Past Webinars

ASNM Webinars provide education for those in the IONM industry and those seeking to learn more about this evolving area of practice. Webinars are included as part of ASNM’s membership and are a worthwhile member benefit. Non-ASNM members can purchase individual webinars. Webinar sessions are presented in "real time” via the Internet. Participants view webinar materials online while listening to the concurrent audio portion of the presentation via their computer audio system.

All ASNM webinars are approved for one (1) credit hour of continuing education for ASNM-CEUs.

Only webinars that are marked are available for AMA PRA Category 1 Credit™ (CME). If a webinar has been up long than a year we can no longer offer CME credit for them. Please keep this in mind. 

Questions regarding ASNM’s webinar series?
Please e-mail [email protected] or call (331) 248–1699.



How to Access Webinars

Cost for all recorded webinars
Members: Complimentary
Non-members: $59

* IMPORTANT ACCESS INSTRUCTIONS *

*Please note that both members and non-members must complete the webinar purchase form below in order to gain access to on-demand webinars. After completing the form, a link titled "View Your On-Demand Webinars" will appear in the menu under Webinars. This link will take you to our On-Demand Learning Portal where you can access all of the webinars that you selected in the webinar purchase form. Your login information for the Learning Portal is the same as your login information for the ASNM website. In order to receive CME credit, you must watch the full webinar recording and complete the survey. 

Purchase Webinars Here
 

Digital Signal Processing Intuition

   OBJECTIVES
How to look at a signal and intuitively know how to optimize it.
PRESENTER: Tom Epplin-Zapf, MS, MA, CNIM
Tom Epplin-Zapf earned a B.S. in Biomedical Engineering with a focus in bioelectrics and an M.S. in Systems Science in Electrical Engineering from Washington University in St. Louis. Currently he is a Ph.D. candidate in Mathematical and Computational Science and a member of the Center for Neurodynamics at the University of Missouri, where he investigates learning neuroplastic networks, nonlinear and stochastic systems, and artificial intelligence. He serves as the Director of Clinical Quality and Education at SpecialtyCare.

 
 

Intraoperative Neurophysiology of Cranial Nerves III, IV, and VI.

 

OBJECTIVES
1. Understand relevant orbital anatomy for extraocular muscle electrode placement.
2. Describes benefits and risks of deep intraorbital needle electrodes for recording extraocular muscle EMG.
3. Differentiate extraocular muscle EMG waveforms from other cranial muscles.
PRESENTER: Matt Hoffman DO, PhD
 
 
 

Techniques for Spinal Cord Mapping

 

OBJECTIVES
1. Learn about essentials regarding patient preop deficits
2. Explore effective spinal cord mapping techniques
3. Identify trends in post operative patient outcomes
 
PRESENTER: Kent Rice, MS, REPT, DABNM, FASNM
 
 

tcMEP Troubleshooting: Is it a good time to optimize your motors?

            

Speakers: Stephanie Schwartz, PA-S, CNIM and Emily Kale, BS, R.EPT, CNIM
Available for (1) hour AMA PRA Category 1 Credit™ (CME) until August 31, 2022

Brain Motor Mapping: The History and Current Status


Speaker: Dr. Mitchel Berger, MD, FACS, FAANS

Available for (1) hour AMA PRA Category 1 Credit™ (CME) until June 23, 2022

Objectives
  1. Review brain mapping techniques.
  2. Explore past vs. present mapping applications.
  3. Discuss post-operative patient outcomes.
 

Probing Pedicle Screw Stimulation: Considerations for Thoracic Screw Placement

 

 

Speaker: Dr. Jonathan Norton, PhD, FACNS

Objectives

  1. Review the literature and experiential concepts distinguishing thoracic from lumbar screw testing.
  2. Discuss a regimen for effective assessment of Thoracic Screws
  3. Explore neural integrity findings from Thoracic Screw stimulation and post-operative patient outcomes.
 
 

Out on a Limb: Key IONM Concepts for Peripheral Orthopedic Surgery

Speaker: Cheryl Wiggins, AuD, DABNM, CNIM                         

Objectives

  1. Identify morbidity data related to peripheral orthopedic procedures.
  2. Describe:
    1.   Relevant peripheral anatomy (both upper & lower extremity)
    2.   Types of peripheral orthopedic procedures & critical stages
    3.   Neural elements at risk
  3. Understand the benefit of IONM during select peripheral orthopedic procedures.

