Neuropack X1 EP/EMG/NCV Measuring System MEB-2300 Desktop System For more than 60 years, healthcare providers Optional Software worldwide have relied on the quality and Packages: reliability of the Nihon Kohden line of • QP-219: Review Station Software • QP-258: Trending Software comprehensive and innovative neuro- • QP-259: Autonomic Nervous System Testing (Microneurogram, R-R Interval, diagnostic and -monitoring instrumentation Sympathetic Skin Response) to aid in the diagnosis, information and • QP-260: Event Related Potential (P300, MRCP, CNV) treatment of their patients.

The MEB-2300 is the latest and most advanced EP/EMG system in the Nihon Mobile Control Low Noise Kohden product portfolio. Available with either a six or twelve channel amplifier and up to two electrical Panel Amplifier stimulators, the MEB is designed with numerous time-saving features to maximize the user’s workflow without compromising the integrity of data acquisition. Basic exam software including EMG, NCS, SEP, ABR and VEP protocols come standard with the MEB-2300.

The new examination list creates a seamless integration of protocols, patients and reports, increasing Operation Panel PV-230 Six Channel JB-206 productivity and reducing test time. The mobile function keypad enables the user The MEB-2300 uses a low noise amplifier to complete an entire exam without the with active electrodes to provide clean use of a keyboard or mouse. This simple waveforms easily and quickly. An control panel contains the main operation integrated impedance check can be buttons seen in previous models, “monitor- activated with the touch of a button from stimulate-analysis-stop and store,” with added the amplifier to ensure properly placed key features such as function keys, a number and seated electrodes. pad and NeuroWorkbench® controls. NeuroNavi Flexible Software Innovation NeuroNavi™ shows Workflow Solutions examination information and NeuroWorkbench is the core integrator of the Nihon electrode and stimulation Kohden product portfolio. This common positions for NCS and other interface allows for examination scheduling, exams. This guide can be protocol administration and data management that improve workflow. NeuroWorkbench provides referenced on the screen at HIPAA Compliant access to clinical data and any time. records with passwords and three levels of administrative rights, as well as audit trails. A NeuroWorkbench – Scheduler flexible NeuroWorkbench option includes an HL7 interface. The NeuroWorkbench SQL Database integrates all of the Nihon Kohden neurology NeuroReport devices to provide a complete database across all neuro- diagnostic and -monitoring modalities. A customized report can Menu Window for an MEB be generated with the click of Examination a button using our proprietary Open an MEB examination screen using the ™ NeuroReport software. examination protocol menu. Included in NeuroReport are several selectable NeuroWorkbench – Patient List layouts which can display your facility’s logo, test Menu Tabs results with highlighted abnormals, waveforms Up to eight category tabs with 10 programs per and a powerful auto-text summary. Saved within tab for a total of 80 preset examination programs. the database, the report can automatically be signed electronically and converted to a PDF, Data Manager Tab protecting the electronic record while keeping it • Database files universally viewable. • Copy, move and delete file • Patient database with search and query function Workbench Tab NeuroWorkbench – Protocol Tab • Scheduler • Remote access • Review patient files Standard Examination Programs

Routine EMG Program Quick Display Trigger EMG Muscle Summary The routine EMG program utilizes auto You can easily switch between four A cascading waveform window displays Measurement results and saved waveforms can MUP detection and classification, and real measurement modes that you can define the waveforms which are triggered be displayed in the muscle summary window. time turns/amp analysis. A functional freely—for example for insertion activity, by either level trigger, window trigger The summary window is the best place to start and sophisticated findings screen meets motor unit detection or turn/amplitude or rise time trigger in chronological order. typing the EMG findings—next to the results various needs in clinical use by easy analysis or interference—by pressing a You can change the beginning and of the examination. The latest EMG findings and smooth operation. button at the bottom of the screen or on end point of the duration. Up to eight screen shows up to 26 traces of waveforms the control panel. new sequential MUP waveforms are with annotations in the Monitor Waves window Interference displayed on the MUP sweep window and up to 20 MUP waveforms in the MUP Turns/amp measurement is automatically MUP Analysis without scrolling. window on one screen for efficient and quick performed. The measurement result MUP waveforms are automatically detected EMG findings. is displayed at every one second on and classified into groups of similar the turns-interval histogram, turns/amp shaped MUPs. MUP measurement result histogram and turns/amp graph. (duration, amplitude, phase, turns and firing EMG Playback/EMG Player The turns/amp normative data of several rate) are shown next to the waveforms muscles are installed as default settings or in a dedicated summary screen. You can also easily review any acquired and its normative area is displayed in The averaged MUP of the same MUP groups waveform with sound after measurement by the turns/amp histogram. You can easily are calculated and displayed with the clicking the EMG player button. This tool lets recognize whether or not the measuring numeric data. you play back EMG files with sound on a waveforms are in the normative range. review station for presentations and lectures. • Display up to 600 sec of EMG with sound • Sweep speed, sensitivity, and filter settings can be changed afterwards; a great function for teaching purposes • Compressed/cascaded waveform display Single Fiber Jitter Quantitative Analysis EMG

