Introduction

In the past, attempts in the UK to create guidelines for common Neurophysiological procedures have foundered on strongly held but divergent views on who was qualified to do what, and what techniques were appropriate in any clinical situation. It was with these factors in mind that the Physiological Measurement Leadership group (PMLG) of the British Society of Clinical Neurophysiology/Electrophysiological Technicians Association commissioned a new set of national guidelines to be prepared. Evidence based guidelines have been prepared in other countries, particularly in the USA but these are culturally determined and do not automatically translate across the Atlantic.

Terminology: As there remains doubt about job titles and to avoid confusion, practitioners are divided into two identifiable groups a) Consultant Clinical Neurophysiologists (CCN) and b) Clinical Physiologists (Neurophysiology) (CP).(also called currently or in the past Medical Technical Officers, Technicians).

This exercise is an opportunity to improve the quality and throughput of Peripheral Neurophysiological investigations. There will be inevitable differences of practice and professional opinion (but see the conscience clause). However, these guidelines should be considered a tool to underpin good standards of Clinical Neurophysiology and to be aspirational for improvements in both medical and physiologist practice.

The likely future pattern of peripheral Clinical Neurophysiology services is a mix between Clinical Physiologist led clinics, Medical Clinical Neurophysiologist clinics and some clinics which use both types of professional staff. The degree of autonomy will depend on available staff, recorded competencies and local decisions.

This document provides liks to a variety of other sources of guidelines relevant to clinical neurophysiology.

Also of interest are recent standards for quantification of EMG and neurography, which update the 1999 ICCN standards.