Please read this information carefully before coming in for your Motor Evoked Potential (MEP) test.

What is an MEP?

MEP stands for motor evoked potential. It is a non-invasive procedure. It is a recording of the electrical signals that assess the function of the motor pathways in the brain, through the spinal cord and into the limbs. It looks at how these pathways are functioning rather than taking images as you would see in a scan.

Why do an MEP?

If you have been experiencing problems with your coordination, weakness, or other changes in limb function you may be referred for a MEP.

What happens during an MEP?

Once you are settled comfortably on the couch, your skin will be wiped with alcohol gel and small sticky recording pads will be placed over muscles in the hands and feet to record the responses.

A plastic paddle will then be held over your head by the physiologist. You will hear a clicking noise when the magnetic pulse from the coil stimulates the brain and this will then cause a response to be recorded from the fingers or toes, causing them to twitch in time to the pulses.

A series of these pulses are given, and the responses collected and stored on the computer.

These pulses can feel briefly uncomfortable but there are no known side effects once stimulation has finished.

The test takes around 60 minutes.

Once the recording has finished all the sticky pads will be removed and the skin wiped clean.

Preparing for the test

• You must arrive with clean, dry hair free from grease, gel, wax or other hair products. You may wish to bring a comb or brush to tidy your hair after the test.
• Please wear clothes which allow easy access to you lower arms and legs.
• Continue to take all regular medication as normal before the test.
• You will be asked if you understand this information and whether you consent to the test before we start. At your appointment, you are welcome to ask the neurophysiologist doing the test to give you further information or to explain more about the procedure.

When will I get my results?

You will not get your results straight after the test or see a doctor on the day as the MEP needs to be fully analysed.

A full report will be sent to the GP or consultant who referred you within 2 weeks, they will then contact you to discuss the results. Please note, results are not sent directly to you.

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on the numbers below and a member of staff will be happy to help.

0117 414 1048 
0117 414 1050 

Your responsibility as a patient

Outpatient services at North Bristol NHS Trust are in great demand. Even so, every week an average of 600 patients fail to attend, which wastes appointments. Please tell us with as much notice as possible if you no longer need your appointment and we can allocate this to another patient. 

What if I am unwell or need to change my appointment?

If you have an infectious condition, such as COVID-19, measles, mumps, chickenpox, flu, stomach upset, have head lice, or are unable to attend your appointment for any other reason, please let us know with as much notice as possible so that your appointment can be rescheduled and offered to someone else.

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003741

Please read this information carefully before coming in for your Lateral Spread Response (LSR).

What is an LSR?

LSR stands for lateral spread response. It is a test that assesses the function of a branch of the facial nerve. It is a non-invasive procedure, that records the responses of the muscles around the eye and mouth to a series of small electrical impulses delivered to the face.

Why LSR?

If you are experiencing hemifacial spasm (involuntary muscle contractions around the eye and mouth on 1 side of the face), you may have been referred for microvascular decompressive (MVD) surgery. Before your MVD surgery, you will be referred for a pre-operative LSR. This is so that the neurophysiology team can see if the LSR can be recorded during your surgery.

What happens during an LSR?

The test will take around 30 minutes. The LSR involves stimulation of the facial nerve.

You will be asked to relax comfortably on a couch whilst a few adhesive pads will be placed on the muscles around your eye and mouth. 

A series of small electrical impulses will then be delivered to a branch of the facial nerve, close to the ear, with a stimulator. During this time, you may experience some subtle twitching of the muscles around your eye, mouth, or both. This will just last for a few seconds whilst a response is collected and recorded on the machine. 

This procedure will need to be repeated a few times and will then also be repeated on the other side of your face.

Preparing for the test

• Continue taking all regular medication and eat normally before to the test.
• You will be asked if you understand this information and whether you consent to the test before we start. At your appointment, you are welcome to ask the neurophysiologist doing the test to give you any further information or explain more about the procedures.

When will I get my results?

You will not get your results straight after the test or see a doctor on the day as the LSR needs to be fully analysed. A full report will be sent to the GP or consultant who referred you within 2 weeks, they will then contact you to discuss the results. Please note, results are not sent directly to you.

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on the numbers below and a member of staff will be happy to help.

