MAGSTIM RAPID Operating Manual Nov 2009

Magstim Rapid2

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GUARANTEE

Equipment manufactured by the Magstim Company Limited is fully guaranteed covering materials and workmanship for a period of one year from the date of shipment. The capacitor is guaranteed for one year, or 1,000,000 discharges, which ever comes first. The Magstim Company Limited reserves the right to perform guarantee services in its factory, at an authorised repair station, or at the customer's installation. The Magstim Company's obligations under this guarantee are limited to repairs or, at the company's option, replacement of any defective parts of our equipment, except batteries, without charge if said defects occur during normal service. Claims for damages during shipment must be filed promptly with the transportation company. All correspondence concerning the equipment must specify both, name and/or number and serial number, as it appears on the invoice for said equipment. Improper use, mishandling, tampering with, or operation of the equipment without following specific operating instructions will void this guarantee and release the Magstim Company Limited from any further guarantee obligations. The Magstim Company Limited will only accept responsibility for the effects on safety, reliability and performance of the equipment if: •

modifications or repairs are carried out by persons authorised by The Magstim Company Limited.

•

the electrical installation of the relevant room complies with local regulations, and

•

the equipment is used in accordance with the instructions for use.

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Magstim Rapid2

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SECTION: 1. WARNINGS AND PRECAUTIONS

USA Only

CAUTION: Magnetic stimulation has not been cleared by the FDA for cortical stimulation. Investigational human uses require that the user complies with the FDA regulations regarding Investigational Devices. Please visit www.fda.gov/cdrh or www.magstim-us.com for more information. CAUTION: In the USA, Federal Law restricts this device to sale by or on the order of a practitioner licensed by the law of the State in which he/ she practices to use or order the use of the device.

Attention: Consult accompanying documentation before using the Magstim Rapid2. CAUTION: The Magstim Rapid2 and its stimulating coils must not be used on, or in the vicinity of, patients or subjects with cardiac demand pacemakers, implanted defibrillators, or other electronic implants. The Magstim Rapid2, its coils and accessories generate high intensity magnetic pulses. The induced eddy current is of sufficient magnitude to stimulate nerves and muscle.

The strong magnetic pulses generated by stimulating coils induce eddy currents in any conductive medium such as the human body, nearby metallic objects or electronic devices. NB Particular care must be taken to ensure that leads connected directly to the patient, or other equipment, are not in a position where the stimulating coil can couple resulting in currents being induced in them. Caution: for safety reasons, do not leave patient cables attached to the MEP Pod if they are not being used. If an unused cable is left connected, and the patient is connected to the other channel, there is the possibility that the unused cable may touch an earthed surface which could allow current to flow through the patient to ground. Caution: do not allow the coil or the coil cable to come into close proximity with the MEP Pod patient cables. During discharge, current may be induced in these cables. Do not discharge the Magstim with the stimulating coil in the vicinity of metallic objects or these may be projected, moved and/or damaged. The Magstim Rapid2 must not be used in an explosive atmosphere or in the presence of flammable anaesthetics. When the magnetic pulse is delivered, a discharge click is produced by the Magstim Rapid2 and its stimulating coil. This discharge click may startle.

Where possible avoid the use of the stimulating coil near the ears. The use of ear plugs is recommended. High voltages are present within this System. Do not remove covers. Refer servicing to qualified personnel. Ensure that the System is not subject to conditions where water/ liquid may be tipped on it, including the UI Controller. To ensure grounding safety, all mains power connections should be made directly to wall power outlet sockets. All of the customer’s electrical cabling must conform to local electrical standards. Do not use a terminal block if insufficient sockets are available, as this will form a potential electrical hazard. The Magstim Rapid2, its stimulating coil and accessories must not be used if there are any signs of external damage or if any parts are damp or wet. Cortical magnetic stimulation runs the risk of inducing seizures.

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Do not discharge the Stimulating Coil in the vicinity of objects sensitive to magnetic fields. Examples are credit cards, floppy disks and computer screens.