Surgical Treatment of Tethered Cords

Speaker: Gregory Heuer, MD, PhD
University of Pennsylvania
Children's Hospital of Philadelphia

Objectives

  1. Examine surgical treatment & at-risk structures for tethered cords cases.
  2. Review pre-surgical collaboration and IONM applications.
  3. Discuss post operative assessments and outcomes. 
 
 

Brainstem Reflexes: New Prospects for Cranial Nerve Monitoring

Speaker: Sedat Ulkatan, MD, DABNM, CNIM

Objectives

  1. Learn emerging concepts for brainstem reflex monitoring
  2. Explore applications for cranial nerve preservation
  3. Review reflex functions for brainstem surveillance and neural integrity assessment
 
 

Impact of Anesthesia on the Diagnostic Process of IONM During Spine Procedures: An Interactive Review 

Speaker: Julie Trott, MS, CNIM, GCertED
Neurophysiologist
Director IONM Education

Objectives

  1. Examine IONM cases, exploring different diagnostic and patient outcomes
  2. Relate case examples to published literature to compare and contrast results
  3. Case examples will illustrate how the anesthetics regimen can influence the interpretive process in neurophysiology and therapy alter the accuracy and impact of IONM
 
 

Intraoperative Sensory and Motor Mapping of the Human Huomunculus 

Speaker: Jeremy Bamford, PhD
Clinical Assistant Professor
Department of Neurosurgery, Tulane University School of Medicine

Objectives
This presentation will review the fundamental neuroscience behind the accurate mapping of the sensory and motor regions of the human homunculus. Focus will be given to common mistakes and controversies present in the published literature. When possible, intraoperative videos combining surgical views and intraoperative neurophysiological data will be used to visually illustrate the techniques discussed.

  1. Understand the neurophysiology that undergirds accurate mapping possible
  2. Understand the common mistakes and why they occur
  3. Understand the practical elements of how to guide a surgeon through the mapping of the homunculus
 
 

Town Hall Interactive MEP Webinar 

 

 

Speakers:

Jeffrey Balzer, PhD, FASNM, DABNM 
Presentation: Advanced Principles of TcMEP: Where We Are in 2020

Alier Franco, PhD
Presentation: MEPs in Infants and Toddlers

Panelists: Jeffrey Balzer, PhD, FASNM, DABNM, Alier Franco, PhD, Laura Hemmer, MD, Faisal Jahangiri, MD, CNIM, DABNM, FASNM, FASET and Rich Vogel, PhD, DABNM, FASNM

Objectives:

This webinar was presented to give attendees the chance to ask questions. There are two presentations about MEPs, each presentation is 20 minutes each, and their is 1 hour and 20 minutes of questions from attendees. 5 different panelists' perspectives are provided.

 

How Much Confidence Should I Have in the Results of This Study? 

Speaker: Dr. Robert Holdefer

Available for (1) hour AMA PRA Category 1 Credit™ (CME) until April 27, 2021

Objectives

  1. Why all evidence is not created equal.  We have more confidence in the results of some studies compared to others.
  2. Sources of bias reduce our confidence in study results and effective tools for recognizing risk of bias.
  3. The differences between systematic reviews, practice guidelines, and good practice statements.
 

Techniques Review: D Wave Motor Potentials 

Speaker: Mr. Kent Rice, MS, CNIM, DABNM, FASNM 
Nuvasive Clinical Services 
Ann Arbor, MI 

Available for ONLY 1 CEU, CME not available for this webinar. 

Objectives

  1. Understand the anatomic and physiologic basis for the D-wave and rationale for its use.
  2. Understand the technique for successful setup and monitoring of the D-wave.
  3. Understand basic troubleshooting and interpretation of the D-wave.
 
 

The below past webinars are educational resources offering CEU's only.
All include a robust Q and A session near the end of each webinar.

Surgeon Communication Relative to the Cortical Bulbar MEPS & Blink Reflex

 

Speaker: Dr. Isabel Fernández-Conejero: Director of Intra-operative Neurophysiology, University Hospital of Bellvitge in Barcelona

Objectives

Cortical Bulbar MEPs & Blink Reflex- utility, meaning, recording techniques, what to communicate to the surgeon. 