0117 414 1048 
0117 414 1050 

Your responsibility as a patient

Outpatient services at North Bristol NHS Trust are in great demand. Even so, every week an average of 600 patients fail to attend, which wastes appointments. Please tell us with as much notice as possible if you no longer need your appointment and we can allocate this to another patient. 

What if I am unwell or need to change my appointment?

If you have an infectious condition, such as COVID-19, measles, mumps, chickenpox, flu, stomach upset, have head lice, or are unable to attend your appointment for any other reason, please let us know with as much notice as possible so that your appointment can be rescheduled and offered to someone else.

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

© North Bristol NHS Trust. This edition published December 2024. Review due Deember 2027. NBT003740

Please read this information carefully before coming in for your Electroencephalography (EEG)

What is an EEG?

EEG stands for electroencephalogram. It is a recording of the electrical signals from the brain, looking at how it is functioning rather than taking images as you would see in a scan. An EEG is a non-invasive, painless procedure and you won’t need to shave or cut your hair. 

Why have an EEG?

You may be referred for an EEG, if you have been experiencing possible fits, seizures, faints, or “funny turns”. The EEG will assess your ongoing electrical brain activity.

What happens during an EEG?

A routine EEG takes around 60 minutes. 20-30 minutes of this time involves measuring your head, and attaching small electrodes with a sticky paste. The rest of the time is to take the recording.

Your head will be measured, then rubbed gently before 28 small metal electrodes attached to wires are applied using a soluble sticky paste. 2 electrodes will be applied to your arms or shoulders to measure your heart rate during the EEG. You will relax on a bed with your eyes closed for most of the recording. Every so often the physiologist will ask you to open your eyes. After several minutes of recording, you may be asked to do some activation techniques including hyperventilation and photic stimulation. 

Hyperventilation

You will be asked to take deep breaths for 3 minutes with your eyes closed. You may feel lightheaded or have tingling in your fingers or lips during this, but these feelings will usually pass quickly once the task has finished. 

Photic Stimulation

You will be asked to look at a series of bright flashing lights with your eyes open and closed for 10 seconds at a time. During this part of the test there is a very small chance, if you are sensitive to flashing lights, that it may provoke a seizure. The physiologist will be watching the EEG at all times and if you appear sensitive they will stop the light immediately. 

Preparing for the test

• You must arrive with clean, dry hair free from grease, gel, wax or other hair products. You may wish to bring a comb or brush to tidy your hair after the test.
• We advise you have something to eat before coming for the test, preferably within 1.5 hours, as you are more likely to be comfortable during the test.
• Continue taking all regular medication as normal prior to the test.
• You will be asked if you understand this information and whether you consent to the test before we start. At your appointment, you are welcome to ask the neurophysiologist doing the test to give you any further information or explain more about the procedures.

When will I get my results?

You will not get your results straight after the test or see a doctor on the day as the EEG needs to be fully analysed.

A full report will be sent to the GP or consultant who referred you within 2 weeks, they will then contact you to discuss the results. Please note, results are not sent directly to you.

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on the numbers below and a member of staff will be happy to help.

0117 414 1048 
0117 414 1050 

Your responsibility as a patient

Outpatient services at North Bristol NHS Trust are in great demand. Even so, every week an average of 600 patients fail to attend, which wastes appointments. Please tell us with as much notice as possible if you no longer need your appointment and we can allocate this to another patient. 

What if I am unwell or need to change my appointment?

If you have an infectious condition, such as COVID-19, measles, mumps, chickenpox, flu, stomach upset, have head lice, or are unable to attend your appointment for any other reason, please let us know with as much notice as possible so that your appointment can be rescheduled and offered to someone else.

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003739

Please read this information carefully before coming in for your Brainstem Auditory Evoked Potentials (BAEP).

What is a BAEP?

BAEP stands for brainstem auditory evoked potential. It is a non-invasive, painless test that assesses the function of the nerves from the ears, and the pathways that travel along the brainstem (a part of the nervous system at the base of the brain). The test assesses the function rather than taking images as you would see in a scan.

Why do a BAEP? 

If you are experiencing changes to your hearing in both or 1 ear, a BAEP may be requested to determine whether there is a problem with how the auditory nerve pathway is functioning.

What happens during a BAEP?

A BAEP takes around 30-45 minutes. Your head will be measured, and a few small metal discs will be attached to your head. neck, and behind your ears with a sticky paste and possible some glue.

