NEUROMEDICAL SYSTEMS INC
10-Q, 1998-05-15
TESTING LABORATORIES
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<PAGE>
 
                       SECURITIES AND EXCHANGE COMMISSION
                             WASHINGTON D.C.  20549
                                   FORM 10-Q
(MARK ONE)

[X]  QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE SECURITIES
                             EXCHANGE ACT OF 1934

     For the quarterly period ended March 31, 1998

                                       OR

[ ]  TRANSITION REPORT PURSUANT TO SECTION 13 OR 15 (d) OF THE SECURITIES
                             EXCHANGE ACT OF 1934


     For the transition period from ____________ to _____________

                         Commission File No.  0-26984


                          Neuromedical Systems, Inc.
  ---------------------------------------------------------------------------
            (Exact Name of Registrant as Specified in its Charter)


             Delaware                                    13-3526980
  --------------------------------------------------------------------------- 
  (State or other Jurisdiction of                     (I.R.S. Employer
   Incorporation or Organization)                   Identification No.)

 
               Two Executive Boulevard, Suffern, NY  10901-4164
  ---------------------------------------------------------------------------
                   (Address of Principal Executive Offices)


  Registrant's telephone number including area code:   (914) 368-3600
                                                       --------------

  ---------------------------------------------------------------------------
                    (Former Name, Former Address and Former
                    Fiscal Year if Changed Since Last Report)



  Indicate by check mark whether the Registrant (1) has filed all reports
  required to be filed by Section 13 or 15(d) of the Securities Exchange Act of
  1934 during the preceding 12 months (or for such shorter period that the
  Registrant was required to file such reports) and (2) has been subject to such
  filing requirements for the past 90 days.   Yes   X       No
                                                 -------      -------

  As of May 7, 1998, an aggregate of 31,055,846 shares of the Registrant's 
  common stock, par value $.0001 per share, were outstanding.

<PAGE>
 
                           NEUROMEDICAL SYSTEMS, INC.

                               Table of Contents
            Form 10-Q for the Quarterly Period Ended March 31, 1998


PART I    FINANCIAL INFORMATION                                       PAGE
- ------    ---------------------                                       ----

Item 1.   Financial Statements
 
 
            Condensed Consolidated Balance Sheets at
            March 31, 1998 (unaudited) and December 31, 1997            3
 
            Condensed Consolidated Statements of Operations for the
            three months ended March 31, 1998 and 1997 (unaudited)      4
 
            Condensed Consolidated Statements of Cash Flows for the
            three months ended March 31, 1998 and 1997 (unaudited)      5
 
            Notes to Condensed Consolidated Financial Statements        6
 

Item 2.  Management's Discussion and Analysis of Financial
         Condition and Results of Operations                            8


PART II  OTHER INFORMATION
- -------  -----------------

Item 1.  Legal Proceedings                                             14

Item 2.  Changes in Securities                                         15
 
Item 3.  Defaults upon Senior Securities                               15
 
Item 4.  Submission of Matters to a Vote
         of Security Holders                                           15
 
Item 5.  Other Information                                             15
 
Item 6.  Exhibits and Reports on Form 8-K                              15
 
Safe Harbor Statement                                                  16
 
Signature                                                              17
<PAGE>
 
                  NEUROMEDICAL SYSTEMS, INC. AND SUBSIDIARIES

                     CONDENSED CONSOLIDATED BALANCE SHEETS
<TABLE> 
<CAPTION> 
                                                                                 March 31,       December 31,
                                                                                   1998             1997
                                                                            -----------------  ----------------
                                                                               (unaudited)
                                                     ASSETS
<S> 
Current assets:                                                             <C>                <C> 
   Cash and cash equivalents                                                $     12,514,000   $    15,842,000
   Short-term investments                                                         24,999,000        30,094,000
   Accounts receivable, net of allowance                                           2,515,000         2,119,000
   Inventories                                                                     3,004,000         2,942,000
   Prepaid expenses                                                                  708,000           617,000
   Other current assets                                                              801,000           525,000
                                                                            -----------------  ----------------
Total current assets                                                              44,541,000        52,139,000
Restricted cash                                                                      638,000           638,000
Property and equipment                                                            11,156,000        12,092,000
Intangible assets, net of accumulated amortization                           
   (1998-$799,000, 1997-$753,000)                                                    771,000           817,000
Note receivable from employee                                                        600,000           600,000
Other assets                                                                          99,000            58,000
                                                                            -----------------  ----------------
                                                                            $     57,805,000   $    66,344,000
                                                                            =================  ================
</TABLE> 
<TABLE> 
<CAPTION> 
                                      LIABILITIES AND STOCKHOLDERS' EQUITY
<S>                                                                         <C>                <C> 
Current liabilities:
   Current portion of notes and bank loans payable                          $      2,315,000   $     2,705,000
   Current portion of capital lease obligations                                    2,274,000         2,424,000
   Accounts payable                                                                1,423,000         1,149,000
   Accrued liabilities                                                             4,499,000         4,247,000
                                                                            -----------------  ----------------
Total current liabilities                                                         10,511,000        10,525,000
Notes and bank loans payable-long-term                                             3,386,000         3,762,000
Capital lease obligations, less current portion                                    4,060,000         4,583,000
Commitments and contingencies
Stockholders' equity:
   Preferred stock, $.0001 par value; authorized -
      10,000,000 shares; none issued and outstanding                                    ----              ----
   Common stock, $.0001 par value; authorized-
      100,000,000 shares; issued and outstanding - 31,054,860
      shares in 1998 and 31,049,510 shares in 1997                                     3,000             3,000
   Additional paid-in capital                                                    178,821,000       178,801,000
   Note receivable from officer                                                     (146,000)             ----
   Deferred compensation                                                            (430,000)         (576,000)
   Accumulated deficit                                                          (138,746,000)     (131,089,000)
   Accumulated other comprehensive income -
      foreign currency translation                                                   346,000           335,000
                                                                            -----------------  ----------------
Total stockholders' equity                                                        39,848,000        47,474,000
                                                                            -----------------  ----------------
                                                                            $     57,805,000   $    66,344,000
                                                                            =================  ================
</TABLE> 
                            See accompanying notes.