Protection circuits disable the equipment if the temperature of the Stimulating Coil exceeds 40oC. Coils must not be immersed in water, put in an ice bucket, or refrigerated, even if placed within a plastic bag, as condensation may be created within the coil. The coils do not have any specialised protection against the ingress of liquids; therefore conditions where ingress of liquid, or the forming of condensation within the coil, can occur must be avoided as the electrical insulation will be compromised. Cooling must only be performed by using a flow of cool air from a fan or air conditioning unit.

Coil Over Temperature

Due to thermal lag, the surface temperature of the Stimulating Coil may continue to rise following the coil over-temp activating and forcing the main unit into a standby condition. Therefore, the Coil must be removed from the patient as soon as the UI indicates that the coil is over-temperature. If the Rapid system is externally triggered via a signal generator, the coil temperature algorithm is disabled. Under this condition, at high frequency/high power, it is possible for the coil temperature to reach levels well in excess of the 41ºC limit specified in EN60601-1, before the hardware temperature cut-out operates. If the system is to be used under these conditions, it is essential that the intended protocol be run prior to use on a patient, to ensure that its temperature remains within the required limit. There are currently few medical papers available regarding the effects of magnetic stimulation on the unborn child/ foetus or the expectant mother. As a result of this, we are unable to verify the safety of the Coil's use on, or by, pregnant women. We recommend that anyone wishing to use the Coil on a pregnant woman, or use it whilst pregnant, should contact the Magstim Company Ltd. for more information as new medical papers become available. On no account must the Magstim Rapid2 and its accessories be used in environmental conditions outside those specified in this operating manual.

No pins of connectors identified with the ESD warning symbol should be touched. The connectors involved are those to be found on the rear of the User Interface. Connections should not be made to these connectors unless ESD precautionary procedures are used. All staff responsible for using the Magstim Rapid2 System should receive an explanation of the ESD warning symbol and receive training in ESD precautionary procedures – Connection should be made only by a person who is wearing a conductive wrist strap, which is connected to a suitable tested earth connection, or following the person grounding themselves by touching a part of the external casing connected to protective earth.

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SECTION: 2. PRODUCT DESCRIPTION 2.1 RAPID2

Unit Power Status Indicator • Flashes when the system is in STANDBY. • On continuously when the system is ON.

UI

ON/OFF/STANDBY This switch toggles the operational state of the Rapid2. ARMED Indicator This LED is continuously illuminated when the system is armed and high voltages are present in the system.

Main Frame

Coil OUTPUT Socket See below for description PSU Power Status Indicator • OFF when system is in STANDBY or OFF. • On continuously when system is ON

PSU

ARMED/FAULT Indicator This LED is continuously illuminated when the system is armed and high voltages are present in the system. This LED turns RED when a fault has been detected in the PSU.

Coil OUTPUT Socket Operation and SYMBOLS This socket is used to connect the stimulating coil to the Magstim Rapid2. Note that the unit cannot be armed and triggered unless the stimulating coil is connected to this output. Ensure that the locating pin in the coil plug is correctly lined up with the coil output socket before inserting the plug. When the coil plug is fully engaged in the socket, lock the plug in place by turning the black locking ring clockwise. To remove the coil, put the Magstim Rapid² into standby and turn the black locking ring anti-clockwise.

HIGH VOLTAGE Symbol This sign warns that voltages in excess of 1500V are present within the instrument. ATTENTION Symbol – Consult Operating Manual See warnings in Section 1 regarding the use of the Magstim Rapid2. APPLIED PART Symbol BF Type Applied Part.

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The applied parts of this device, namely the stimulating coil, MEP Pod and MEP Pod patient leads, are electrically isolated from the other parts of the equipment as required by the safety standards of BSEN60601-1.