Once you are comfortable on a couch, a set of headphones will be placed on your head. From the headphones, you will hear clicking sounds of moderate intensity that will be applied to each ear for a short time. At this time, you will be asked to relax and lie with your eyes closed.

The series of clicks will continue for several minutes until all responses needed have been recorded.

Once the recording has finished all the metal discs will be removed and your head wiped with warm water, however, you may still need to wash your hair when you get home.

Preparing for the test

• You must arrive with clean, dry hair free from grease, gel, wax, or other hair products.
• Continue taking all regular medication and eat normally before to the test.
• If you have any obvious hearing problems or wear hearing aids, tell the physiologist before starting the test.
• You will be asked if you understand this information and whether you consent to the test before we start. At your appointment, you are welcome to ask the neurophysiologist doing the test to give you further information or explain more about the procedures.

When will I get my results?

You will not get your results straight after the test or see a doctor on the day as the BAEP needs to be fully analysed.

A full report will be sent to the GP or consultant who referred you within 2 weeks, they will then contact you to discuss the results. Please note, results are not sent directly to you.

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on the numbers below and a member of staff will be happy to help.

0117 414 1048 
0117 414 1050 

Your responsibility as a patient

Outpatient services at North Bristol NHS Trust are in great demand. Even so, every week an average of 600 patients fail to attend, which wastes appointments. Please tell us with as much notice as possible if you no longer need your appointment and we can allocate this to another patient. 

What if I am unwell or need to change my appointment?

If you have an infectious condition, such as COVID-19, measles, mumps, chickenpox, flu, stomach upset, have head lice, or are unable to attend your appointment for any other reason, please let us know with as much notice as possible so that your appointment can be rescheduled and offered to someone else.

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003738

R454 Mavacamten for treating symptomatic obstructive hypertrophic cardiomyopathy

Please read this information carefully before coming in for your Brainstem Auditory Evoked Potentials (BAEP) and Lateral Spread Response (LSR).

What is a BAEP?

BAEP stands for brainstem auditory evoked potential. It is a non-invasive, painless test that assesses the function of the nerves from the ears, and the pathways that travel along the brainstem (a part of the nervous system at the base of the brain). The test assesses the function rather than taking images as you would see in a scan.

Why do a BAEP? 

If you are experiencing changes to your hearing in both or 1 ear, a BAEP may be requested to determine whether there is a problem with how the auditory nerve pathway is functioning.

What happens during a BAEP?

A BAEP takes around 30-45 minutes. Your head will be measured, and a few small metal discs will be attached to your head. neck, and behind your ears with a sticky paste and possible some glue. 

Once you are comfortable on a couch, a set of headphones will be placed on your head. From the headphones, you will hear clicking sounds of moderate intensity that will be applied to each ear for a short time. At this time, you will be asked to relax and lie with your eyes closed.

The series of clicks will continue for several minutes until all responses needed have been recorded.

Once the recording has finished all the metal discs will be removed and your head wiped with warm water, however, you may still fneed to wash your hair when you get home.

What is an LSR?

LSR stands for lateral spread response. It is a test that assesses the function of a branch of the facial nerve. It is a non-invasive procedure, that records the responses of the muscles around the eye and mouth to a series of small electrical impulses delivered to the face. 

Why LSR?

If you are experiencing hemifacial spasm (involuntary muscle contractions around the eye and mouth on one side of the face), you may have been referred for microvascular decompressive (MVD) surgery.

Before your MVD surgery, you will be referred for a pre-operative LSR. This is so the neurophysiology team can see if the LSR can be recorded during your surgery.

What happens during an LSR?

The test will take around 30 minutes. The LSR involves stimulation of the facial nerve.

You will be asked to relax comfortably on a couch whilst a few adhesive pads are placed on the muscles around your eye and mouth.

A series of small electrical impulses will then be delivered to a branch of the facial nerve, close to the ear, with a stimulator. During this time, you may experience some subtle twitching of the muscles around your eye, mouth, or both. This will just last for a few seconds whilst a response is collected and recorded on the machine.

This procedure will need to be repeated a few times and will then also be repeated on the other side of your face.

