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Career in Neurodiagnostics


If you are a science and technology oriented individual who likes to work with people and who is looking for a challenging career in a health care field, neurodiagnostic technology may be the allied health field for you.
Neurodiagnostics analyzes and monitors nervous system function to promote the effective treatment of neurological diseases and conditions.
Neurodiagnostic technologists record electrical activity arising from the brain, spinal cord, and peripheral nerves using a variety of techniques and instruments. This involves preparing patients for procedures, obtaining medical histories, recording electrical potentials, calculating results, and maintaining equipment. Technologists may work with specific treatments. They develop a good rapport with patients and comfort them during the recording procedure, which can last from 20 minutes (for a single nerve conduction study) to 8 hours (for an overnight sleep study). Neurodiagnostic technologists are trained to understand neurophysiology and recognize normal and abnormal electrical activity. They act as eyes and ears for specially trained doctors who later review and interpret the data. Considerable individual initiative, reasoning skill, and sound judgment are all expected of the electroneurodiagnostic professional.
The most common procedures that neurodiagnostic technologists perform are the electroencephalogram, long term monitoring, intraoperative neuromonitoring, the polysomnogram, evoked potential studies, and nerve conduction studies. The electroencephalogram [EEG] is the most frequently performed procedure.

Electroencephalogram [EEG] – Reveals different brain patterns

The Electroencephalogram [EEG] is a recording of the on-going electrical activity of the brain. An EEG is used to assist in the diagnosis of epilepsy and a variety of neurological symptoms. EEGs also are used to evaluate the effects of head trauma or the consequences of severe infectious disease. EEG information can help doctors determine medical and surgical treatment of epilepsy. Patients having surgery on arteries in the neck or around the heart often have EEG monitoring performed during the procedure, providing the surgeon with additional information about brain function and assuring surgeons that the brain receives enough oxygen. In conducting an EEG, highly sensitive monitoring equipment records the activity through electrodes that are placed at measured intervals on a patient’s scalp. The test is not painful. The test itself usually takes about 90 minutes and the principal role of the patient is simply to remain still, relaxed and comfortable.

The simultaneous recording of EEG and videotaped behavior over extended periods of time is referred to as long-term monitoring (LTM). It is useful in diagnosing patients with intermittent or infrequent disturbances as well as in the diagnosis of seizures and other neurological disorders, such as unexplained coma.

Intraoperative Neuromonitoring – Monitors nervous system during surgery

Intraoperative Neuromonitoring [IONM] is the use of neurophysiological monitoring techniques during surgery to provide information to the surgeon about nervous system integrity. The use of IONM guards against neurological complications during surgery and helps reduce the risk of negative surgical outcomes such as paralysis or stroke. IONM is used to monitor neurosurgical procedures and orthopedic procedures, including spinal surgery for scoliosis, tumors, and aneurysms; vascular surgeries; acoustic neuroma surgery; and carotid endarterectomy. Otolaryngologists use intraoperative neuromonitoring to monitor cranial nerve function during ear, nose, and throat (ENT) surgeries.

Polysomnograms [PSG] – Recording during sleep
The Polysomnogram [PSG] is a recording during sleep that uses EEG and other physiologic monitors to evaluate sleep and sleep disorders, such as loud snoring, difficulty staying awake during the day, falling asleep at inappropriate times, insomnia, and uncontrollable urge to move one’s legs. Physicians use polysomnograms to identify dysfunction in sleep/wake cycles, to diagnose breathing disorders during sleep, and to evaluate treatment of these disorders.
Evoked Potentials [EP] – Record electrical activity in response to stimulation
Evoked Potentials [EP] are recordings of electrical activity from the brain, spinal nerves, or sensory receptors in response to specific external stimulation. Evoked potentials are helpful in evaluating a number of different neurological problems, including spinal cord injuries, hearing loss, blurred vision and blind spots, acoustic neuroma, and optic neuritis. This test is commonly performed by the technologist during surgery on the spine to help the surgeon make sure nerves are not damaged during the operation. Evoked potentials also are performed in a clinical neurodiagnostic laboratory, using either earphones to stimulate the hearing pathway, a checkerboard pattern on a television screen to stimulate the visual pathway, or a small electrical current to stimulate a nerve in the arm or leg.
Nerve Conduction Studies [NCS] – Record stimulated nerve response time
Nerve Conduction Studies [NCS] evaluate electrical potentials from peripheral nerves. Technologists stimulate the nerve with an electrical current and then record how long it takes the nerve impulse to reach the muscle. Patients referred for NCS tests suffer from nerve conditions which produce numbness, tingling, muscle pain, muscle weakness, muscle cramping, abnormal movements, pain or loss of sensation, or neurological diseases affecting primarily the feet, legs, hands, arms, back, and neck.