                                      -3-
<PAGE>
 
                  NEUROMEDICAL SYSTEMS, INC. AND SUBSIDIARIES

                CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS
                                  (Unaudited)
<TABLE> 
<CAPTION> 
                                                                Three Months Ended March 31,
                                                              --------------------------------
                                                                   1998              1997
                                                              --------------    --------------
<S>                                                           <C>               <C> 
Revenues:
   Slide processing and equipment sales                       $   2,574,000     $   1,651,000
                                                              --------------    --------------
       Total revenues                                             2,574,000         1,651,000
                                                              --------------    --------------
Costs and Expenses:
   Cost of sales                                                  3,120,000         2,593,000
   Sales and marketing                                            2,147,000         5,478,000
   Research and development                                       2,313,000         1,948,000
   General and administrative                                     2,750,000         1,940,000
                                                              --------------    --------------
       Total costs and expenses                                  10,330,000        11,959,000
                                                              --------------    --------------
Loss from operations                                             (7,756,000)      (10,308,000)
Other income (expense):
   Interest income                                                  547,000           992,000
   Interest expense                                                (371,000)         (388,000)
   Foreign exchange                                                 (77,000)          (21,000)
                                                              --------------    --------------
       Other income (expense) - net                                  99,000           583,000
                                                              --------------    --------------
Net loss                                                      $  (7,657,000)    $  (9,725,000)
                                                              ==============    ==============

Basic and diluted net loss per share                          $       (0.25)    $       (0.32)
                                                              ==============    ==============
 
Weighted average shares used in computation of
   net loss per share                                            31,055,000        30,825,000
                                                              ==============    ==============
</TABLE> 
                            See accompanying notes.
 

                                      -4-
<PAGE>
 
                  NEUROMEDICAL SYSTEMS INC. AND SUBSIDIARIES

                CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
                                  (Unaudited)

<TABLE>
<CAPTION>
                                                          Three Months Ended March 31,
                                                          ----------------------------
                                                             1998             1997
                                                          -----------     ------------
<S>                                                       <C>             <C>
Operating Activities                                                    
Net Loss                                                  $(7,657,000)    $ (9,725,000)
Adjustments to reconcile net loss to net cash used in                   
 operating activities:                                                  
   Depreciation and amortization                            1,171,000        1,144,000
  Non cash compensation related to issuance of                          
     common stock warrants and options                        166,000             ----
   Foreign exchange loss                                       90,000           11,000
Changes in operating assets and liabilities:                            
   Increase in accounts receivable                           (396,000)         (46,000)
   Increase in inventory                                      (62,000)            ----
   Increase in prepaid expenses                                         
    and other assets                                         (408,000)        (126,000)
   Increase (decrease) in accounts payable                    274,000         (622,000)
   Increase in accrued liabilities                            252,000          608,000
                                                          -----------     ------------
   Net cash used in operating activities                   (6,570,000)      (8,756,000)
                                                          -----------     ------------
Investing Activities                                                    
Purchases of short-term securities                               ----      (25,138,000)
Proceeds from maturing short-term securities                5,095,000             ----
Purchases of property and equipment                          (210,000)      (2,040,000)
                                                          -----------     ------------
   Net cash used in investing activities                    4,885,000      (27,178,000)
                                                          -----------     ------------
Financing Activities                                                    
Issuance of stock pursuant to exercise of options                ----          128,000
Proceeds from notes and bank loans                               ----          212,000
Note receivable from officer                                 (146,000)            ----
Payment of notes and bank loans                              (767,000)        (403,000)
Payments on capital leases                                   (686,000)        (534,000)
                                                          -----------     ------------
   Net cash used in financing activities                   (1,599,000)        (597,000)
                                                          -----------     ------------
Effect of exchange rate changes on cash                       (44,000)          23,000
                                                          -----------     ------------
   Net decrease in cash and cash equivalents               (3,328,000)     (36,508,000)
Cash and cash equivalents, beginning of period             15,842,000       83,391,000
                                                          -----------     ------------
Cash and cash equivalents, end of period                  $12,514,000     $ 46,883,000
                                                          ===========     ============
</TABLE>

                            See accompanying notes.

                                      -5-
<PAGE>
 
                  Neuromedical Systems, Inc. and Subsidiaries
                        NOTES TO CONDENSED CONSOLIDATED
                             FINANCIAL STATEMENTS
                                March 31, 1998

                                  (Unaudited)

                                        
NOTE 1.   BASIS FOR CONSOLIDATION

The accompanying unaudited condensed consolidated financial statements have been
prepared in accordance with generally accepted accounting principles for interim
financial information and in accordance with the instructions to Form 10-Q and
Article 10 of Regulation S-X.  Accordingly, they do not include all of the
information and footnotes required by generally accepted accounting principles
for complete financial statements.  In the opinion of management, all
adjustments (consisting of normal recurring accruals) considered necessary for
the fair presentation have been included. These condensed consolidated financial
statements and footnotes thereto are included in the Neuromedical Systems, Inc.
(the "Company" or "NSI") Annual Report on Form 10-K for the year ended December
31, 1997 (the "1997 Form 10-K").  Operating results for the three month period
ended March 31, 1998 are not necessarily indicative of the results that may be
expected for the year ended December 31, 1998.

NOTE 2.   RELATED PARTY TRANSACTION

On March 13, 1998, the Company entered into a Note Agreement with its President
and Chief Executive Officer in the amount of $146,000.  The Note is due on March
13, 2003, bears interest at 5.61% per annum and is secured by 70,000 shares of
the Company's common stock.

NOTE 3.   STOCK OPTIONS

During March 1998 the number of shares authorized under the Neuromedical
Systems, Inc. 1993 Stock Option Plan, as Amended and Restated October 25, 1995,
and as further amended, was increased by 900,000 shares to 5,040,000 shares.

NOTE 4.   COMPREHENSIVE INCOME

As of January 1, 1998, the Company adopted Statement 130, Reporting
Comprehensive Income.  Statement 130 establishes new rules for the reporting and
display of comprehensive income and its components; however, the adoption of
this Statement had no impact on the Company's net loss or shareholders' equity.
Statement 130 requires unrealized gains or losses on the Company's foreign
exchange translation adjustments, which prior to the adoption were reported
separately in shareholders' equity to be included in other comprehensive income.
Prior year financial statements have been reclassified to conform to the
requirements of Statement 130.

                                      -6-
<PAGE>
 
                  NEUROMEDICAL SYSTEMS, INC. AND SUBSIDIARIES

                        NOTES TO CONDENSED CONSOLIDATED
                FINANCIAL STATEMENTS (Unaudited) -- (Continued)
 
During the first quarter ended March 31, 1998 and 1997 total comprehensive loss
amounted to $7,646,000 and $9,745,000, respectively.