2.2 INDICATIONS The Rapid2 works by inducing electrical currents in tissue using a non-invasive stimulating coil at frequencies of up to 100Hz. The stimulating coil is placed near the intended site of stimulation and trigger pulses initiate brief magnetic pulses. The magnetic fields can pass through clothing, tissue and bone to reach otherwise inaccessible areas. One feature of magnetic stimulation is that it is less likely to stimulate pain fibres at the skin surface, reducing the discomfort when compared with conventional electrical stimulation. Magstim Rapid² magnetic stimulators combine stimulation frequencies from 1Hz to 100Hz with a touch screen interface which controls every aspect of the stimulator's control and operation. INDICATIONS FOR USE. The Magstim Rapid2 magnetic nerve stimulator systems are intended for the stimulation of peripheral nerves and the human cortex for diagnostic and research purposes. CONTRAINDICATIONS.

Magstim Rapid2 systems and their accessories should not be used on or in the vicinity of patients or users with cardiac demand pacemakers, implanted defibrillators and/or implanted neurostimulators.

CAUTION.

Check the Magstim Rapid2 System and its accessories for any signs of damage. If the Magstim Rapid2 System or any of its accessories are damaged in any way they must not be used. Federal law restricts this device to sale by or on the order of a practitioner licensed by the law of the State in which he/she practices to use or order the use of the device. To avoid interference problems the Magstim Rapid2, and its accessories, should not be used in the vicinity of any equipment that does not comply with EMC Standard EN 60601-1-2, including mobile phones. For reasons of safety and reliability, if the system is set at 100% power, the user must not exceed 250 stimuli per minute, or 4000 stimuli per hour or 24,000 stimuli for every 24 hour period. This limitation is in addition to any other limitation imposed by the dedicated controller, or heating effects on the stimulating coil and charger circuitry. The entire Operating Manual should be studied prior to use and users should be aware, in particular, that high voltages and currents, which can prove lethal, are present if the covers are removed. The Magstim Rapid2 system’s parts are detailed in Sections 3-6. Each of the mains connections for the Rapid2 System must be made via separate, permanent, mains outlets. On no account should a multi-way extension lead be used to connect more than one mains connector to a single mains outlet. The Rapid2 System must be used only with the supplied mains leads fitted with an integral filter, as they are required to maintain the System’s compliance with EN 60601-1-2 regarding ElectroMagnetic emissions, as is the earth strap fitted between the stimulator and the power supply unit (PSU). The MEP Pod is designed to be fitted to the Magstim Rapid2 UI only. Do not attempt to connect it to a computer, or any other equipment, with a similar connector. To do so could result in electric shock/ burns to the patient at the site of electrode attachment. The MEP Pod connector has a hole deliberately blocked to prevent incorrect connection. 100Hz must not be used for cortical stimulation, it is for peripheral

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use only. For safety guidelines relating to transcranial stimulation, see Section 9 of this Operating Manual. The Stimulating Coil must not be discharged in the vicinity of the patient’s heart.

2.3 COILS A variety of coils is recommended to stimulate specific neutral pathways. These coils have their coil heads labelled with blue arrows, which represent the direction of the coil discharge current. The virtual cathode for these coils is approximate to the valley or trough formed by the conjunction of the two coils, directly opposite the handle towards the leading edge of the coil. Double 70mm Coil 2nd Generation Double 70mm Stimulating Coil P/N 3191-00. Also Standard Double 70mm Stimulating Coil P/N 9925-00. The Double 70mm coil is capable of accurate stimulation of cortical areas and spinal nerve roots. Applications Include: • • • •

Selective monohemispheric transcranial stimulation Excitation of spinal roots Motor cortex Peripheral nerves

Coil Adapter Coil P/N 9925-00 must be connected to the stimulator via the supplied coil adaptor (P/N 3110-00). This coil will not function if connected directly to the stimulator.

Please note: it is important that the coil is connected correctly. If the coil appears to be misaligned, remove and re-connect the coil. Do not use if the coil appears misaligned.

High Power 90mm Coil (additional item available) P/N 3193-00 The High Power 90mm Coil can be used for central motor conduction studies. The design of the coil allows between 120 and 160 stimuli at the maximum power level before requiring a few minutes to cool. Location The Double 70mm Coil is localised in its area of stimulation. For reproducible results from cortical stimulation, the most effective site of stimulation should be established and marked using the Brainsight Frameless Image-Guided TMS stereotactic 3D imaging system. For further information on this system please contact The Magstim Company Limited. For peripheral sites, the stimulation site can be marked with a suitable pen. 5 November 2009 The MAGSTIM Company LTD

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For further information regarding coils, see relevant coil operating manuals, or visit the Magstim website at www.magstim.com.

