Midliner Sep 2009

Sep 2009 Issue 1 I wanted to take this opportunity to initiate a long overdue process. There are several officer positions that need to be filled, and the CSET bylaws state that the elections will be held via mailed ballots. Those who have been kind enough to offer themselves as candidates submitted brief biographical sketches of themselves, and for those who might not be familiar with all of them can get a little insight into their qualifications and motivation. Within a few weeks you should get a ballot in the mail, and once all those ballots have been collected and tabulated we’ll have a complete Board again. There are two other positions that normally would have needed to be filled this year. Peggy O’Neill graciously volunteered to serve another term as Treasurer because she saw how difficult it was to transition both Secretary and Treasurer simultaneously. President is another position that should have been filled this year, transitioning me to Past President and board membership. No nomination was offered, so I will continue in this position but will willingly step aside once a new President has been elected. Of course, mark your calendars for the 2010 Annual Meeting, to be held this year in Peoria, Illinois at the Hotel Pere Marquette. Courses Thursday, April 21st and Friday, April 22nd will cover basic and advanced END topics, including 2 full days of polysomnography, and ABRET will be having oral EEG and EP boards on the weekend.

In no particular order, I would like to present the officer candidates: Board Member Steven Shafer, R.EEGT. was nominated by Jason Snell because he has “…shown interest in participating and contributing to CSET growth and future events…”. He currently works for OSF St. Francis hospital in Peoria, Illinois. Sara Batson, R.EEGT., R.PSGT. was also nominated by Jason Snell. She has an AAS in END, and is currently employed by OSF Healthcare. Sara is also the Site Coordinator for the 2010 Annual Meeting in Peoria. Jennifer Carranza, R.EEEGT., lives in Normal, Illinois and graduated from the St. John’s School of END in 2006. She currently works at BroMenn Regional Medical Center. She is a member of both CSET and ASET. Alissa Krambeck, R.EEGT., R.PSGT., lives in Davenport, Iowa and has an AAS in END. Her employers have included Genesis Medical Center and Trinity Medical Center, and she is a member of CSET and IAET. Lucinda Rodrigues, R.PSGT., has an AAS in END and is currently employed in the Cedar Rapids, Iowa Sleep Lab. She is currently a member of CSET, and states that she is “Passionate about keeping sleep technology in neurology not respiratory.”

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From The President ABRET Exam Schedule 2009 Business Minutes Magnetic Source Imaging

Angie Gustafson, R.EEGT., R.PSGT., got her END training at Scott Community College. She currently lives in Moline, Illinois and is the Lead Sleep Technologist at Genesis Medical Center. Previous employment in the field includes stints at the University of Chicago, with SleepMed as Clinical Manager, and performing EEG and IOM at Northwestern Memorial Hospital. She has presented at CSET and is currently a member of ASET and CSET. Ryan Lau, R.EEG/EPT., CNIM, CLTM, has an AAS in END from Scott Community College as well as a BA in Exercise Science, and is pursuing an MS in Psychology. He is currently the Neurophysiology Department Coordinator for Clarian Health Neuroscience in Indianapolis, and previously held a supervisory position at Minnesota Epilepsy Group. He has presented at numerous regional meetings, is involved with the ASET Newsletter IONM section and as an Item Writer and Examiner for ABRET,

sits on the boards of ISETT and the Epilepsy Foundation of Indiana, and is a member of the ASET LTM Task Force Committee. He is also a member of ASET, CSET, and ISETT. Treasurer Sherry Kelly, R.EEG/EPT., R.PSGT. is currently the END Program Director at Scott Community College, where she obtained her AAS in the field. Her previous employers include Genesis Medical Center and Mississippi Valley Sleep Disorders Center. She has contributed to the ASET Clinical Manual and Polysomnography Competencies Committee, and has participated in the Committee on Accreditation of END Programs. She is currently a member of CSET, ASET, and AAST. Beth Anderson is actively working toward her R.EEGT., and has passed the written exam. Along with her interest in serving as Treasurer, she would like to help

EP & CNIM Written Exams February 6-20, 2010 LaserGrade/PSI Sites Deadline: 12/15/2009

EP & CNIM Written Exams July 31-August 14, 2010 LaserGrade/PSI Sites Deadline: 06/15/2010

EEG & CLTM Written Exams May 1-15, 2010 LaserGrade/PSI Sites Deadline: 03/15/2010

EEG & CLTM Written Exams October 2-6, 2010 LaserGrade/PSI Sites Deadline: 08/15/2010

EEG & EP Oral Exams February 6 & 7, 2010 San Diego, CA Deadline: 12/10/2009

EEG & EP Oral Exams July 17 & 18, 2010 Cleveland, OH Deadline: 05/17/2010

EEG & EP Oral Exams April 24 & 25, 2010 Peoria, IL Deadline: 02/25/2010

EEG & EP Oral Exams October 16 & 17, 2010 Houston, TX Deadline: 08/17/2010

For more info visit www.abret.org

with the Midliner. She has a BA in Biology Education, and is currently employed as an EEG Tech by MeritCare in Bemidji, Minnesota. Beth also has experience in Medical Transcription at MeritCare in Fargo, North Dakota, and is a member of CSET, ASET, and METS.