The components of comprehensive loss, net of related tax, for the three month
periods ended March 31, 1998 and 1997 are as follows:
<TABLE> 
<CAPTION> 
                                                      1998            1997   
                                                      ----            ----   
    <S>                                            <C>             <C>  
    Net Loss                                       (7,657,000)     (9,725,000)
    Foreign currency translation adjustment            11,000          20,000
                                                   -----------     -----------
    Comprehensive loss                             (7,646,000)     (9,745,000)
                                                   ===========     ===========
</TABLE> 

The components of accumulated other comprehensive income at March 31, 1998 and
December 31, 1997 are as follows:
<TABLE> 
<CAPTION> 
                                                       1998            1997    
                                                       ----            ----   
    <S>                                            <C>             <C>  
    Foreign currency translation adjustment and
    accumulated other comprehensive income            346,000         335,000 
                                                   ===========      ===========
</TABLE> 
                                                                                

                                      -7-
<PAGE>
 
ITEM 2.   MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND       
          RESULTS OF OPERATIONS.




OVERVIEW

     Neuromedical Systems, Inc., a Delaware corporation (the "Company") is a
healthcare technology company focused on bringing intelligent vision to
medicine.  It is the Company's objective to become the premier supplier of
cytology screening and     anatomic pathology diagnostic equipment and services
to laboratories. The Company's first, and to date, only product, the PapNet
Testing System, is a sophisticated interactive system that assists the
laboratory professional in the detection of abnormal cells on cervical cytology
specimens (also known as Pap smears).  Since its inception, the Company has been
primarily engaged in the development, manufacturing and marketing of the PapNet
Testing System, and the scanning of Pap smears at its slide processing
facilities.  The Company's revenues are currently being derived from sales of
PapNet testing services,  sales of PapNet Testing Systems under the  PAPNET-on-
CyteTM trade name,  laboratory services and interest income.

     In the United States, the PapNet Testing System is promoted to assist the
cytology professional in the examination of conventionally prepared smears that
have first been assessed by standard manual microscopy to be "negative", "within
normal limits", or evidencing "benign cellular changes."  Outside of the United
States, some of the Company's laboratory customers use the PapNet Testing System
in a variety of different modes, including to assist in the interpretation of
liquid-based Pap specimens and Pap smears that have not first been assessed by
manual microscopic review.

     The PapNet system may be purchased or leased by the laboratory customer in
its entirety or individual components, or accessed on a patient by patient
basis.

     The PapNet Testing System was approved by the United States Food and Drug
Administration (the "FDA") for commercial use in the United States on November
8, 1995.  Prior to that time, the PapNet Testing System was permitted to be
utilized in the United States on an investigational basis only, and the Company
was permitted to derive revenue with respect thereto only to recover certain of
its costs.  However, during that time the Company was selling PapNet testing
services for commercial use outside of the United States.  The Company
established three scanning facilities (the "Scanning Centers"), one each in the
United States, The Netherlands and Hong Kong.  The Netherlands Scanning Center
has scanned slides primarily from customers in Europe while the Hong Kong
Scanning Center has scanned slides from Asia and Australia.  During the third
quarter of 1997, the Company announced a strategic shift in its European
business approach from being a supplier of scanning services via a centralized
scanning center to selling and leasing the PapNet Testing System equipment to
laboratories under the PAPNET-on-Cyte trade name During the fourth quarter of
1997 the Company placed the first PAPNET-on-Cyte system to a customer.  During
the first quarter of 1998 the Company placed five PAPNET-on-Cyte systems, three
as sales and two leased systems.

                                      -8-
<PAGE>
 
In addition, the Company announced plans to close its Netherlands Scanning
Center during the second quarter ending June 30, 1998 and intends to lease or
sell its existing PapNet Systems to laboratory customers. The charge to
operations resulting from closure of the Netherlands Scanning Center is not
expected to be material.


     In the United States, the Company continued laying the groundwork for a
similar transition.  However, due to differences in the laboratory marketplace,
reimbursement practice and regulatory requirements, the Company expects this
transition will extend until at least the end of 1999.

     In addition to slide scanning services, the Company's Asia Pacific
operations provide PapNet-assisted screening for customers in Hong Kong, China
and Taiwan through the Company's acquired laboratory business, New System
International, Ltd.

     The Company has incurred net losses since inception through March 31, 1998
of $138,746,000  and has to date generated only limited commercial revenues.
Since the approval of the PapNet Testing System by the FDA, the Company has been
increasing the scale of operations to commercial levels in the United States and
internationally.  Management believes that its existing cash resources will be
sufficient to fund operations and to meet its cash requirements through 1999,
although there can be no assurance in this regard.  The Company's past results
of operations reflect its early commercial stage and are not necessarily
indicative of the results from operations that may be expected in the future.

RESULTS OF OPERATIONS

     The Company's results of operations have fluctuated significantly from year
to year and quarter to quarter, principally due to the variations in the level
of expenditures relating to its marketing and sales programs, clinical trials,
research projects and international expansion.  The Company's results of
operations are expected to continue to fluctuate significantly and to result in
substantial losses for the forseeable future.

     The Company believes that significant revenue growth during 1998 is
dependent on the success of the strategic shift of its European business
strategy to sell PAPNET-on-Cyte system directly to customers.  The Company does
not expect significant revenue growth in the United States until it obtains FDA
approval for use of the PapNet Testing System as an interactive primary screener
of Pap smears and there is commercial acceptance for such use.

     From inception through March 31, 1998, the Company has experienced negative
gross margins due to the significant underutilization of its scanning and
manufacturing operations.  Improvement in the Company's future gross margins
will be dependent upon the level of commercial acceptance of the PapNet Testing
System, and, in particular, during 1998, the degree of success of PAPNET-on-Cyte
sales and leases in Europe.

                                      -9-
<PAGE>
 
     The Company's costs and expenses decreased during the first quarter of 1998
compared to the first quarter of 1997.  The Company anticipates that aggregate
costs and expenses will decrease in 1998 compared to 1997, following the
Company's decision to focus sales and marketing efforts on laboratory customers
and opinion leading clinicians, sell equipment in Europe and consolidate product
development in the United States. However, the Company does not expect total
costs and expenses to decrease significantly in 1998 because of the expected
increased costs of clinical studies for a primary screening indication in the
United States, a full year of cost associated with the Company's Asia/Pacific
operations versus a partial year of cost in 1997 associated with two mid year
acquisitions, uncertainty over the level of costs associated with ongoing
litigation, and higher royalty payments in sales territories of the Company's
territorial licensees that will increase proportionate to increases in the
Company's revenues in those territories.

     Interest expense is expected to decrease in 1998, compared to 1997, due to
the scheduled repayment of existing debt.  Interest income from the Company's
investment of excess funds is expected to offset interest expense in 1998.  The
Company expects that interest income will decrease in 1998, compared to 1997,
because of the significant use of cash during 1997, the first quarter of 1998
and the anticipated use of cash in the remainder of 1998.

RESULTS FOR THE FIRST QUARTER ENDING MARCH 31, 1998.

