USER MANUAL
User Manual
Rev. 1.04.57 page 2 of 205
User Manual
INDEX
INTRODUCTION TO THE SOFTWARE.................................................................................9
Copyright........................................................................................................................9
GENERAL PRECAUTIONS AND WARNINGS...................................................................... 11
Responsibility ................................................................................................................... 11
Intended Use..................................................................................................................... 11
Xegis configuration........................................................................................................... 11
DATA SAFETY....................................................................................................................12
DATA ACQUISITION and ANALYSIS ...................................................................................12
ARCHIVE ............................................................................................................................ 15
Introduction......................................................................................................................17
Archive window................................................................................................................17
Menu Bar.......................................................................................................................17
Tool Bar ........................................................................................................................ 22
Patient list .................................................................................................................... 23
Exam list ....................................................................................................................... 23
File list .......................................................................................................................... 23
Resource list .................................................................................................................24
Status Bar ..................................................................................................................... 25
Custom list view and sorting ............................................................................................ 25
Options ............................................................................................................................26
About the General window. ..........................................................................................26
About the EEG window. ................................................................................................30
Accessing Data.................................................................................................................30
Modify - New Resource.................................................................................................30
New\Search Patient .......................................................................................................31
Patient Information - Modify ..........................................................................................31
Exam Information - Modify............................................................................................ 32
File Information - Modify............................................................................................... 33
Property window..........................................................................................................34
Advanced Functions.........................................................................................................34
Backup Properties.........................................................................................................34
Backup Scheduler.........................................................................................................36
Research of a patient or group of patients ....................................................................36
Auto Archive of a resource............................................................................................38
Rev. 1.04.57 page 3 of 205
User Manual
Automatic CD/DVD Writing Procedure...........................................................................38
EMG.................................................................................................................................... 41
Introduction.....................................................................................................................43
System Description..........................................................................................................43
Use of the mouse and the keyboard.................................................................................43
Amplifiers and stimulators...............................................................................................43
The amplifiers ...............................................................................................................43
The stimulators .............................................................................................................44
Getting started .............................................................................................................44
Selecting an exam............................................................................................................45
Protocol Grid ................................................................................................................46
Acquisition setup .............................................................................................................47
Markers ........................................................................................................................49
Correlation....................................................................................................................50
Average........................................................................................................................50
Headbox........................................................................................................................51
Cycles............................................................................................................................51
Pressure ....................................................................................................................... 52
Muscles and sites.......................................................................................................... 53
Calculation .................................................................................................................... 53
Footswitch.................................................................................................................... 53
MEP Setup....................................................................................................................54
Automatic program ......................................................................................................54
Lines............................................................................................................................. 55
Remote Control ............................................................................................................56
Needle EMG Report ......................................................................................................56
Acquisition and review window.......................................................................................56
Menu bar...................................................................................................................... 57
Tool bars....................................................................................................................... 61
Layout setup ....................................................................................................................62
Tables Parameters setup..................................................................................................63
EMG exams......................................................................................................................65
Needle EMG - Turns & Amplitude - QEMG......................................................................65
MUAP...........................................................................................................................74
MNCV and SNCV ........................................................................................................... 77
Inching .........................................................................................................................80
RNS ..............................................................................................................................82
H Reflex........................................................................................................................84
Rev. 1.04.57 page 4 of 205
User Manual
F Wave..........................................................................................................................87
Blink Reflex...................................................................................................................89
MEP..............................................................................................................................92
SSR...............................................................................................................................95
RR ................................................................................................................................96
SFEMG..........................................................................................................................98
Hot keys......................................................................................................................... 100
Footswitch...................................................................................................................... 101
EP ..................................................................................................................................... 103
Introduction....................................................................................................................105
System Description ......................................................................................................105
Use of the mouse and the keyboard.............................................................................105
Amplifiers and stimulators..............................................................................................105
Getting started .............................................................................................................. 108
Selecting an exam........................................................................................................... 110
Protocol Grid ................................................................................................................111
Acquisition setup .............................................................................................................111
Markers ....................................................................................................................... 116
Interpeaks ................................................................................................................... 116