Perform jitter reanalysis at different trigger levels for all acquired waveforms. MCD, MSD, MIPI, firing rate and blocking can be automatically analyzed. Two single fiber modes are available: voluntary contraction and stimulated.

Eight Channels Real time MUP analysis of Macro EMG With the template matching method, MUP are automatically classified into several patterns Simultaneous eight channel macro EMG and the amplitude, phase, turns, area, rise time recording is possible. Acquired waveforms can and firing rate are quantitatively analyzed in be reanalyzed. Triggered waveforms real time. There are two methods of analysis: and averaging result can be simultaneously triggered and continuous. The analysis results displayed. can be statistically processed.

Real time interference pattern analysis Interference patterns can be analyzed in two ways: turns/amp analysis and power spectrum analysis with FFT. Conduction Study

F-Wave With the dual sensitivity function, both M- and F-wave are displayed with a proper amplification. F-Wave latency is displayed in the F-Wave histogram window.

The NCS program lets you perform MCS, SCS and F-Wave in one program. Any number and combination of examinations can be created in your own custom routine protocol by selecting H- nerve, side and exam. You can change the examination by just The intensity-amplitude graph clicking the item in the list box, or by clicking a button on the and superimposed waveforms are dedicated operation panel of the Neuropack. displayed on the same window.

Motor NCS/Sensory Repetitive Stim • When measuring with the MEB there is • The amplitude of each sequence is no need to manually pick the stimulation displayed as a bar graph on the site before starting the recording. same screen. You can see the summary The software does this automatically of the repetitive stimulation study Blink-Reflex for you and, if necessary, it can be at a glance. The waveform of each The relation between the mark easily changed. sequence can be displayed by clicking position and the normative • Side comparisons and combined the corresponding bar graph. range is easy to see on the blink motor and sensory tests can be shown • Up to 12 sequences of stimulation measurement table window. in one waveform screen and also patterns can be set for one automatic have their own dedicated evaluation measurement (automatic sequence tables. function). • Normative data are shown on the • Stimulation can be done with either same screen. high or low frequency or combined • The superimposed waveform in real in the same protocol. time is shown at the same time, so you can easily compare the amplitudes of all stimulation sites and thus judge the quality of your stimulation. Evoked Potentials

Standard SEP examination Simultaneous SSEP and SEP Standard VEP examination Standard AEP examination protocols are: measurement protocols are: protocols are: • SEP (somatosensory ) Upper and lower extremity measurements • Pattern-VEP • ABR (auditory brainstem response) • SSEP (short-latency SEP) can be conducted at the same time on • Goggle-VEP • MLR (middle latency response) • ECG-SSEP (ECG-triggered SSEP) the same screen. • Flash-VEP • SVR (slow vertex response) • ESCP (evoked spinal cord potential) • ERG (electroretinogram) • EcochG (electrocochleogram) Side comparison • EOG (electrooculogram) ECG artifact-free SSEP Split screen display allows for side Three types of auditory stimulation With ECG-SSEP protocol, stimulation and comparisons at a glance. Flexible pattern stimulations Click, tone burst, and tone pip stimulation averaging is done during the flat period VEP protocol requires a VEP monitor. are available. of the ECG waveform so artifact-free Pattern reversal stimulation can waveforms can be recorded. be selected from full, half, and quarter ABR auto marking visual field. 4 to 128 horizontal divisions In the ABR protocol, automatic waveform Signal triggering and can be selected for patterns. marking allows time-saving measurement back averaging of latency, amplitude, and interval. Variety of visual stimulations Cortical potentials prior to muscle contraction can be recorded by A monitor for pattern reversal, LED Automatic separation of AP using a rectified EMG signal trigger goggles and flash stimulator options and CM waveforms allow complete visual testing. and back averaging. In EcochG examination, AP and CM can EOG velocity waveform be automatically separated from the original waveforms in real time. The original, display AP and CM waveforms are simultaneously With the integrated differential displayed on the screen. amplifier, the velocity waveform can be simultaneously displayed with the Simultaneous ABR and MLR original EOG signal. ABR and MLR can be measured simultaneously on the same screen. Specifications