     Revenues for the first quarter ended March 31, 1998 were $2,574,000, an
increase of $923,000 or 56% from $1,651,000 during the first quarter ended March
31, 1997.  Revenue from European operations increased to $1,059,000 during the
first quarter ended March 31, 1998 compared to $280,000 in the first quarter
ended March 31,1997.  The increase was due primarily to the Company's continued
implementation of its business strategy in Europe of selling and leasing PAPNET-
on-Cyte systems directly to laboratory customers.  Revenues from United States
operations decreased to $890,000 in the first quarter ended March 31, 1998
compared to $993,000 in the first quarter ended March 31, 1997.  The decrease
reflected a number of factors which included the continued challenge surrounding
cervical screening reimbursement.  Revenues from Asia/Pacific operations
increased to $625,000 in the quarter ended March 31, 1998 compared to $378,000
in the first quarter ended March 31, 1997.  The increase primarily reflected the
acquisition of a laboratory business in June 1997.

     Total costs and expenses for the first quarter ended March 31, 1998 were
$10,330,000 compared to $11,959,000 for the quarter ended March 31, 1997, a
decrease of $1,629,000 or 14%.  The decrease was primarily due to decreased
sales and marketing expenses offset by increases in research and development
expense, general and administrative expense and cost of sales.

     Cost of sales expense increased to $3,120,000 during the quarter ended
March 31, 1998, compared to $2,593,000 during the quarter ended March 31, 1997,
an increase of $527,000.  The increase primarily reflected costs associated with
the cost of sales of

                                      -10-
<PAGE>
 
PAPNET-on-Cyte systems and costs associated with the acquired laboratory
business in Hong Kong in June 1997.

     Sales and marketing expense decreased to $2,147,000 during the quarter
ended March 31, 1998, compared to $5,478,000 during the quarter ended March 31,
1997, a decrease of $3,331,000.  The decrease in sales and marketing expense was
due primarily to a reduction of sales and marketing expense in the United States
and Australia as a result of the Company's decision to suspend consumer
advertising and channel communications through laboratories which was offset by
higher marketing and sales expenses associated with acquired operations in the
Asia/Pacific region in June of 1997 and Taiwan in August of 1997.

     Research and development expense increased to $2,313,000 during the quarter
ended March 31, 1998, compared to $1,948,000 during the quarter ended March
31,1997, an increase of $365,000.  The increase in research and development
expense was due primarily to costs associated with preparation for clinical
studies for an interactive primary screening indication in the United States and
costs associated with consolidation of product development operations from
Israel to the United States.

     General and administrative expense increased to $2,750,000 during the first
quarter ended March 31,1998, compared to $1,940,000 during the first quarter
ended March 31, 1997, an increase of $810,000.  The increase in general and
administrative expense was due primarily to severance costs related to two
former executives and increased costs in Europe to support operations.

     Interest income decreased to $547,000 for the first quarter ended March 31,
1998, compared to $992,000 for the first quarter ended March 31, 1997, a
decrease of $445,000.  The decrease reflected the lower level of cash, cash
equivalents and short-term investments available to the Company during the first
quarter of 1998 as a result of the Company's continuing losses in 1997 and the
first quarter of 1998.

     Interest expense decreased to $371,000 for the first quarter ended March
31, 1998, compared to $388,000 for the first quarter ended March 31, 1997, a
decrease of $17,000.

     The Company incurred a net loss during the first quarter ended March 31,
1998 of $7,657,000, or $0.25 per share, compared to a net loss of $9,725,000, or
$0.32 per share during the first quarter ended March 31, 1997.  The decreased
net loss was due primarily to the factors discussed above.

LIQUIDITY AND CAPITAL RESOURCES

     The Company has financed its operations since its inception primarily
through the issuance of equity securities; sales of PapNet Testing System
services; sales of PAPNET-on-Cyte systems to laboratories in Europe; funds
received for the territorial license agreements (prior to 1992); interest earned
on cash, cash equivalents and short-term investments; and proceeds from notes,
bank loans and equipment leasing agreements.

                                      -11-
<PAGE>
 
The Company expects to generate increased revenue from the sale and leases of
PAPNET-on-Cyte systems to customers in 1998.

     The Company's combined cash, cash equivalents, and short-term investments
totaled $37,513,000 at March 31, 1998, a decrease of $8,423,000 from December
31, 1997.  During the first quarter of 1998, the Company used $6,570,000 for
operating activities; $210,000 for investing activities (excluding proceeds of
$5,095,000 from the sale of short-term investments); and $1,599,000 for
financing activities.

     The primary uses of cash for operating activities during the first quarter
ended March 31, 1998 were the net loss of $7,657,000, inclusive of non cash
items totaling $1,427,000 and increased accounts receivable and other asset
balances in Europe. These items were offset by increased accounts payable and
accrued liabilities.

     The primary uses of cash for financing activities were payment of $300,000
under a note payable to stockholder, $467,000 of payments under bank and
equipment loans, a loan of $146,000 to the President and Chief Executive Officer
secured by 70,000 shares of the Company's common stock and $686,000 of payments
under capital lease obligations.

     The Company anticipates that its use of cash will be substantial for the
foreseeable future.  In particular, the Company anticipates that expenditures
will continue to be substantial in 1998 due to the cost of marketing and sales
in both the United States and internationally, the expansion of research and
development programs for potential additional clinical indications and claims,
and the cost of ongoing litigation.  The Company anticipates that during 1998 it
will invest approximately $3.0 million for working capital purposes and
approximately $2.0 million for capital expenditures and leasehold improvements.
Although funding for these capital expenditures is expected to be available out
of the Company's cash resources, management of the Company believes that it may
be desirable for the Company to finance certain such capital expenditures
through additional debt or capital lease obligations.  There can be no
assurance, however, that such financing can be obtained or, if  obtained, that
the terms thereof will be reasonable.

     During 1995, 1996 and 1997, the Company entered into a number of loan and
equipment lease agreements with financing companies to provide the Company with
lines of credit to finance certain of the Company's equipment purchases.
Certain of these loan and lease lines of credit commitments expired on December
31, 1997.  Under the terms of certain of these loan agreements, the loans are
secured by a first priority interest in the financed equipment.  These loan and
lease agreements require that the Company maintain certain financial covenants
throughout the duration of the repayment period.  During the second quarter
ending June 30, 1998 the Company will be required, under certain of these
financial covenants, to provide a letter of credit and restricted cash of
$812,000.  Additionally, during 1998 the Company anticipates that it will be
required, under certain of these financial covenants, to provide additional
letters of credit or restricted cash estimated to be approximately $2,900,000.