Neuroimaging to Identify at Risk Structures Augments Neuromonitoring

 

Speaker: Melanie Brown Fukui, MD 

Diagnostic Radiology Specialist

Innovation Institute, Aurora Medical Group 

 

Objectives

Neuroimaging techniques and findings relevant to the patient surgical work up. Journey through deciphering imaging of Neural structures to learn visual cues and landmarks that are strategic for identifying at risk structures 

Illustrative Case Studies of IONM Strategies During Lumbar Surgeries Part 2 of 2

 

 

Michael Riley, MS, CNIM
President
Peak Neurophysiology Group, LLC

Chris Martin, R.EP.T. CNIM
Neurophysiologist
NeuroAlert

Objectives:

  1. Panel Discussion: IONM Case Studies During Lumbar Surgical Approaches/Case Examples in the Literature
  2. Procedural Implementation – includes Modifications if...
  3. Data Review and Surgical Interventions

Review of IONM Strategies Relative to Lumbar Surgical Approaches
Part 1 of 2

 

 

Michael Riley, MS, CNIM
President
Peak Neurophysiology Group, LLC

Chris Martin, R.EP.T. CNIM
Neurophysiologist
NeuroAlert

Objectives:

  1. Differentiate among the several surgical approaches for lumbar surgery and identify the procedure type based on standard acronyms
  2. Demonstrate understanding of the surgical steps of each approach type discussed, and the concomitant neurologic risks associated with the steps
  3. Plan and execute an appropriate intraoperative monitoring plan in order to avoid/mitigate the above-mentioned risks and provide comprehensive neurophysiologic coverage for the patient 

The Changing Face of Carotid Endarterectomy Surgeries: A Comprehensive Neuromonitoring Review


 

Jefrey Balzer, PhD
Associate Professor
Director, Clinical Services, Center for Clinical Neurophysiology
Director, Cerebral Blood Flow Laboratory

The participant will understand:

  1. How carotid disease is treated surgically and endovascularly
  2. Appropriate monitoring modalities
  3. How to effectively communicate change during carotid surgery
  4. Efficacy of individual IOM modalities for predicting significant change during the procedures
  5. Efficacy of individual IOM modalities for predicting post-operative and long-term stroke risk in these patients

The Role of Electrophysiology During Dorsal Root Entry Zone Microcoagulation to Treat Neuropathic Pain in Spinal Cord Injury

 

 

 

David Barnkow, AuD, DABNM, CNIM, CCC/A
Surgical Neurophysiologist
Medsurant Health 

The participant will understand:

  1. The mechanism of Central Pain after Spinal Cord injury (SCI)
  2. That pain can present At-Level and Below-Level of the SCI
  3. That dorsal-column and sympathetic nervous system have different somatotopic maps

The Surgeon Perspective: IONM in Spinal Cord Tumors

 

Francesco Sala, MD, FRCP(C), ABCN
Assistant Professor of Neurosurgery
Department of Neurosurgical Sciences and Movement, University of Verona 

Objectives:

  1. Understand the most relevant clinical aspects of intramedullary spinal cord tumors (ISCT) (signs and symptoms, MRI features, pathology)
  2. Describe the various steps of the surgery and the related IONM modalities
  3. Understand the role of different mapping and monitoring IONM techniques (SSEP, muscle MEPs, D-wave, sensory and motor mapping)
  4. Identify warning signals in IONM and suggest to the surgeon the related corrective measures
  5. Predict neurological outcome after ISCT surgery   

Transcranial Electric Stimulation Motor Evoked Potential Monitoring Update


David B. MacDonald M.D., FRCP(C) ABCN
Section of Neurophysiology
Department of Neurosciences
King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia 

Experiential evidence for optimizing TcMEP data will be covered.  Propel your knowledge and understanding of TcMEP practice recommendations.

