,
EMG, NCS, PSG, and evoked potentials) should be previously unpublished, interesting
material highlighting clear examples of established observations curated for a trainee
readership. Authors should also submit three multiple-choice questions along with
answers related to the respective manuscript.
Authors may consider selecting cases of uncommon presentations of common neurophysiologic
disorders or common presentations of uncommon neurophysiologic disorders. Additionally,
describing artifacts that may be mistakenly interpreted as abnormal also has great
educational value. Within the realm of EEG and epilepsy, authors may consider the
following examples as reference:
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A case of typical notched delta pattern on EEG in a patient with Angelman syndrome[1].
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A report of the “texting rhythm” on EEG associated with cortical processing related
to the use of personal electronic devices[2].
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A description of snoring-related artifact, which was previously thought to arise from
the cortex overlying the amygdala (“limbic spindles”)[3].
Within the realm of electrodiagnostic testing in neuromuscular medicine, the following
examples may serve as excellent teaching tools in highlighting the technical aspects
of testing as well as the importance of a keen clinical correlation:
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The presence of ‘pseudo-conduction block’ without other demyelinating features in
vasculitic mononeuritis multiplex, where a conduction block is manifested by focal
infarction and axonal loss rather than the typical demyelinating mechanism[4].
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The lack of temporal dispersion and conduction block with a predominance of prolonged
distal latencies in anti-MAG demyelinating neuropathy, which provides a distinguishing
feature from CIDP (chronic inflammatory demyelinating polyradiculopathy)[5].
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The evaluation of anatomical variants, such an accessory deep peroneal nerve, in case
of peroneal neuropathy resulting in foot drop with preservation of toe extension[6].
We hope to attract outstanding and highly educational neurophysiology manuscripts
ideally led by trainees from across the globe. We are truly grateful to the Arquivos de Neuro-Psiquiatria for creating this new subsection in the journal. We hope Images in Clinical Neurophysiology will become a unique educational resource and serve to (i) supplement neurophysiology
education on an international level and (ii) inspire neurology trainees to embrace
the fascinating field of neurophysiology.