                                      -12-
<PAGE>
 
     The Company anticipates that its current cash, cash equivalents and short-
term investments will be sufficient to enable it to meet its future operating
requirements through 1999, although there can be no assurance in this regard.
The Company does not expect to generate a positive cash flow in the foreseeable
future due to continued working capital requirements and capital expenditures,
repayment of debt and capital lease obligations and ongoing losses from
operations during 1998.  The Company may need to arrange additional equity or
debt financing for future operation of its business.  There can be no assurance
that such financing can be obtained or, if it obtained, that the terms thereof
will be reasonable.  The Company plans to invest excess funds in short-term
instruments, including money market funds.

     To date, the Company has not implemented a program to hedge its foreign
currency risk, but may do so in the future.

     The Company is involved in several lawsuits.  See "Legal Proceedings" under
Item I of Part II herein for a complete discussion of the legal proceedings in
which the Company is involved, which discussion is incorporated herein by
reference thereto.

                                      -13-
<PAGE>
 
PART II   OTHER INFORMATION

ITEM 1.   LEGAL PROCEEDINGS.


     As previously disclosed in the Company's reports filed with the Securities
and Exchange Commission, on March 28, 1997, Neopath, Inc. ("Neopath") filed a
patent infringement lawsuit against the Company in the United States District
Court for the Western District of Washington.  The lawsuit seeks to enjoin the
Company from allegedly infringing three of Neopath's patents.  Neopath is
seeking preliminary and permanent injunctive relief as well as compensatory
damages, including treble damages.  On March 18, 1998, NeoPath and the Company
filed a stipulated dismissal of two of the three NeoPath patents asserted
against the Company in this case.  Also on March 18, 1998, the Company filed a
motion for summary judgment of non-infringement on the remaining NeoPath patent.
That motion has since been denied by the Court.  On April 14, 1998, the Court
permitted NeoPath to amend its Complaint to add an allegation of infringement of
a further NeoPath patent, which Neopath has done.  The Company has filed an
answer denying infringement of the patents and asserting that the patents are
invalid.  The Company believes that it has valid legal and factual defenses to
NeoPath's allegations of infringement of the patents.  The Company intends to
continue to vigorously defend this action.  The Company also believes that an
adverse judgment in this case would not have a material effect on the Company's
operations, financial position or cash flow.

     Also as previously disclosed in the Company's reports filed with the
Securities and Exchange Commission, on March 18, 1998, NeoPath filed an
additional patent infringement lawsuit against the Company in the United States
District Court for the Western District of Washington.  The lawsuit seeks to
enjoin the Company from allegedly infringing two additional NeoPath patents.
NeoPath is seeking preliminary and permanent injunctive relief as well as
compensatory damages, including treble damages.  The Company has filed an answer
to the Complaint in the lawsuit denying infringement and asserting that the
patents are invalid.  The Company believes that it has valid legal and factual
defenses and intends to vigorously defend this action.


     Except for the developments set forth above, no material developments
occurred during the first quarter of 1998 with respect to legal proceedings in
which the Company is involved.  A complete discussion of such proceedings may be
found in Item 3 of Part I of the Company's Annual Report on Form 10-K for the
fiscal year ended December 31, 1997.

                                      -14-
<PAGE>
 
ITEM 2.   CHANGES IN SECURITIES.
          
          Not Applicable.

ITEM 3.   DEFAULTS UPON SENIOR SECURITIES.

          Not applicable.

ITEM 4.   SUBMISSION OF MATTERS TO A VOTE OF SECURITY HOLDERS.

          Not applicable.

ITEM 5.   OTHER INFORMATION.

          Not Applicable.

ITEM 6.   EXHIBITS AND REPORTS ON FORM 8-K.

(a)       Exhibits.
<TABLE> 
<CAPTION> 
          Number                  Exhibit
          ------                  ------- 
          <S>                     <C> 
          10.45                   Secured Promissory Note, dated March 13, 1998, between the Company
                                  and Paul R. Sohmer, M.D.                                          
                                                                                                    
                                                                                                    
          10.46                   Amendment to the Neuromedical Systems, Inc. 1993 Stock Option     
                                  Plan, as Amended and Restated October 25, 1995.                    
                                  
                           
          27.1                    Financial Data Schedule
</TABLE> 

(b)       Reports on Form 8-K during the quarter for which this report is filed:
<TABLE> 
<CAPTION> 
          Date                    Subject of Report
          ----                    ----------------- 
          <S>                     <C> 
          February 10, 1998       Fourth Quarter 1997 and 1997 Year-End Financial Results
                              
          March 9, 1998           Appointment of new Chief Financial Officer of the Company
</TABLE> 

                                      -15-
<PAGE>
 
SAFE HARBOR STATEMENT

Statements in this Quarterly Report of the Company on Form 10-Q which are not
historical facts, including statements about the Company's confidence and
strategies and its expectations about demand for and acceptance of the PapNet
Testing System, are forward looking statements that involve risks and
uncertainties. The forward looking statements are made pursuant to the safe
harbor provisions of the Private Securities Litigation Reform Act of 1995.
Actual results may differ materially due to a variety of factors which include,
but are not limited to, the Company's continuing negative cash flow, reliance on
a single product, competition, dependence on key personnel, the impact on the
Company of its territorial license agreements, dependence on patents and
proprietary technology, government regulation of both products and advertising,
limited marketing and sales history, the impact of third party reimbursement
decisions, risk of litigation and other risks detailed in the Company's
Securities and Exchange Commission filings, including its 1997 Form 10-K and
Exhibit 99.1.

                                      -16-
<PAGE>
 
                                   SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the
registrant has duly caused this report to be signed on its behalf by the
undersigned, a duly authorized officer and the Company's principal financial
officer.



                                             NEUROMEDICAL SYSTEMS, INC.



Dated: May 15, 1998                          By:  /s/ Mark L. Smith
                                                ------------------------------
                                                Mark L. Smith
                                                 Vice President, Finance and
                                                 Administration, Chief Financial
                                                 Officer

                                      -17-

<PAGE>
 
                                                                   Exhibit 10.45
                            SECURED PROMISSORY NOTE

$145,689.85                                                     MARCH 13, 1998

          FOR VALUE RECEIVED, the undersigned, Paul Sohmer (the "Borrower"),
                                                                 --------   
hereby agrees and promises to pay to the order of Neuromedical Systems, Inc., a
Delaware corporation, and its transferees, successors and assigns (collectively,
the "Lender"), the principal sum of One Hundred Forty-Five Thousand Six Hundred
     ------                                                                    
Eighty-Nine and 85/100 Dollars ($145,689.85) in accordance with the terms and
conditions set forth below together with interest on the unpaid principal
balance hereof from time to time at the rate and on the dates set forth below.