Amplifier Acquisition Stimulation rate Auditory Stimulators LED Goggles Dimensions and Weight A/D converter: 18 bits With the list box: 0.1 to 0.9 Hz in 0.1 Hz steps, 1 to 10 in 1 Hz step, 13, 15, 17 Hz, Time base modes: Individually Examination side: Left, both, right Side: Left, right, both Main Unit: 390(W) x 55(H) x 304(D) mm, Number of channels: JB-206B: 6, 20 to 100 Hz in JB-212: 12 selected for each channel (up to 12 3.2 kg channels) 10 Hz steps (within ±5% of the preset Stimulation waveform: Click, tone burst Input impedance: 200 MΩ ±20% Printer 180(W) x value × 0.95) Stimulation phase (polarity): Electrode Junction Box: (differential mode), 200 MΩ ±20% Monitor time base: 5, 10, 20, 30, 50 ms/ Condensation (positive), rarefaction 56.5(H) x 234.5(D) mm, 1.5 kg (when the active electrode cable is div, 0.1, 0.2, 0.5, 1 s/ div (within ±5%) With the keyboard: 0.1 to 100 Hz in 0.1 Hz steps (within ±5%) (negative), alternating stimulation Printing mode: Hard copy, review Constant current stimulator unit: used, differential mode), ≥ 1000 MΩ Data points: 2048/20 div (common mode) 0 to 135 dB SPL (within ±2 dB) 56.5(W) x 190(H) x 240(D) mm, 1.0 kg Conversion speed: 5 μs/1 ch, 10 μs/2 Intensity: External Units Noise: < 0.6 μVrms at 1 Hz to 10 kHz, ch, 20 μs/3 and 4 ch, 50 μs/5 to 10 ch, Delay time contralateral white noise masking: Somato control box: 37(W) x 62(H) x < 1.1 μVrms at 1 Hz to 10 kHz (when 100 μs/11 and 12 ch With the list box: 0 to 9 ms in 1 ms −10, −20, −30, −40, −50 dB or off (within 21(D) mm, 0.16 kg the active electrode cable is used) steps, 10 to 90 ms in 10 ms steps, 100 to ±5 dB) External input: 8 ch, 0.2, 1 V/div Analysis time base: 0.1, 0.2, 0.5, 1, 2, 3, Control panel unit: 253(W) x 100(H) x 900 ms in 100 ms steps, 1 to 10 s Common mode rejection ratio: 5, 10, 20, 30, 50 ms/ div, 0.1, 0.2, 0.5, 1 Click pulse duration: 0.1, 0.2, 0.3, 0.5, External output: 8 ch 1 V/div (5 kHz at 300(D) mm, 1.0 kg ≥ 106 dB (balanced mode), ≥ 90 dB s/div (within ±5%) or 0.1 to 0.9 ms in 0.1 With the keyboard: 0 to 10 s in 0.01 ms 1 ms (within ±5%) 1 ch, 200 Hz at 8 ch) Multi interface box: 160(W) x 24(H) x (balanced mode, when the active ms steps (within ±5%) steps electrode cable is used), ≥ 112 dB Line I/O: Available 120(D) mm, 0.8 kg 1 to 99 ms in 1.0 ms steps (within ±5%) (Isolation mode) Tone burst frequency 100 to 1000 ms in 0.01 s steps (within Electric stimulators Trigger input: 6 ch Sensitivity: 1, 2, 5, 10, 20, 50, 100, 200, With a list box:125, 250, 500, 1 k, 1.5 k, Power Requirements ±5%) Number of channels: 2 (monophasic/ Amplitude: more than 4 V (positive), 500 μV/div, 1, 2, 5, 10 mV/div ±5% 2 k, 3 k, 4 k, 6 k, 8 kHz (within ±5%) Delay time: −10 to 10 div in 1 div steps biphasic stimulation, high current less than 0.5 V (negative) Low-cut filter: 0.01, 0.02, 0.05, 0.1, 0.2, stimulation) With a keyboard: 50 Hz to 10 kHz or 0 to 500 ms in 0.1 ms steps Available for pulse whose duration is Line voltage and frequency 0.5, 1, 2, 5, 10, 20, 30, 50, 100, 200, 500 (within ±5% plateau time of tone burst) 1 to 9999 Output mode: Constant current Hz, 1, 2, 3 kHz (±20%) Number of averages: more than 10 μs, either positive and MEB-2300A (DC-230BA): 100-120 V With a list box: 0, 1, 2, 5, 10, 20, 50, 100, Artifact reject inhibit range: ±1 to ±5 Output current: Monophasic/biphasic negative can be selectable ±10% 