1. Explain the Underlying Physiology For TcMEP’s
2. Optimize TcMEP Stimulation
3. Minimize Adverse Effects of TcMEP Stimulation
4. Apply Proper Warning Criteria for TcMEP Responses

Essentials of Intraoperative Auditory Brainstem Response Monitoring

 

Lawrence Wierzbowski AuD, DABNM, FASNM
President, Avatrode, LLC
IONM Consulting and Education

Since the first published description of the auditory brainstem response (ABR) by Jewett and Williston in 1971, there have been hundreds of published works on both clinical and perioperative ABR applications. Intraoperatively, the eighth cranial nerve is in jeopardy of being injured during microvascular decompression surgery. Auditory function preservation is enhanced by ABR monitoring during resection of small vestibular schwannomas.  Surgical manipulation of the brainstem during excision of large cerebellar pontine angle tumors has been monitored by ABR to detect any deleterious effect to the brainstem auditory pathways that might occur. 

Interpretation criteria for the auditory brainstem response is available from several published guidelines that are based on the literature mentioned above but what are the "other" factors we encounter daily in the operating room that we need to consider as well.

Neuromonitoring during SCS Placement: Physiological Basis

 

Jay Shils, PhD, DABNM, FASNM, FACNS
Director, IONM
Associate Professor, Anesthesiology, Rush University Medical Center

This lecture will describe, in detail, the common IONM methodologies that are used during the placement of SCS leads as well as the physiology behind those methods. Common methods include the use of antidromic activation of the alpha-motor neurons via stimulation of the dorsal columns and the use of dorsal column collisions to lateralize the placement of leads. With new stimulation patterns the utilization of these techniques may be more important given standard awake lateralization cannot be used due to lack of standard clinical markers. Additionally, the physiology behind any IONM technique is critical to understand to both know the benefits and limitations of each technique. 

Intraoperative Neuromonitoring for Neuromodulation Procedures

Steven M. Falowski, MD, FAANS
Director, Functional Neurosurgery
St. Lukes University Health Network

The use of IONM for neuromodulation is not only used as a modality for safety, but is also used as a confirmation of lead placement with spinal cord stimulators. It is this factor that is most important given the need to have a marker of proper lead position in an asleep patient. Newer protocols have also determined methods of lead placement with DRG stimulators. Newer research has examined the spinal and cortical responses of various programming waveforms, and has given an ability to have human spinal recording data.

Minimizing Confounding Variables and IONM Conflicts

 

Christopher Pace, PhD, CNIM
Chief Clinical Officer, Neuro Alert Monitoring Services
Director, Center for Electroneurodiagnostics

IONM is a helpful tool employed during spine surgery to reduce the risk of injury to delicate spinal cord and nerve pathways. IONM can, furthermore, be used to evaluate the integrity of bony structures into which metal implants have been placed (i.e. pedicle screw testing) and, also, to identify and localize neural structures. We may not always appreciate (take for granted) how many variables we are evaluating, and how much information we are integrating in order to provide the highest quality and value of IONM data. This presentation is intended to give an overview of IONM for major spine procedures and, through general discussion and case studies, to expand on this basic understanding. It will explore how specific technical, physiologic, anesthetic, surgical and communication variables (-based issues) impact IONM.

A “Bright” Future for FVEP’s? + “Insider” Tips for Brainstem Mapping

 

David Houlden, PhD
Associate Professor, Faculty of Medicine
University of Ottawa 

  • Describe anatomy and methods for direct brainstem and spinal stimulation
  • Describe limitations of stimulation and recording techniques during brainstem surgery
  • Demonstrate the utility of brainstem and direct spinal stimulation with case studies
  • Present Rationale and Factors that confound Flash Visual Evoked Potentials (FVEP) recordings
  • Detail the relationship between FVEP changes and outcomes

A Comprehensive Guide to Corticospinal Tract Mapping and Monitoring

 

Charles Yingling, PhD, CNIM, DABNM, FASNM, FACNS
Chief Executive Officer
Golden Gate Neuromonitoring

  • Understand the anatomy and physiology of SEP polarity reversal as a method for identifying the central sulcus
  • Understand when transcranial vs direct cortical MEP stimulation should be employed
  • Understand the correct parameters and indications for short vs long train stimulation
  • Know current procedures for avoiding damage to subcortical motor tracts
  • Know safe access methods for resection of intrinsic spinal cord tumors

IONM and Current Trends in Pediatric Surgeries

 

George Jallo, MD
Director
Johns Hopkins All Children's Institute for Brain Protection Sciences 

  • Understand the most common pediatric neurosurgical conditions
  • Determine what is the best for intraoperative monitoring
  • Discuss the need to alert the surgeon in cases
  • Understand communication for intraoperative team

Neuromonitoring in the Interventional Radiology Suite

James A. Watt, Jr.
VP of Neuromonitoring Services
Comprehensive Neuromonitoring Services

This presentation will review the relevant cortical and spinal anatomy, published literature, types of arteriovenous malformations, mapping techniques and case examples. We will also discuss things to think about when monitoring in the IR suite.