SECTION: 3. SYSTEM SETUP 3.1 REAR VIEW UI Cable

Isolated Trigger Port

Mains Power Switch

Foot Switch Pneumatic Socket

Fuse Access and Voltage Selector

Cooling Fan Outlet

Power Entry Module

HV Power Entry Socket

10A Link Lead Earth Strap

HV Cable

3.2 Power Supply Module (PSU – 3014-00)

Power Supply Module (PSU – 3013-00)

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230VPSU units shown. 115V units are identical in appearance to the 230V units, with the exception of the voltage/power rating labels sited on the rear of the units.

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3.3 ADDITIONAL CONNECTIONS SD Card Insertion Point.

Printer Connection

15 Way D Type Connector

25 Way D Type Connector

Batteries.

26 Way D Type Connector

25 Way D Type Connector (situated on rear of the UI, 2 rows of pins) This connector is situated on the rear of the UI, and has 2 rows of pins. The connector links the UI to the Magstim Rapid2 as shown on the diagram on the previous page. 26 Way D Type Connector (situated on rear of UI, 3 rows of pins) This connector is situated on the rear of the UI, and has 3 rows of pins. It provides trigger input and output signals (see page 54). DC Power Jack (situated on rear of UI) The DC Power Jack is situated on the rear of the UI. This connector allows an external 24V, 750mA DC power supply to be attached. A suitable medical grade supply must be used, conforming to IEC 60601-1. This is NOT required when the UI is connected to the Magstim Rapid2. Printer The Printer is attached to the User Interface via an Optical/RS232 Interface Cable which slides into place on the right hand side at the rear of the UI.

SD Card Socket (situated on rear of the left side panel) This socket is situated on the rear of the left hand side panel of the UI. This allows connection of an SD Card. This removable memory storage facility enables transfer of data between the UI and external devices, such as PCs. 15 Way D Type Connector (situated on rear of UI behind cover) This connector is situated on the rear of the UI behind the removable cover. It is designed to accept the Motor Evoked Potential (MEP) pod, available as a separate item. It has type BF connection.

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3.4 MEP POD CONNECTION NOTE. The Rapid2 must be switched off before connecting or disconnecting the MEP Pod. The Motor Evoked Potential (MEP) Pod is an optional component which allows the user to capture EMG signals and display them on the UI. 2 channels are available. The MEP Pod should be mounted as close as possible to the subject but should be kept away from sources of interference, such as power cables. It is recommended that all EMG cables are screened to minimise interference. The MEP Pod is designed to be used with surface electrodes only. The MEP Pod is designed to be fitted to the Magstim Rapid2 UI only. Do not attempt to connect it to a computer, or any other equipment, with a similar connector. To do so could result in electric shock/ burns to the patient at the site of electrode attachment. The MEP Pod connector has a hole deliberately blocked to prevent incorrect connection. CONNECTION The MEP Pod is attached to the rear right hand side of the UI when viewed from the rear. Remove the plastic cover to expose a 15 way D Type socket. Attach the MEP Pod cable, ensuring that the plug is properly inserted. The plastic cover has a notch in its lower edge through which the cable must pass. This cover, when replaced, provides strain relief for the connector. Do not operate the equipment without replacing this cover, as damage to the connector and the internal electronics of the UI is likely.