60Hz±1% Power input 200, 500, 1000 ms (within ±5%) High-cut filter div in 0.1 div steps, Off stimulation, 0 to 100 mA (load Trigger output: 6 ch DC-230BA main unit: 75 VA resistance: 1 kΩ, step can be selected Waveform storage capacity: Depends With a keyboard: 0 to 1,000 ms in 1 ms Channel 1 and 2: 10, 20, 50, 100, 200, from 0.05, 0.1, 0.2, 0.5, 1 mA) Amplitude: 5 V (positive), less than on the hard disk free space of the steps (within ±5%) 500 Hz, 1, 1.5, 2, 3, 5, 10, 20 kHz (±20%) 0.5 V (negative) Operating Environment PC unit High current stimulation: 0 to 200 mA Channel 3 to 5: Upper limit 10 kHz at (load resistance:1 kΩ, step can be Rise/fall time of tone burst Pulse duration: 1, 5, 10 ms −12 dB/oct (±20%) selected from 0.05, 0.1, 0.2, 0.5, 1 mA) Temperature: 10 to 35°C (50 to 95°F) Display With a list box: 0.1, 0.2, 0.3, 0.5, 1, 2, 3, Either positive and negative can be Channel 6 to 10: Upper limit 5 kHz at Stimulation pulse duration: 0.05-1.0ms Humidity: 30 to 80% (non condensing) Number of examination windows: 10 ms (within ±5%) selectable −12 dB/oct (±20%) +/- 10% 0.05ms when stimulus is greater Up to 12 700 to 1060 hPa 0.1 to 3000 ms in 0.1 Response switch: When closed, Atmospheric pressure: Channel 11 and 12: Upper limit 3 kHz than 2mA.+/- 20% 0.03ms when With a keyboard: : Monitor operates at low level at −12 dB/oct (±20%) Waveform display mode stimulus is less than 2mA ms steps (within ±5%) (free run), sweep (trigger), average Digital input: When closed, operates Storage and Transport AC interference notch filter: 50 or 60 Hz Number of outputs on the stimulation Two vertical or horizontal lines (rejection ratio: < 1/20) Cursor: pod: 5 available Visual Stimulators at low level 6 ch for time or amplitude measurements, Biphasic stimulation mode: Positive, less than 0.5 V (negative) Temperature: -20 to 65°C (-4 to 149°F) Reset: Available one vertical line for mark set Amplitude: negative, bipolar, alternate Stimulation modes: Pattern reversal, Humidity: 10 to 95% (non condensing) Rectification: Off, half, full Available for pulse whose duration Scale: 5, 10, 15, 20 div LED goggles, external visual stimulation Temperature measurement: 0 to 45°C is more than 1 ms Atmospheric pressure: 700 to 1060 hPa Electrode impedance check: 2, 5, 10, Grid: Line, dot, off (32 to 113°F) ±0.1°C (0.18°F) 20, 50 kΩ indication stimulator common functions Pattern reversal Amplitude calibration: 1, 10, 100 μV, 1, 10 mV (within ±5%) Triggers Field format: Full, left, right, upper, lower, upper left, lower left, upper right Number of channels: 6 and lower right field Trigger mode: Recurrent, random, Patterns: Checkerboard, horizontal foot switch, single stimulation, bars, vertical bars signal 1 to 5, somato 1, somato 3, external 1 to 6 Number of horizontal divisions: 4, 8, 16, 32, 64, 128 Trigger wave mode: Single, double, train Brightness: More than 80 cd/m2 When performance counts, you can rely on Nihon Kohden to assist you in delivering the highest quality patient care as efficiently as possible. Nihon Kohden is committed to bringing trusted and innovative solutions to the changing demands of the neurodiagnostics field today and into the future.

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NeuroWorkbench is a registered trademark and NeuroReport NMLB 027 [C]-CO-0162 and NeuroNavi are trademarks of Nihon Kohden Corporation.