Average....................................................................................................................... 117
Headbox...................................................................................................................... 117
Parameters View.......................................................................................................... 118
Advanced Average....................................................................................................... 119
Acquisition......................................................................................................................120
Acquisition Window.....................................................................................................120
Acquisition procedure..................................................................................................124
Hot keys ......................................................................................................................125
Review............................................................................................................................127
Review Window...........................................................................................................127
IOM ...................................................................................................................................137
Introduction....................................................................................................................139
System Description ......................................................................................................139
IOM hardware setup and protocol configuration..........................................................139
Main window..................................................................................................................139
Menu bar.....................................................................................................................139
Toolbars ......................................................................................................................143
Status Bar ....................................................................................................................143
Rev. 1.04.57 page 5 of 205
User Manual
Window components: clock, stimulator, traces, average, trends, parameters and notes143
IOM acquisition window ............................................................................................. 144
IOM review................................................................................................................. 144
Positioning the flags: the template trace..................................................................... 144
Setup ..............................................................................................................................145
Protocol Manager........................................................................................................145
Protocol Setup.............................................................................................................145
MAPS ............................................................................................................................... 149
Introduction.................................................................................................................... 151
Types of Maps ............................................................................................................. 151
Access to the Maps section ............................................................................................. 151
Menu, tool bar and status bar ......................................................................................... 151
Tool bar .......................................................................................................................153
Status bar ....................................................................................................................153
Amplitude Maps..............................................................................................................154
Amplitude Maps ..........................................................................................................154
Frequency Maps and Spectrums .....................................................................................158
Frequency Maps ..........................................................................................................158
Access to the Frequency Maps and Spectrums.............................................................159
Frequency Map Settings ..............................................................................................159
Spectral Analysis ..........................................................................................................162
Single Spectrum Analysis .............................................................................................162
Advanced functions ........................................................................................................163
Dynamic Amplitude Maps ............................................................................................163
Three-dimensional Maps ..............................................................................................163
Electrode Position....................................................................................................... 164
REPORT.............................................................................................................................167
Introduction................................................................................................................... 169
Report Models............................................................................................................... 169
Report Window ............................................................................................................. 169
Menu bar.................................................................................................................... 169
Toolbars ......................................................................................................................173
About Microsoft Word .................................................................................................173
Create a Model................................................................................................................173
APPENDIX - EMG APPLICATION NOTE ...........................................................................175
ELECTROMYOGRAPHY ....................................................................................................177
Rev. 1.04.57 page 6 of 205
User Manual
SPONTANEOUS AND VOLUNTARY ACTIVITY STUDYING..................................................177
Clinic indications ..........................................................................................................177
Acquisition parameters of spontaneous activity ...........................................................178
Acquisition Parameters of voluntary activity ................................................................178
Acquisition Parameters of maximum effort activity ......................................................178
Work modality .............................................................................................................179
MUAP Analysis................................................................................................................179
Acquisition Parameters ................................................................................................179
Work modality ............................................................................................................ 180
APPENDIX - EP APPLICATION NOTE.............................................................................. 187
EVOKED POTENTIALS..................................................................................................... 189
Synchronized average.................................................................................................... 189
Recording place and patient condition........................................................................... 190
Electrode application..................................................................................................... 190
Filters.............................................................................................................................. 191
Stimulation artefacts ...................................................................................................... 191
Evoked Potential Types...................................................................................................192
SOMATOSENSORY EVOKED POTENTIALS – UPPER LIMB..............................................193
SOMATOSENSORY EVOKED POTENTIALS – LOWER LIMB.............................................195
BRAINSTEM EVOKED POTENTIALS...............................................................................197
VISUAL EVOKED POTENTIALS ..................................................................................... 199
LASER EVOKED POTENTIAL..........................................................................................201
Cognitive Evoked Potentials........................................................................................ 203
Rev. 1.04.57 page 7 of 205
User Manual
Rev. 1.04.57 page 8 of 205
User Manual
Introduction to the software
Xegis™ is the software that handles all of EMG and EP Acquisition and Review systems, which
means that according to the enabled key options, Xegis integrates all types of exams in a
single application, such as:
• Electromyography
• Evoked Potentials
• Intra-Operative Monitoring
The configurations are opened towards external systems and are organized according to
the criteria of maximum working flexibility. The single archive and project design guarantee
that all the standard activities of Acquisition, Review, Analysis, Report and Archive of all
exams can be managed in a single unit or on several systems distributed over a network.
The program has been designed to be offered in various performance / feature levels.
Hence, some of the features described in the present manual could be not available on the
software installed on your system.
Copyright
All information in this document can be updated without notice. Names of companies,
people, and data eventually mentioned are fiction and in any way do not represent people,
companies or products unless clearly specified. No part of this document can be
reproduced or transmitted in any format or with any way, electronically or mechanically, for
any aim without Micromed. S.p.a. written consent.
© 2009 Micromed S.p.a. All rights reserved.
Xegis software is a Micromed S.p.a. product.
Micromed S.p.a.
via Giotto 2
31021 Mogliano Veneto - Treviso - Italy
Microsoft, MS, MS-DOS, ActiveX, Internet Explorer, Visual Basic, Visual C++, Windows,
Windows NT, Win32, and Win32s are registered marks of the Microsoft Corporation of the
United States and in other countries.
Other products and company names mentioned can be owner registered mark.
Rev. 1.04.57 page 9 of 205
User Manual
Rev. 1.04.57 page 10 of 205
User Manual
General Precautions and Warnings
Responsibility
Micromed and Compumedics can be held responsible only for the correctness of signals
recorded under circumstances described in the user manuals. These data never substitute
the interpretation and the clinical conclusions that pertain to the physician only.