Navigating Legal Issues in Neuromonitoring

Eric D. Fader
Counsel
Day Pitney LLP

There is considerable confusion and disagreement regarding many of the legal and regulatory requirements pertaining to IONM. The laws of different states and the federal government differ and are constantly changing, and IONM providers must also navigate insurance carriers’ and hospitals’ requirements, and relationships with their own or outsourced personnel, in order to bill and get paid for their services while complying with applicable law. State licensure and delegation issues, and what constitutes the “practice of medicine” in a given state, can vary considerably, and contractual dealings with customers, employees and contractors, and billing and IT service providers can also be complex. This webinar will discuss some common legal issues facing IONM providers and, where possible, offer possible solutions.

Utility of Spontaneous EMG, SSEPs, and MEPS to Monitor the Functional Integrity of Spinal Nerve Roots and Plexuses

 

W. Bryan Wilent, PhD, DABNM
Vice President of Education and Training
Sentient Medical Systems

During most orthopedic procedures SSEPs and MEPs are utilized primarily to assess conduction of the spinal cord pathways, but they obviously monitor the entire pathway, from peripheral nerve to brain or from brain to muscle, and can detect a functional compromise in specific nerve roots or plexuses. The usage of these modalities for monitoring peripheral function is debatable, however, because their utility is procedure/patient specific and the sensitivity and specificity is technique dependent; therefore, the IONM team should be aware when peripheral structures are most at risk and optimize the IONM accordingly

IONM Considerations in Endonasal Skull Base Surgery

 

Adam T. Doan, DC, DABNM
Director of Clinical Services
Safe Passage Neuromonitoring

Minimally invasive intracranial surgery continues to gain popularity, as advances in visualization, instrumentation and anatomical understanding allows the endoscope to be used to approach the skull base. The endonasal endoscopic route to the skull base can now be used to gain access from the crista galli to the odontoid process. It behooves the neuromonitoring team to appreciate the different neurovascular structures that may be encountered, in order to devise a specific multimodality strategy unique to the patient and the surgery. Knowing the rationale and limitations of the plan optimizes the information collected and communicated.

Variables in Pedicle Screw Monitoring


 

Lawrence R. Wierzbowski, AuD, DABNM, FASNM
Neurophysiologist
Neurological Monitoring Services

It is important to take anatomical, neurophysiological, surgical technique, surgical instrument conductivity and many other variables into consideration when recording triggered and free running electromyographic (EMG) signals in the operating room during spinal fusion with pedicle screw instrumentation. During the electrical evaluation of either the pedicle hole or the subsequent pedicle screw a "threshold" stimulation is commonly employed using the minimum amount of current to provoke an observable and repeatable compound muscle action potential (CMAP). Interpretation and alarm criteria for pedicle screw integrity using stimulated electromyography is usually based on the several published guidelines but are there "other" factors that we need to consider as well?

Troubleshooting Intraoperative Neurophysiologic Monitoring Data

 

Kent Rice, MS, REPT, CNIM, DABNM, FASNM
Director of Education and Training
Biotronic Neuro Network

  • Strategies for evaluating, identifying and resolving common noise patterns observed during IONM.
  • Review a variety of recording and signal processing related technical problems including their identifying characteristics.
  • Troubleshooting intraoperative neurophysiologic monitoring data.

The Use of SEP and MEP Monitoring During Cerebral AneurysmSurgery to Predict Brain Ischemia

Lanjun Guo, MD, MS, DABNM
University of California - San Francisco

  • The participants will be able to understand the two main causes of brain ischemia during aneurysm surgery.
  • Describe the roles of using SEPs and MEPs during cerebral aneurysm clipping procedures.
  • Identify brain cortical and subcortical ischemia using SEPs and MEPs during the operation.