          1.  Final Maturity.  the Borrower shall pay the entire outstanding
              --------------                                                
principal balance of this Note, together with all accrued and unpaid interest
thereon, in full on March 13, 2003 (the "Maturity Date").
                                         -------------   

          2.  Optional Prepayments.  this Note may be prepaid at any time and
              --------------------                                           
from time to time at the discretion of the Borrower, in whole or in part,
without penalty or premium.

          3.  Interest Rate and Interest Payment Dates.
              ---------------------------------------- 

               (a) Ordinary Interest.  The Borrower shall pay interest on the
                   -----------------                                         
          unpaid principal amount of this Note from the date of this Note until
          payment in full thereof at a rate equal to 5.61% per annum, compounded
          semi-annually, until paid in full.  Interest on this Note shall be due
          and payable in arrears on the Maturity Date.

               (b) Default Interest; Maximum Legal Rate.  If the Borrower shall
                   ------------------------------------                        
          fail to pay any principal amount of this Note when due and payable
          (whether at the Maturity Date, by acceleration or otherwise), such
          principal amount shall thereafter bear interest, payable on demand
          from time to time and upon payment in full of such overdue amount,
          until paid in full, at a rate of equal to 5.61%, plus two points.  In
          no event shall the Borrower pay interest on this Note at a rate in
          excess of that permitted by applicable law, any such excess payments
          being deemed for all purposes a prepayment of principal.

               (c) Calculation.  Interest shall be calculated on the basis of
                   -----------                                               
          the actual number of days elapsed over a 365 day year.
<PAGE>
 
          4.  Payments; Application to Interest and Principal.  The Borrower
              -----------------------------------------------               
shall make all payments of principal and interest and other amounts payable
under this Note not later than 11:00 A.M., New York City time, on the date such
payment is due, in lawful money of the United States of America by wire transfer
of immediately available funds to the Lender's account (or by such other method
or at such other bank account) as may be designated in writing from time to time
by the Lender.  Any prepayment pursuant to Section 2 shall be applied to reduce,
first, the accrued and unpaid interest on the principal balance of this Note
and, then, the unpaid principal balance hereof, in each case outstanding at the
time of such prepayment.

          5.  Pledge of Collateral.
              -------------------- 

          5.1  Pledge.  The Borrower hereby pledges, assigns and grants to the
               ------                                                         
Lender a security interest in the assets referred to in Section 5.2 (the
"Collateral") to secure the prompt payment and performance of the Borrower's
- -----------                                                                 
obligations under this Note (the "Obligations").
                                  -----------   

               5.2  Collateral.  The Collateral consists of the following types
                    ----------                                                 
or items of property:

                   (a) 70,000 shares of common stock, par value $.0001 per share
         ("Common Stock"), of Neuromedical Systems, Inc., a Delaware corporation
           ------------                                                         
         (the "Issuer"), which shares are being purchased contemporaneously
               ------                                                      
         herewith with the amount borrowed under this Note; and

                   (b) (i) the certificates or instruments, if any, representing
         such securities, (ii) all dividends (cash, stock or otherwise), cash
         instruments, rights to subscribe, purchase or sell and all other rights
         and property from time to time received, receivable or otherwise
         distributed in respect of or in exchange for any or all of such
         securities, (iii) all replacements, additions to and substitutions for
         any of the property referred to in this Section 5.2, and (iv) the
         proceeds, interest, profits and other income of or on any of the
         property referred to in this Section 5.2.

          5.3  Transfer of Collateral.  All certificates or instruments
               ----------------------                                  
representing or evidencing any of the securities referred to in Section 5.2(a)
and all additional securities, if any, constituting Collateral (the "Pledged
                                                                     -------
Securities") shall be delivered to and held pursuant hereto by the Lender and
- ----------                                                                   
shall be in suitable form for transfer by delivery, or shall be accompanied by
duly executed instruments of transfer or assignment in blank.  The Lender shall
have the right, at any time during the continuance of an Event of Default to
transfer to or to register in the name of the Lender or any of its nominees any
or all of the Pledged Securities, subject only to the revocable rights specified
in the fourth sentence of Section 8.

                                      -2-
<PAGE>
 
          5.4  Representations, Warranties and Agreements. The Borrower
               ------------------------------------------              
represents and warrants to and agrees with the Lender that:

                   (a) Ownership of Collateral; Encumbrances.  The Borrower is
                       -------------------------------------                  
         the legal and beneficial owner of the Pledged Securities owned from
         time to time by the Borrower free and clear of any adverse claim or
         lien except for the security interest created by this Note, and the
         Borrower has full right, power and authority to pledge, assign and
         grant a security interest in the Collateral to the Lender.

                   (b) No Required Consent.  No authorization, consent, approval
                       -------------------                                      
         or other action by, and no notice to or filing with, any governmental
         authority is required for (i) the due execution, delivery and
         performance by the Borrower of this Note, (ii) the grant by the
         Borrower of the security interest granted by this Note, (iii) the
         perfection of such security interest or (iv) the exercise by the Lender
         of its rights and remedies under this Note, except that filings may be
         required to perfect such security interest (to the extent such security
         interest cannot be perfected by possession) and sale of the Collateral
         must be made in accordance with applicable law.

                   (c) Pledged Securities.  The Pledged Securities have been
                       ------------------                                   
         duly authorized and validly issued, and are fully paid and non-
         assessable.

                   (d) First Priority Security Interest.  The pledge of Pledged
                       --------------------------------                        
         Securities pursuant to this Note creates a valid and perfected first
         priority security interest in such Collateral, enforceable against the
         Borrower and all third parties and securing payment of the Obligations.

                   (e) Sale, Disposition or Encumbrance of Collateral.  The
                       ----------------------------------------------      
         Borrower will not in any way encumber any of the Collateral (or permit
         or suffer any of the Collateral to be encumbered) or sell, pledge,
         assign, lend or otherwise dispose of or transfer any of the Collateral
         to or in favor of any person or entity other than the Lender.

                   (f) Dividends or Distributions.  So long as no Event of
                       --------------------------                         
         Default (as defined in Section 6 hereof) shall have occurred and be
         continuing, the Borrower shall be entitled to receive and retain any
         and all dividends and interest paid in respect of the Collateral;
                                                                          
         provided, however, that any and all
         --------  -------                  

                         (i) dividends and interest paid or payable other than
               in cash in respect of, and instruments and other property
               received, receivable or otherwise distributed in respect of, or
               in exchange for (including, without limitation, any certificate
               or share 

                                      -3-
<PAGE>
 
               purchased or exchanged in connection with a tender offer
               or merger agreement), any Collateral,

                         (ii) dividends and other distributions paid or payable
               in cash in respect of any Collateral in connection with total
               liquidation or dissolution, and

                         (iii)  cash paid, payable or otherwise distributed in
               redemption of, or in exchange for, any Collateral,

          shall be, and shall be forthwith delivered to the Lender to hold as,
          Collateral and shall, if received by the Borrower, be received in
          trust for the benefit of the Lender, be segregated from the other
          property or funds of the Borrower, and be forthwith delivered to the
          Lender as Collateral in the same form as so received (with any
          necessary endorsement).