Preparing for the test

• You must arrive with clean, dry hair free from grease, gel, wax, or other hair products.
• Continue taking all regular medication and eat normally before the test.
• If you have any obvious hearing problems or wear hearing aids, tell the physiologist before starting the test.
• You will be asked if you understand this information and whether you consent to the test before we start. At your appointment, you are welcome to ask the neurophysiologist doing the test to give you any further information or explain more about the procedures.

When will I get my results?

You will not get your results straight after the test or see a doctor on the day as the BAEP and LSR needs to be fully analysed.

A full report will be sent to the GP or consultant who referred you within 2 weeks, they will then contact you to discuss the results. Please note, results are not sent directly to you.

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on the numbers below and a member of staff will be happy to help.

0117 414 1048 
0117 414 1050 

Your responsibility as a patient

Outpatient services at North Bristol NHS Trust are in great demand. Even so, every week an average of 600 patients fail to attend, which wastes appointments. Please tell us with as much notice as possible if you no longer need your appointment and we can allocate this to another patient. 

What if I am unwell or need to change my appointment?

If you have an infectious condition, such as COVID-19, measles, mumps, chickenpox, flu, stomach upset, have head lice, or are unable to attend your appointment for any other reason, please let us know with as much notice as possible so that your appointment can be rescheduled and offered to someone else.

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003737

Please read this information carefully before coming in for your Ambulatory Electroencephalography (aEEG).

What is an ambulatory EEG?

EEG stands for electroencephalogram. Ambulatory monitoring involves recording the electrical activity in your brain when you are going about your normal daily activities, meaning you leave the department with the electrodes attached. This recording is usually done for 48 hours. 

What does an ambulatory EEG involve? 

An ambulatory EEG recording involves coming to Southmead Hospital for 3 separate appointments, 3 days in row. 

What happens during an ambulatory EEG?

Your first appointment 

This appointment will take around 60 minutes.

• Your head will be measured, then rubbed gently and 23 small metal discs will be applied to your head with soluble sticky paste, before being firmly attached with Mavidon glue.
• 2 electrodes will be applied to your shoulders to measure your heart rate during the EEG.
• These discs will then be attached to the small recording box with wires.
• The box will stay attached to you for the duration of the test and can be carried in a bag over your shoulder.
• You will be given a diary to complete. You will need to give a basic outline of your daily activities (eating, sleeping etc) as well as any typical events.
• We will also ask you to press a red event button, which is attached to the recorder, if you have any of your typical events. If you have no recollection of your events happening, it could be useful to have someone stay with you overnight to help you fill in the diary.

Your second appointment

This appointment will take around 30 minutes.

• You will need to bring your diary sheet back. The information on the recorder will be downloaded, the batteries will be replaced and all discs will be checked.

Your third appointment

This appointment will take around 60 minutes.

• The discs will be removed with acetone and as much glue as is possible will be removed, but you may still find loose bits in your hair.
• Use conditioner and a fine comb at home to help remove the final bits of glue.

Preparing for the test 

• You must arrive with clean, dry hair with no grease, gel, wax, or other hair products - these can impair electrode/skin contact. You will not be able to wash your hair until after the electrodes are removed on the third day.
• Wear clothing which is loose fitting around the neck, preferably an open neck shirt/blouse with button fastening or a wide necked T-shirt. This will make it easier to undress when going to bed.

When will I get my results?

You will not get your results straight after the test or see a doctor on the day, as the ambulatory EEG needs to be fully analysed.

A full report will be sent to the GP or consultant who referred you within 2 weeks, they will then contact you to discuss the results. Please note, results are not sent directly to you.

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on the numbers below and a member of staff will be happy to help.

0117 414 1048 
0117 414 1050 

Your responsibility as a patient

Outpatient services at North Bristol NHS Trust are in great demand. Even so, every week an average of 600 patients fail to attend, which wastes appointments. Please tell us with as much notice as possible if you no longer need your appointment and we can allocate this to another patient. 

What if I am unwell or need to change my appointment?

If you have an infectious condition, such as COVID-19, measles, mumps, chickenpox, flu, stomach upset, have head lice, or are unable to attend your appointment for any other reason, please let us know with as much notice as possible so that your appointment can be rescheduled and offered to someone else.

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003736

Please read this information carefully before coming in for your actigraphy test. 

What is an actigraphy? 

Actigraphy is a non-invasive way to find out your sleep patterns by monitoring your rest and activity cycles over 1 or 2 weeks. 