What Is the Career Outlook for Neurodiagnostic Technologists? Employment opportunities are abundant. Particularly strong growth areas are polysomnography and the specialty areas of long term monitoring for epilepsy and intraoperative monitoring. There is a continuous need for well-educated electroneurodiagnostic technologists, and the demand grows as new labs open and existing labs expand.
How Much Do Neurodiagnostic Technologists Earn? Salaries depend on education, experience, level of responsibility, type of employment, and area of the country. Consequently, salaries range from $31,100 for a neurodiagnostic program graduate just entering the field to over $70,000 per year for lab managers or independent contractors. The mean (average) salary for all neurodiagnostic technologists across the country was $48,173, based on data collected from neurodiagnostic laboratories in 2006. Technologists who hold professional credentials, college degrees, and who own their own business command the highest salaries.
What Basic Qualifications Do Neurodiagnostic Students Need? They must have actively inquiring minds, above average intelligence, and a willingness to engage in life-long learning. They must have tact, patience, and compassion. Manual dexterity and a capacity to deal with visual, electrical, and computer concepts are important.
What Type of Education/Training is Required? Persons interested in pursuing a career in neurodiagnostic technology are strongly encouraged to attend a school specializing in the field. Currently, most of the schools are associated with two-year colleges, with a few located within hospitals or vocational schools. Some schools offer distance-learning programs. It is anticipated that in the near future colleges and universities will begin offering Bachelor’s degree programs for the END profession.
According to the American Society of Electroneurodiagnostic Technologists (ASET) minimum educational requirements for performing electroneurodiagnostic procedures, an individual entering the profession must have earned an associate degree or higher and have successfully completed a program reviewed by the Commission on Accreditation for Educational Programs in Electroneurodiagnostic Technology (CoA-END) and accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). Within two years of graduation, individuals are strongly encouraged to take and pass a recognized, national examination for professional credentials in an area of neurodiagnostic specialty. Both education and clinical experience are necessary to attain sufficient knowledge base and clinical expertise. Click here for a list of schools offering programs of study in neurodiagnostic technology and polysomnography.
What are the skills I will need to be successful in this profession? The knowledge base and clinical proficiencies required for performing EEG, evoked potentials, nerve conduction studies, intraoperative neuromonitoring, long term monitoring and polysomnography have evolved tremendously. The level of independent judgment and personal responsibility involved in neurodiagnostic procedures mandate the need for individuals who possess a consistent knowledge and performance that is expected by patients, physicians and employers. Consequently, formal education with a minimum of an associate degree or higher, is critical for long-term success.

How do I prepare to enter the profession? High school students can prepare for the profession by taking math, science, computer and language courses. ASET then recommends attending a CAAHEP accredited END program that grants an associate degree or higher. Click HERE for a listing of schools.

What if I have a college degree and want to learn neurodiagnostic technology? There are accredited neurodiagnostic schools that offer neurodiagnostic certificate programs for individuals who have already obtained an associate or higher degree. This certificate program allows a person to complete an accredited neurodiagnostic program without requiring the student to obtain another full degree.

What if I am already working in health care or want to make a career change? Individuals interested in making career transition into the END profession should visit with a supervisor at a local hospital electroneurodiagnostic lab to consider job shadowing and acclimate yourself with the profession; contact an accredited school for advice; or consider enrolling in an on-line END program. In all cases, it’s important to verify that the school is a CAAHEP accredited institution.

Do I need a license to work as an END technologist? A license is a term relating to legislation that regulates the profession within a specific state. Just like a state driver’s licenses, a license is issued by a state regulatory body. Licensure is different than professional credentials/registration.

Currently, neurodiagnostic technologists performing EEGs, EPs, IONM and NCS procedures are not required to have a license. However, there are efforts taking place to require licensure in some states. Technologists performing polysomnography studies should be aware that many states do require a RPSGT credential in the performance of duties and may be licensed/controlled under the auspices of a respiratory board. Louisiana and New Jersey now require licensure for technologists performing polysomnography studies. Click HERE for more details. Visit the Governmental Advocacy section of this Website for regular updates.

Do Neurodiagnostic Technologists Need Credentials? Occupational regulation is a necessity in many allied health fields to protect the health, safety and welfare of patients. Regulation gives clearly defined scopes of practice for each occupation and defines who is qualified to be a professional in each field. The public benefits as a result of the professionals being able to concentrate on clearly established guidelines and requirements within their scope of practice.
The competency standard for neurodiagnostics is successful completion of national board examinations for professional credentials. Professional credentials are available in EEG, evoked potentials, intraoperative monitoring, polysomnography, nerve conduction studies, and long-term monitoring. The certificates and registrations for the neurodiagnostic profession are voluntary. To assure the public that each neurodiagnostic procedure performed is conducted by only qualified personnel, it is necessary to have in place a regulation that is enforceable by law. ASET believes that occupational regulation in the form of state licensure is the most effective means to establish legal authority for the scope of practice for electroneurodiagnostic professionals. Many states currently require technologists to be licensed in order to conduct nerve conduction studies and polysomnograms. It is anticipated that similar licensure requirements for conducting EEGs and other neurodiagnostic tests will be enacted in states as well.

For Further Information about the profession, please explore our website, where you will find information on minimum standards and competencies for practice, distance and on-line education and training opportunities, publications and instructional materials, and links to the credentialing bodies.