Regards,

Ed Carlson, President

Meeting called to order at 12:30pm by President, Ed Carlson. Attendees and Vendors were thanked for coming and the meeting was successful with good attendance. A quorum was present. [12:33pm] Approval of 2008 Board Meeting Minutes–Motion made by Phyllis Videtich-Skowron, seconded by Patti Baumgartner. No one opposed. Motion passed. Reading of Reports [12:34pm] Treasurer Report: Peggy O’Neill-Last year CSET had $14,935.73 at years end and so far in 2009 we are $2500 ahead. [12:35pm] Nominating Chairperson-Board and Secretary have nominations, need President nomination. [12:36pm] Membership Chairperson: Jaime KurtzMembership remains $25.00 with student membership at $15.00. Currently CSET has 104 members, 10 are new this year.

[12:46pm] Thanks to Brenda Terranova for arranging the local meeting. [12:47pm] Sara Batson gave an update on meeting arrangements for Peoria. [12:49pm] 2001 CSET site, Bloomington, MN was proposed, Patti Baumgartner motioned, Phyllis Videtich-Skowron seconded, Bloomington was approved. [12:50pm] Outgoing Board members are Brenda Terranova, Pat Trudeau, Karen Lucey, Joyce Riedel, Peggy O’Neil, Michelle McHugh [12:55pm] Brenda Terranova recognizes Joyce Riedel as Education Chair. [12:50pm] Motion to AdjournMotion to adjourn made by made by Patti Baumgartner, seconded by Sara Batson. Meeting then adjourned.

[12:36pm] Vendor Coordinator: We had 13 vendors for 2009. [12:36pm] Scholarship Chairperson: There were 4 eligible scholarships, 3 were awarded. [12:37pm] ABRET Update: There are 70 candidates for boards; 46 labs accredited; a NIOM lab accreditation in development; an LTM accreditation focus group; a change in CNIM certification requirements; need nomination for board members. New Busines [12:43pm] Outstanding Educator was given to Ed Carlson by Lucy Sullivan. A moment of silence in remembrance for Lewis Kull.

--Minutes Respectfully Submitted by Michelle McHugh (CSET Secretary)

EEG recording is the summation of EPSP's and IPSP's (Excitatory Pre3D representation of MSI data Synaptic, & subdural electrode array and Inhibitory Post-Synaptic, Potentials) from cortical areas; the numbers of these cortical areas firing in concert produces the amplitude of the electrical activity we record. As these neurons fire, they produce electrical "flow" - the flow of electricity is, elementally, the flow of electrons from a relatively negative pole to a relatively positive pole. As this flow is occurring, it produces changes in the magnetic flux inherent in the surrounding environment, at an infinite number of right angles to the electron flow. The power of the magnetic fluctuation relates directly to how close or far away from the electrical source the measurement is being taken; when we do Magnetoencephalography, we use multiple sensor arrays from which we can triangulate the original electrical source that produced the magnetic fluctuation. The technology we use had as one of its' first practical applications

submarine detection on the open ocean. SONAR was limited by the proximity of the object to be detected; Superconducting Quantum Interference Detection (SQUID) extended the range of detection. We still call the sensors used for magnetic source detection SQUID’s. The types of "discharges" we can localize with these SQUIDS can be epileptogenic in nature, or they can be associated with normal brain functions like speech, movement, sensation, and maybe in the future, memory. The "dipoles" of these discharges can be calculated and projected onto X, Y, and Z planes which relate to correlates of the subject' head; these dipole maps can then be cross-correlated with similar X, Y, and Z planes on the subjects imaging studies like CT or MRI to produce functional/anatomical models of the brain. This merging of functional and anatomic data produces Magnetic Source Imaging. In essence, magnetic source imaging and EEG activity are intimately related - if there is no electrical flow, there is no change in magnetic flux. EEG is limited by the fact that it is routinely recorded from the surface of the scalp, so we record through physiologic filters of bone, skin, etc., which gives us a reasonable

Please submit comments and/or article submissions to:

Brian Owens Editor/Webmaster Midliner A Publication for the Central Society of Electroneurodiagnostic Technologists Phone: 651.241.5342 Email: [email protected] Web: www.csetonline.org

representation if a) enough cortex is involved, and b) the origin of the discharge is not too deep. The increased sensitivity of SQUIDS allows us to see a more "neuronal" sort of activity, rather than summated EPSP's and IPSP's, and because of this fact and the large sensor arrays used by MSI we are able to more accurately triangulate the origin of deep electrically active areas and the relatively small electrical impulses generated when functional areas of the brain are activated. Magnetoencephalography and Magnetic Source Imaging have proven valuable in mapping cortical regions of patients facing surgery for brain lesions and/or intractable epilepsy. Other applications of this technology are also being explored. While the logistics and cost of building and maintaining a suite limit the number of sites able to perform MEG/MSI, the sensitivity and specificity of this mode of functional mapping warrants continued investigation. Besides, it’s just plain cool! --Submitted by Ed Carlson, R.EEGT/EPT, CNIM, CLTM