          Upon the occurrence and during the continuance of an Event of Default,
          all rights of the Borrower to receive the dividends and interest
          payments which it would otherwise be authorized to receive and retain
          pursuant to this clause (f) shall cease, and all such rights shall
          thereupon become vested in the Lender who shall thereupon have the
          sole right to receive and hold as Collateral such dividends and
          interest payments, but the Lender shall have no duty to receive and
          hold such dividends and interest payments and shall not be responsible
          for any failure to do so or delay in so doing.

                   (g) Stock Powers.  The Borrower shall furnish to the Lender
                       ------------                                           
         such stock powers and other instruments as may be required by the
         Lender to assure the transferability of the Collateral when and as
         often as may be requested by the Lender.

                   (h) Voting and Other Consensual Rights.  The Borrower shall
                       ----------------------------------                     
         be entitled to exercise any and all voting and other consensual rights
         pertaining to the Collateral or any part thereof for any purpose not
         inconsistent with the terms of this Note.

          6.  Events of Default.  If any of the following events (each, an
              -----------------                                           
"Event of Default") shall occur and be continuing:
- -----------------                                 

               (i) the Borrower shall fail to pay any principal of, or interest
          on, this Note when the same becomes due and payable in accordance with
          the terms hereof;

                                      -4-
<PAGE>
 
               (ii) the Borrower shall fail to comply in any material respect
          with any other agreement in this Note and such failure shall continue
          for 30 days after notice from the Lender; or

               (iii)  the Borrower shall generally not pay his debts as such
          debts become due, or shall admit in writing his inability to pay his
          debts generally, or shall make a general assignment for the benefit of
          creditors; or any proceeding shall be instituted by or against the
          Borrower seeking to adjudicate him a bankrupt or insolvent, or seeking
          liquidation, winding up, reorganization, arrangement, adjustment,
          protection, relief, or composition of him or his debts under any law
          relating to bankruptcy, insolvency or relief or the appointment of a
          receiver, trustee, or other similar official for him or for any
          substantial part of his property;

then, and in any such event, the Lender may, by notice to the Borrower,

          (a) Declare the entire unpaid principal amount of this Note and all
     interest thereon to be forthwith due and payable, whereupon the entire
     unpaid principal amount of this Note and all such interest shall become and
     be forthwith due and payable, without presentment, demand, protest or
     further notice of any kind, all of which are hereby expressly waived by the
     Borrower.

          (b) Sell, in one or more sales and in one or more parcels, or
     otherwise dispose of any or all of the Collateral in any commercially
     reasonable manner as the Lender may elect, in a public or private
     transaction, at any location as deemed reasonable by the Lender either for
     cash or credit or for future delivery at such price at the Lender may deem
     fair, and (unless prohibited by the Uniform Commercial Code, as adopted in
     any applicable jurisdiction, the "Code") the Lender may be the purchaser of
                                       ----                                     
     any or all Collateral so sold and may apply the purchase price therefor
     against any Obligations secured hereby.  Reasonable notification of the
     time and place of any public sale of the Collateral, or reasonable
     notification of the time after which any private sale or other intended
     disposition of the Collateral is to be made, shall be sent to the Borrower
     and to any other person or entity entitled to notice under the Code;
     provided that, if any of the Collateral threatens to decline speedily in
     value or is of the type customarily sold on a recognized market, the Lender
     may sell or otherwise dispose of the Collateral without notification,
     advertisement or other notice of any kind.  Any such sale or transfer by
     the Lender either to itself or to any other person or entity shall be
     absolutely free from any claim of right by the Borrower, including any
     equity or right of redemption, stay or appraisal which the Borrower has or
     may have under any rule of law, regulation or statute now existing or
     hereafter adopted.  Upon any such sale or transfer, the Lender shall have
     the right to deliver, assign and transfer to the purchaser or transferee
     thereof the Collateral so sold or transferred.  If the 

                                      -5-
<PAGE>
 
     Lender deems it advisable to do so, it may restrict the bidders or
     purchasers of any such sale or transfer to persons or entities who will
     represent and agree that they are purchasing the Collateral for their own
     account and not with the view to the distribution or resale of any of the
     Collateral. The Borrower agrees that private sales so made may be at prices
     and on other terms less favorable to the seller than if the Collateral were
     sold at public sale, and that the Lender has no obligation to delay the
     sale of the Collateral for the period of time necessary to permit the
     registration of the Collateral for public sale under the Securities Act of
     1933 and under applicable state securities or "blue sky" laws. The Borrower
     agrees that a private sale or sales made under the foregoing circumstances
     shall be deemed to have been made in a commercially reasonable manner. The
     Lender may, at its discretion, provide for a public sale, and any such
     public sale shall be held at such time or times within ordinary business
     hours and at such place or places as the Lender may fix in the notice of
     such sale. The Lender shall not be obligated to make any sale pursuant to
     any such notice. The Lender may, without notice or publication, adjourn any
     public or private sale by announcement at any time and place fixed for such
     sale, and such sale may be made at any time or place to which the same may
     be so adjourned. If only part of the Collateral is sold or transferred such
     that the Obligations remain outstanding (in whole or in part), the Lender's
     rights and remedies hereunder shall not be exhausted, waived or modified,
     and the Lender is specifically empowered to make one or more successive
     sales or transfers until all the Collateral shall be sold or transferred
     and all the Obligations are paid. In the event that the Lender elects not
     to sell the Collateral, the Lender retains its rights to dispose of or
     utilize the Collateral or any part or parts thereof in any manner
     authorized or permitted by law or in equity, and to apply the proceeds of
     the same towards payment of the Obligations. Each and every method of
     disposition of the Collateral described in this clause (b) shall constitute
     disposition in a commercially reasonable manner.

          (c) Apply proceeds of the disposition of the Collateral to the
     Obligations in any manner elected by the Lender and permitted by the Code
     or otherwise permitted by law or in equity.

          (d) Appoint any person as agent to perform any act or acts necessary
     or incident to any sale or transfer by the Lender of the Collateral.

          (e) Exercise all other rights and remedies permitted by law or in
     equity.