Why have an actigraphy?

If you are having problems with your sleep such as irregular sleep and wake times or excessive sleepiness, you may be referred for an actigraphy test. 

What happens during an actigraphy?

Actigraphy monitors movement over days or weeks in real life situations. It involves wearing a device like a watch which has an accelerometer that detects movements.

You will wear the watch on your wrist at all times for around 2 weeks and complete a diary sheet of your daily activities and sleep times. You must only remove the watch when you shower, bathe, or wash and then log this on the diary sheet. It is important that you remember to re-attach the watch after this.

You will press a button on the watch when you go to bed and when you wake up. This will be fully explained to you by the clinical neurophysiologist at your initial appointment. During this appointment, you will be given some diary sheets to write down your daily activities whilst wearing the watch.

After you have completed your period of actigraphy you must return the watch in person at the time specified in your letter. These watches are in high demand for use by other patients and failure to return at the specified time may result in the cancellation of other patients’ appointments.

Preparing for the test

• You can eat and drink as normal before the test.
• Please follow the guidance provided by your consultant neuropsychiatrist about reducing or stopping medications before coming for the test. This information should be in the clinic letter following your appointment. Please call 0117 414 1048 or 0117 414 0452 if you have any concerns or questions.
• You will be asked if you understand this information and whether you consent to the test before we start. You are welcome to ask the neurophysiologist doing the test to give you any further information or to explain more about the procedure.
• Your appointment should take about 10-15 minutes.

How long until I get my results?

The results will be sent to your GP/consultant. You will not receive any results during the test. Your consultant may send you a letter with the results or see you again for a follow-up appointment. Please note, results are not sent directly to you. 

Contact details

This information is intended as a guideline only. If you have any further questions about your test (excluding about results) please contact the department on 0117 414 1048 or 0117 414 1052 and a member of staff will be happy to help.

Your responsibility as a patient

Outpatient services at North Bristol NHS Trust are in great demand. Even so, every week an average of 600 patients fail to attend, which wastes appointments. Please tell us with as much notice as possible if you no longer need your appointment and we can allocate this to another patient. 

What if I am unwell or need to change my appointment?

If you have an infectious condition, such as COVID-19, measles, mumps, chickenpox, flu, stomach upset, have head lice, or are unable to attend your appointment for any other reason, please let us know with as much notice as possible so that your appointment can be rescheduled and offered to someone else.

If you want to change the appointment for a second time, we cannot offer you another date unless there are exceptional circumstances.

What if I don’t attend?

We will assume that you no longer require your appointment, and we will not offer you another one. We will write to the consultant/doctor who referred you and inform them that you did not attend.

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003735

How dupilumab may affect your eyes

Dupilumab is an effective treatment for severe asthma, but it has been linked to side effects of the eyes in some people. Most of the side effects are mild, but some can become serious if they are not managed properly.

Mild side effects which you can often manage yourself:

• Dry eyes: dryness, burning, or grittiness in the eyes.
• Conjunctivitis: red, itchy, watery eyes with possible discharge.

Uncommon side effects which require advice from a healthcare professional: 

• Blepharitis (eyelid inflammation): redness and swelling around the eyelids, often with crusting.
• Keratitis (corneal inflammation): eye pain, blurred vision, light sensitivity, or feeling like something is in your eye.

Managing mild eye side effects

If you have eye symptoms while on dupilumab, try these steps:

• Use artificial tears: over-the-counter lubricating eye drops (for example sodium hyaluronate) can help with dryness and irritation. Use preservative-free drops if needed. Speak to your community pharmacist for advice on eye drops.
• Warm compresses: apply a warm, moist compress to your eyelids for a few minutes to relieve discomfort.
• Maintain eye hygiene: clean your eyelids daily with a warm cloth or mild eyelid scrub.
• Limit contact lens use: wear glasses more often than contact lenses if you have symptoms of conjunctivitis or dry eyes.
• Avoid touching or rubbing your eyes: this can make symptoms worse and cause infections.
• Protect your eyes from irritants: avoid smoke, dust, and strong wind. Sunglasses can help.

When to contact a healthcare professional

Phone the Severe Asthma team on 0117 414 2030 if you have:

• Eye discomfort that won’t go away or is getting worse.
• Vision changes, like blurred vision or light sensitivity.
• Severe redness or swelling of the eyes.
• Symptoms that don’t improve with over-the-counter treatments.