USE Attach the EMG cable to the MEP Pod and snap the free connectors onto surface type electrodes (for example, Kendall ARBO H124). Suitable electrodes are available from many medical supply companies, and no recommendation is made as to a particular type. Electrodes should be chosen which are suitable for the collection of EMG data, have snap connectors, and which are compliant with local regulations. When connecting the electrodes, follow the colour code on the MEP Pod. The EMG connection cable should be screened and should be suitable for use when in direct contact with the skin. No latex should be present in the cable. The electrodes should be positioned on the target muscle which is controlled by the neurons being stimulated. For example, if the area of the motor cortex which controls the hand is to be stimulated, the surface electrodes should be placed on abductor digiti minimi, about 1cm apart. The ground electrode should be placed on the wrist. Care should be exercised when placing surface electrodes. It is important that a consistent approach is observed, as the amplitude of the EMG signal is dependent on the position of the electrodes. Good practice in relation to skin cleaning should be observed. CAUTION For safety reasons, do not leave patient cables attached to the MEP Pod if they are not being used. If an unused cable is left connected, and the patient is connected to the other channel, there is the possibility that the unused cable may touch an earthed surface which could allow current to flow through the patient to ground. Do not allow the coil or the coil cable to come into close proximity with the MEP Pod patient cables. During discharge, current may be induced in these cables.

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3.5 PRINTER TO SET UP THE PRINTER 1.

Insert the cable connector straight into the Printers Serial Port to power the printer via the Mains

Serial Port

2.

Connect the other end of the cable to the back of the UI via an optical RS/232 Interface cable by sliding the connector into the slot until tight. Connect the printer to its power supply and the power supply to the mains.

Optical RS/232 Interface cable

3.

Switch the printer on via the green button on the left hand side of the printer. The ‘Power’ LED should now be illuminated green.

TO LOAD THE PAPER 1.

Push the Cover Open buttons on the side of the printer; this should open the Roll Paper Cover.

2.

Align the edges of the paper roll against the paper holders and push down gently.

3.

Pull the paper through and close the cover.

The Printer is now ready to be used.

Roll Paper Cover

On/Off Button

Cover Open Button Feed Cover Open Button

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3.6 SET-UP 1.

Before using the instrument, ensure that the correct fuses are fitted and that the voltage selector is set to suit the country’s supply voltage (this statement applies to the Rapid2 Main Frame only). There are 2 fuses, rated at T 1.25A for both 115V~ ±10% and 230V ~ ±10%. For information on changing the fuses, please see Section 9.

2.

Place the system in a room near multiple power sockets and ensure easy access to and around the equipment.

3.

Label the entrances to the room to warn of the presence of strong magnetic fields and to exclude those wearing pacemakers and/or electronic implants.

4.

Connect the power cables provided to the power supply socket(s) on the rear of the PSU. The power requirement of the Magstim Rapid2 depends on the PSU used and the parameters set by the UI.

5.

The power cables must be connected directly to wall power outlet sockets, and not via a terminal block. The Rapid2 System must be used only with the supplied mains leads fitted with an integral filter, as they are required to maintain the System’s compliance with EN 60601-1-2 regarding Electro-Magnetic emissions, as is the earth strap fitted between the stimulator and the power supply unit (PSU).

6.

Connect the HV cable from the PSU to the rear panel of the Main Frame. Connect the mains link between the PSU Module and the Main Frame.

7.

Connect the UI Controller to the Magstim Rapid2 via the interface cable supplied.

8.

Connect the Stimulating Coil to the front panel connector of the Magstim Rapid2.

9.

Apply mains power to the Rapid2 System by switching the mains power switch on the rear panel of the Rapid2 Main Frame to the ON position.

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3.7 USER INTERFACE (UI) ARM Button Trigger Button Touch Sensitive Screen

SYSTEM STOP Button Output Control Knob

ARM Button The Magstim Rapid2 can be put into the ARMED mode by momentarily pushing the Green RUN button. This can only be achieved if the stimulating coil is connected to the COIL OUTPUT socket. TRIGGER Button The Magstim Rapid2 can be triggered, and a magnetic pulse produced, by pushing the Yellow TRIGGER button. SYSTEM STOP Button The Magstim Rapid2 can be put into the safe inactive default mode by momentarily pushing the Red STOP button. In this mode, the instrument will discharge internally.