Communication in IONM, Let's Talk



Joseph J. Moreira, MD
Neurologist
Intraoperative Monitoring Associates

  • Review of the essential components of the legal document known as chat
  • Fully appreciate the medicolegal ramifications and benefits of a proper line of communication between the neurosurgeon and technician
  • Have both sides of the monitoring team understand each other’s limitations and pitfalls

Surgical Repair of the Brachial Plexus: A Surgeon’s Perspective of IONM

 

Lynda Jun-San Yang, MD, PhD
Clinical Associate Professor, Neurological Surgery

  • Understand the indications for brachial plexus surgery
  • Understand the role of IOM in brachial plexus surgery
  • Understand the strategies for nerve reconstruction of the brachial plexus.

Neuromonitoring Challenges in the Pediatric Population




Anthony Sestokas, PhD, DABNM, FASNM
Chief Clinical Officer, Neuromonitoring
SpecialtyCare

  • Highlight aspects of nervous system development that produce neuromonitoring challenges in pediatric patients
  • Identify strategies for overcoming neuromonitoring challenges secondary to nervous system development.
  • Review anesthesia management strategies to optimize neuromonitoring in pediatric patients.

Neurosurgical Anesthesiology and Intraoperative Neurophysiological Monitoring: Uniqueness, Controversies, and Case Presentations



Laura Hemmer, MD
Assistant Professor, Northwestern University
Feinberg School of Medicine

  • Emphasize value of teamwork and communication between OR teams before and during the surgical procedure.
  • Describe how different anesthetics impact evoked potentials & some controversies on use of different regimes.
  • Discuss frequent anesthetic intraoperative maneuvers’ during neurosurgery and their impact on neuromonitoring.

Neurophysiological Monitoring During Endovascular Procedures



Jeffery Balzer, PhD, D.ABNM, FASNM
Associate Professor of Neurological Surgery, Neuroscience and Acute and Tertiary Care Nursing
Associate Director of the Center for Clinical Neurophysiology
Director of Cerebral Blood Flow Laboratory
University of Pittsburgh Medical Center

  • Understand which procedures pose neurophysiological risk
  • Understand how application of IOM reduces these risks
  • Understand which modalities are applicable to each procedure

Neuromonitoring During Spine Instrumentation and Deformity Correction Procedures

 

Jay Shils, PhD, D.ABNM, FASNM
Director of IONM
The Lahey Hospital and Health System
Associate Professor in Neurosurgery
Tufts University Medical School
Founding Partner
Engineurix

Neuromonitoring Below the Belt

 

Stanley Skinner, MD, FASNM, FACNS
Neurophysiologist
Allina Health

New Practice Guidelines in Facial Nerve Monitoring






Jack Kartush, MD, FASNM
Professor Emeritus
Michigan Ear Institute
Wayne State University

  • Understand the increasing role that practice guidelines and checklists now play in clinical medicine and neurophysiological monitoring
  • Understand the critical issues in intraoperative monitoring including a) which surgical procedures should be monitored, b) how they should be monitored, and c) who should monitor.
  • Be able to list the critical steps in facial nerve monitoring.

Instrumentation Basics from the Amplifier to the Skin: Methods to Minimize Artifact and Risk for Electrical Surgical Unit and MRI Burns

 

Brett Netherton, MS, FASNM, CNIM
Managing Director
Signal Gear

  • How do you minimize artifact in your recordings?
  • How do you avoid injuring your patient with your electrode attachments?

Blood Supply of the Spinal Cord

 

Leo Happel, PhD
Professor, Neurology, Neurosurgery, Physiology, and Neuroscience
LSU Health Science Center

  • Present a comparison of functional and classic anatomy
  • Emphasize the DYNAMIC aspect of spinal cord circulation
  • Relate functional anatomy to surgical procedures on the spine

Current Status of Perioperative Multimodality Neuromonitoringfor Cardiovascular Surgery



Harvey L. Edmonds Jr., PhD, ScD
Research Professor Emeritus
Department of Anesthesiology & Perioperative Medicine
University of Louisville School of Medicine

  • Identify the causes and means of detecting potentially injurious physiologic imbalance affecting the nervous system of cardiovascular surgery patients in the perioperative environment.
  • Identify the treatment options available to correct these physiologic imbalances.