Micromed and Compumedics cannot be held responsible for data generated by misuse of
the equipment from the operators.
Intended Use
Xegis software is explicitly designed to help physicians in recording, archiving and reviewing
data coming from Xegis digital acquisition systems.
Xegis software can be used for EMG and EP exams and other neurophysiological studies
based on the data recorded from the patient through Xegis acquisition devices.
Some analysis functional tools are provided as default or software options. Results coming
from these tools must never substitute the critical interpretation and the clinical conclusions
that pertain to the physician only.
Xegis software is not intended to continuously monitor the central nervous system
functionality, in conditions where a warning on the change of patient condition is essential
(e.g. OR and ICU automatic monitoring without the presence of the physician), since it is not
endowed with proper alarms that substitute continuous medical surveillance. The use of
Xegis software must always be carried out under the supervision of a physician or a qualified
technician.
Xegis configuration
Xegis software installation must always be carried out by authorized technicians, having
deep knowledge of the inside software structure and of the hardware system is needed.
To solve any problems that can arise during the use of software, contact your Compumedics
representative and the Compumedics Service department.
DO NOT ATTEMPT TO MODIFY THE SYSTEM CONFIGURATION BY YOURSELF (including the
parts of software that manages hardware setup and that are highlighted and described in
the user manual as reserved to the technicians) : for any need contact the Service
Department or a Micromed or Compumedics authorized technician.
The configuration of the resource list must be performed by authorized personnel only,
since a wrong or incomplete configuration of resources can lead to data loss. Ask for
Technical Assistance if you need to modify your system: the best software and hardware
configuration according to your new exigencies will be suggested.
Moreover, it is strongly suggested not to install other software on the PC. Any additional
software you install is at your own risk and Micromed or Compumedics cannot be held
responsible for any problem rising from that installation. Intervention for resuming a
Rev. 1.04.57 page 11 of 205
User Manual
situation where an additional installation has lead to problem will be charged according to
the standard Service Price List.
DATA SAFETY
Xegis software is endowed with advanced storage and data management features, allowing
enhanced SQL query and the use of multiple storage resources. Nevertheless, these
features are always available and work properly, ONLY if the user doesn’t tamper, copy or
move data without using the proper archive function, that are better explained in the
appropriate section of the user manual. This allows the software archive references to be
synchronized always with the current situation. OPERATIONS PERFORMED ON DATA FILE
NOT USING THE XEGIS ARCHIVE COMMAND CAN LEAD TO TEMPORARY OR DEFINITIVE
PATIENT DATA, EXAM OR FILE LOSS.
It is highly recommended to never access to Xegis (SystemPlus) work directories (defined in
the path selection box of the installation setup, the database and resources setup screens)
using the operating system functions (Windows Explorer or the desktop My Computer or
Network Neighbourhood icons) to avoid any possible damage to the files.
Xegis allows to continuously store trace data on external memory supports and to perform
a periodic backup of the database on the same kind of supports, setting the “Database
Backup Scheduler” properties. If these are already set, you should modify the time interval
only between two backups while the other configurations (e.g. the path) should be changed
only under authorized technician instructions. Refer to the related chapter of the user
manual for detailed instructions.
IT IS RECOMMENDED TO PERFORM BOTH DATA AND DATABASE BACKUPS REGULARLY to
prevent data loss due to physical support damage (e.g. scratches on CD-ROM surfaces) or to
a problem with wrong linkage in the database management or to interference with some
other running software.
Trace data and database backup can be performed on a similar or different type of support
than the original one. Considering the particular critical operation, BACKUP MUST BE
PERFORMED ON DEVICES NOT CONNECTED TO THE NETWORK (or temporarily
disconnected), in order to avoid accidental access to the data during the copy operation.
DATA ACQUISITION and ANALYSIS
Since the software widely uses the PC resources (memory and CPU) to work, it is
recommended to close other running applications, especially when performing operations
that require the management of a great amount of data (e.g. acquisition at high sampling
rate and so on).
During data acquisition, it is recommended that the user checks the result traces quality,
keeping them displayed on the monitor. No other operation should be performed during
acquisition, in order to minimize the error probability.
During the review of the traces for interpretation, it is recommended to check the
correspondence of the traces displayed to those desired (patient data, trace parameters,
montage).
The measures automatically performed (e.g. nervous conduction velocity calculation) by
EMG and EP software, according to the settings chosen by the user, display the numerical
Rev. 1.04.57 page 12 of 205
User Manual
results on the side of the related trace. The flags on the trace indicate the calculation points.
The physician that performs the exam should always check if the points selected by the
software are the most significant ones from a clinical point of view, and should eventually
correct them manually. In all the software features, any automatic analysis tool has always
to be considered as a help in interpreting traces, and not the interpretation itself.
Rev. 1.04.57 page 13 of 205