OUTPUT CONTROL Knob This control allows the user to change the screen-selected parameter to the desired value. It is therefore used to alter screen settings as well as changing the power output of the stimulator. TOUCH-SENSITIVE SCREEN/ SYSTEM DISPLAY All selections are made via the touch-screen. To select, touch the centre of the button symbol next to the desired menu option. Do not press hard, or use a sharp or pointed object to make the selection, as this may damage the touch screen. In the set-up screens, all selectable items are coloured in pale blue; white items are nonselectable. The Rotary Control Knob can only be used to change parameters already selected. Details regarding the contents and operation of the UI Screens are given in Sections 4, 5 and 6 Note: If the UI is not used for 30 minutes it will go into a standby condition. In standby, the screen will appear blank and the blue LED in the upper right corner of the front bezel will pulse. Touch the screen to restore the UI.

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3.8 STIMULATION See Section 4 to select the desired mode, stimulating power, stimulation frequency, train duration and inter-train delay. Activate the ARM button on the UI bezel to arm the unit. The system will charge and the UI will display READY in the system status window. NOTE: The system cannot be armed if the footswitch is active.

Position the stimulating coil on the desired area of tissue. The system can be triggered by pressing a coil switch button and either pressing the footswitch on the trigger button or on the UI. A clicking noise will emanate from both the stimulating coil and the Magstim Rapid² each time the Magstim Rapid² is triggered. This indicates that a magnetic pulse is being delivered by the stimulating coil, which is stimulating the nerves beneath it.

When necessary, it is possible to reposition the stimulating coil and/or to modify the power level on the UI to suit the requirements for the next stimulus. Meanwhile, the system will have recharged and can be triggered once again in the normal manner.

When the stimulations have been completed, press the SYSTEM STOP button on the UI.

The system can only be fired when one of the following UI screens is displayed: • • •

Single Pulse Mode, Repetitive Mode Session Mode.

EXTERNAL TRIGGERING If an external triggering device is used, the Rapid2 uses the power set to govern the maximum discharge frequency. Therefore, if the external frequency is set higher than the power set will allow, the stimulator will discharge at the maximum rate the stimulator can achieve for the power set, and not at the rate from the external trigger source. In these situations, reducing the power will allow the discharge frequency to increase. However, during external triggering there are no duration limits on the trains. Therefore, it is probable under high frequency operation that enough energy will be discharged into the coil to result in its temperature rising rapidly above 40oC following the system going into a coil over-temp condition and reverting to its discharged state. It is important that if this type of operation is intended the protocol be run prior to use on a patient and the surface temperature of the coil monitored to ensure that the patient is not exposed to excessive temperatures. NOTE. If the external trigger is set to the level triggering option it is possible for auto-triggering to occur.

IMPORTANT The temperature of the system is internal components becomes elevated during operation. The system should be left on, and uncovered, for approximately ten minutes following completion of stimulation to enable the fan to cool the internal system components.

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SECTION: 4. SYSTEM OPERATION INSTRUCTIONS. Switch on the system using the ON/OFF/STANDBY button on the front of the Rapid2 Main Frame.

4.1 WELCOME SCREEN The UI will activate automatically. The ‘Welcome Screen’ will be displayed.

The system will fully initialise and the Options Menu will appear after 15 seconds. Pressing the Continue button before the system has fully initialised gives access to the following options: Single Pulse Mode System File Maintenance The system needs to be fully initialised before Repetitive Mode and Session Mode are accessible.

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4.2 MAIN OPTIONS MENU

All selections are made via the touch-screen. To select, touch the centre of the button symbols.

Single Pulse

Selecting this option will call up the Single Pulse Mode Screen. This allows the system to be fired at a maximum rate of 1Hz, up to 100% power and 0.5 Hz from 101-110%. It also allows an MEP module to be configured.

Repetitive Mode

Selecting this option will call up the Repetitive Mode Set-up Screen. (See section 4.5) This allows the system to run a user defined train of pulses from a single trigger.

Session Mode

Selecting this option will call up the Session Mode Setup Screen. (See section 4.9) This allows the system to run a series of separately defined trains of pulses from a single trigger.