When to go to A&E at the Bristol Eye Hospital

If you have any of the following eye symptoms go to Bristol Eye Hospital A&E for urgent care.

• Sensitivity to light.
• Significant pain.
• Sudden changes in vision.
• Severe itching.

Please inform the Severe Asthma team if you have gone to the eye hospital A&E when possible. Contact us on 0117 414 2030.

Eye care tips while on dupilumab

• Regular eye exams: schedule eye exams to detect changes early.
• Report new symptoms: inform the severe asthma team about any new or worsening symptoms.
• Follow treatment instructions: stick to your treatment plan to minimise side effects and get the full benefit of dupilumab.

Summary

Eye issues can be a side effect of dupilumab but can often be managed with the right steps. Knowing the symptoms, how to manage them, and when to seek help will help you continue to benefit from dupilumab while protecting your eye health.

For any concerns or questions, contact the severe asthma team on 0117 414 2030.

© North Bristol NHS Trust. This edition published December 2024. Review due December 2027. NBT003755

What is a CPEX test?

A Cardiopulmonary Exercise Test (CPEX, also known as CPET) is a safe exercise test used to measure your fitness. It is the best test to measure how your heart and lungs will cope with surgery. It is a short exercise test on a static bicycle (like exercise bikes you see in gyms). Many hospitals offer it as part of your pre-operative assessment and planning for surgery.

Why do I need to have this test? 

We do this test to find out how you are likely to react to surgery. This will inform surgeons and anaesthetists how best to look after you. This may reduce your risk of complications, and it will also provide useful information about your potential recovery time following the operation.

What happens during the test?

Before your test begins, staff will fully explain what will happen and answer any questions you may have. The test usually lasts between 5 and 12 minutes. Staff will ask you to tell them if you feel any discomfort or pain during the test. You are free to stop if you feel fatigued (tired) or uncomfortable; but the longer you can go, the better the information we will get.

Whilst cycling your breath will be analysed and your heart and blood pressure monitored. You will have some simple medical equipment attached to you so that we can take these readings. A specialised mask will measure the oxygen and carbon dioxide in your breath.

A health professional will be with you at all times. We may ask you to stop if we see you look fatigued or there are changes to your heart rate or blood pressure.

The test begins gently, with a low intensity cycle; you will feel no resistance as you pedal. Gradually you will feel increased resistance when pedaling. Most people do enough of the test for us to get the medical information we need. After the test, you rest on the bike until you are ready to sit down and discuss the results.

Occasionally, with your permission, we may include your anonymised results in research to improve patient care.

Important information

• Please continue to take all your medications as normal – or how you have been instructed by your doctor.
• Please do not wear nail varnish to your appointment.

Will I experience any discomfort or side effects?

There are no known side effects. CPEX testing is very safe. Rarely patients experience problems with abnormal blood pressure, irregular heart rates, or chest pain.

Complications happening during the test is actually a good thing. This identifies patients who will potentially have problems during surgery and minimises the risk of surgery that you are exposed to.

Every effort will be made to minimise any risk by evaluation of your medical information before the test, and careful observation during the test.

Is there a different test I could have?

There is no other test that provides this information about your heart and lung ‘fitness’.

When will I be told the results of my test?

You will be told of the results on the same day by the doctors performing the test. The information will also be shared with the doctor or surgeon who requested the test.

What if it tells me I cannot have my operation?

Sometimes the information will tell us that your body will find the stresses and strains of the operation too much. We will discuss the risks and benefits of the surgery with you and your surgeon.

I have bad joints and am worried about riding the bike? 

Unless you have very severe joint pain, most people are able to ride the bike for the duration of the test.

How ‘fit’ do I have to be to perform the test?

People of all levels of ability, ages and fitness are able to perform the test.

I am worried or anxious about completing the test

We understand that many patients find the idea of this test worrying for many reasons. We have excellent staff at hand to reassure and support you through the process. Feel free to answer ask questions on the day. We will do our best to make you feel safe and well-cared for during your appointment.

What should I wear for my test?

You should wear normal comfortable clothing and flat shoes (ideally trainers) suitable for cycling in.

© North Bristol NHS Trust. This edition published October 2024. Review due October 2027. NBT002669