System

Selecting this option will call up the Systems Options Menu Screen. (See Section 5)

File Maintenance

Selecting this option will call up the File Maintenance Screen. (See section 6)

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4.3 SINGLE PULSE MODE The trace window is always active on this screen and is intended to display EMG response information from the MEP Pod. If no MEP pod is connected, the screen message will show ‘MEP NOT INSTALLED.’ To alter the settings, touch the window next to the required setting. A dark blue margin will appear within the selected window. The settings can be quickly altered using the Rotary Control Knob. POWER PANEL Power Panel

Trace Window %MT Window

The Power Panel is selected by pressing the Power button. When Power is selected, the button turns green. Power

To adjust the system power level, touch the Stimulator Output window on the Power Panel. The power level is set to the default value of 30%. The power can be increased, or decreased, in 1% increments by using the Rotary Control Knob. Each complete 360º rotation changes the output level by approximately 20%.

%MT

The %MT (Motor Threshold) window, displays the percentage of stimulator output which is to be transferred to the Protocol Intensity window. The %MT cannot be adjusted to give more than the 100% in the Protocol Intensity window.

Enhanced

This option enables the power level to be increased up to 110% power. This option is only available in Single Pulse Mode.

If Repetitive Mode or Session Mode is accessed via Single Pulse Mode, the Protocol intensity value will be carried over into these modes. All other configurable Single Pulse Mode options are available only when the MEP Pod is connected. NOTE. The Rapid2 must be switched off before connecting or disconnecting the MEP Pod.

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4.4 SINGLE PULSE MODE (MEP POD CONNECTED.) The MEP Pod must be connected to access the following options and to view the traces. . NOTE. The Rapid2 must be switched off before connecting or disconnecting the MEP Pod. PARAMETERS PANEL

Press the Parameters button (green when selected) to access the MEP Configuration panel.

Time Base

Selecting the Time Base window allows the user to set the MEP total sample period. The selectable options are; 20ms, 50ms, 100ms, 200ms and 500ms and are selected using the Rotary Control Knob. The trace width will show the whole of the selected sample period.

Filters

Selecting the Filters window allows the user to set the MEP Filter using the Rotary Control Knob. Selectable options: 2Hz-10kHz and 20Hz-10kHz.

Volts/Div Trace 1

Selecting the Volts/Div Trace window allows the user to set the scaling factor for channel 1. Selectable options: 50μV, 100μV, 200μV, 500μV, 1mV, 2mV, 5mV and 10mV. The default setting is 200μV.

Volts/ Div Trace 2 Selecting the Volts/Div Trace window allows the user to set the scaling factor for channel 2. Selectable options: 50μV, 100μV, 200μV, 500μV, 1mV, 2mV, 5mV and 10mV. The default setting is 200μV.

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TIME CURSORS PANEL

Press the Time Cursors button (green when selected) to access the Time Cursors panel.

Status

Select the Status window to turn the Latency Cursors on and off. The default setting is OFF.

Channel 1 Latencies

Select L1 or L2 to activate a cursor for adjustment. When the cursors are active, their current screen time value will be displayed on the trace window. The trace of the selected cursor can be moved using the Rotary Control Knob, for example to identify the time of an event.

Channel 2 Latencies

Select L1 or L2 to activate a cursor for adjustment. When the cursors are active, their current screen time value will be displayed on the trace window. The trace of the selected cursor can be moved using the Rotary Control Knob, for example to identify the time of an event.

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AMPLITUDE CURSORS PANEL

Press the Amplitude Cursors button (green when selected) to access the Amplitude Cursors panel.

Status

Select the Status window to turn the Amplitude Cursors on and off. The default setting is OFF.

Trace 1

This window allows the Amplitude Cursor on Trace 1 to be moved, for example to mark peaks.

Trace 2

This window allows the Amplitude Cursor on Trace 2 to be moved, for example to mark peaks.

Each time a new set of MEP waveforms are displayed and the Amplitude Cursors are active, the cursors will automatically move to the peak values for each trace. In Repetitive Mode or Session Mode, the peak achieved in Single Pulse Mode will remain marked by the Amplitude Cursor on the trace.

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