          The Borrower hereby irrevocably appoints the Lender as the Borrower's
attorney-in-fact, with full authority in the place and stead of the Borrower and
in the name of the Borrower or otherwise, from time to time during the
continuance of an Event of Default to take any action and to execute any
assignment, certificate, financing statement, stock power, notification,
document or instrument which the Lender may deem necessary 

                                      -6-
<PAGE>
 
or advisable to accomplish the purposes of this Agreement, including, without
limitation, to receive, endorse and collect all instruments made payable to the
Lender representing any dividend, interest payments or other distribution in
respect of the Collateral or any part thereof and to give full discharge for the
same.

          If any applicable provision of any law requires the Lender to give
reasonable notice of any sale or disposition or other action, the Borrower
hereby agrees that fifteen days' prior written notice shall constitute
reasonable notice thereof.  Such notice, in the case of public sale, shall state
the time and place fixed for such sale and, in the case of private sale, the
time after which such sale is to be made.

          The Lender may enforce its rights hereunder without prior judicial
process or judicial hearing, and to the extent permitted by law the Borrower
expressly waives any and all legal rights which might otherwise require the
Lender to enforce its rights by judicial process.

          The Borrower shall pay on demand all reasonable costs and expenses of
Lender in connection with the enforcement of this Note including the reasonable
fees and expenses of counsel with respect thereto.

          7.  Notices.  All notices and other communications provided for
              -------                                                    
hereunder shall be in writing (including telecopy communication) and mailed,
telecopied, or delivered

if to the Lender:    Neuromedical Systems, Inc.
                     Two Executive Boulevard
                     Suffern, New York  10901-4164
                     Telecopy No.:  (914) 368-3894
                     Attention:  Chief Financial Officer

if to the Borrower:  Paul Sohmer
                     c/o Neuromedical Systems, Inc.
                     Two Executive Boulevard
                     Suffern, New York  10901-4164
                     Telecopy No.:  (914) 368-3896

or at such other address or telecopy number as shall be designated by a party in
a written notice to the other party.

          8.  No Waivers; Cumulative Remedies; Amendment; Survival of Covenants;
              ------------------------------------------------------------------
Headings; Governing Law; Submission to Jurisdiction; Express Waiver.  No action,
- -------------------------------------------------------------------             
delay or omission by the Lender shall constitute a waiver of any of the rights
or privileges of the Lender under this Note nor shall any single or partial
exercise of any such right or privilege preclude any other or further exercise
thereof or the exercise of any other right or privilege.  Such rights are
cumulative and not exclusive of any rights 

                                      -7-
<PAGE>
 
provided by law. This Note may not be amended or otherwise modified except by a
written instrument signed by the Lender. Upon the complete payment of the
Obligations, the Lender will release, reassign and transfer the Collateral to
the Borrower and this Note shall be of no further force or effect. Section
headings herein shall have no legal effect. THIS NOTE SHALL BE DEEMED MADE
UNDER, AND BE GOVERNED BY, THE LAW OF THE STATE OF NEW YORK WITHOUT REGARD TO
CONFLICT OF LAWS RULES. THE BORROWER HEREBY IRREVOCABLY SUBMITS TO THE NON-
EXCLUSIVE JURISDICTION OF ANY UNITED STATES FEDERAL OR NEW YORK STATE COURT
SITTING IN THE COUNTY AND STATE OF NEW YORK IN ANY ACTION OR PROCEEDING ARISING
OUT OF OR RELATING TO ANY LOAN DOCUMENTS AND THE BORROWER HEREBY IRREVOCABLY
AGREES THAT ALL CLAIMS IN RESPECT OF SUCH ACTION OR PROCEEDING MAY BE HEARD AND
DETERMINED IN ANY SUCH COURT AND IRREVOCABLY WAIVES ANY OBJECTION IT MAY NOW OR
HEREAFTER HAVE AS TO THE VENUE OF ANY SUCH SUIT, ACTION OR PROCEEDING BROUGHT IN
SUCH A COURT OR THAT SUCH COURT IS AN INCONVENIENT FORUM. NOTHING HEREIN SHALL
LIMIT THE RIGHT OF THE LENDER TO BRING PROCEEDINGS AGAINST THE BORROWER IN THE
COURTS OF ANY OTHER JURISDICTION. ANY JUDICIAL PROCEEDING BY THE BORROWER
AGAINST THE LENDER OR ANY AFFILIATE OF THE LENDER INVOLVING, DIRECTLY OR
INDIRECTLY, ANY MATTER IN ANY WAY ARISING OUT OF, RELATED TO, OR CONNECTED WITH
THE NOTE SHALL BE BROUGHT ONLY IN A COURT IN THE COUNTY AND STATE OR A FEDERAL
COURT IN SUCH COUNTY OF NEW YORK SO LONG AS SUCH COURT HAS PERSONAL
JURISDICTION. THE BORROWER AND THE LENDER HEREBY WAIVE TRIAL BY JURY IN ANY
JUDICIAL PROCEEDING INVOLVING, DIRECTLY OR INDIRECTLY, ANY MATTER (WHETHER
SOUNDING IN TORT, CONTRACT OR OTHERWISE) IN ANY WAY ARISING OUT OF, RELATED TO,
OR CONNECTED WITH THE NOTE. Except as expressly provided in this Note, the
Borrower expressly waives diligence, presentment, demand for payment, any other
demand, protest, notice of dishonor, notice of presentment, notice of demand or
notice of protest and all other notices of any kind in connection with this Note
and any payment due hereunder.

                                      -8-
<PAGE>
 
          IN WITNESS WHEREOF, the Borrower has executed this Note as of the date
first above written.

                              /s/
                              __________________________
                                      Paul Sohmer


Agreed and Accepted:

NEUROMEDICAL SYSTEMS, INC.


By:/s/
   -------------------------

                                      -9-

<PAGE>
 
                                                                   Exhibit 10.46

                           NEUROMEDICAL SYSTEMS, INC.
                             1993 STOCK OPTION PLAN
                    AS AMENDED AND RESTATED OCTOBER 25, 1995

                                   AMENDMENT
                                        
          This AMENDMENT of the Neuromedical Systems, Inc. 1993 Stock Option
Plan, as Amended and Restated on October 25, 1995, as further amended (the
"Plan") is effective as of March 24, 1998. Capitalized terms not otherwise
defined herein shall have the meanings assigned thereto in the Plan.

          WHEREAS, under the terms of the Plan, 4,140,000 shares of the
Company's Common Stock (such amount taking account of the reverse split
of Common Stock in December 1995) were made available for issuance for the
purpose of providing an incentive to Company employees, officers, consultants
and directors (the "Original Allotment");

          WHEREAS, the Original Allotment remaining available as of the date
hereof is no longer sufficient to provide for grants of Company securities in
accordance with the purposes of the Plan;

          WHEREAS, the Board of Directors of the Company (the "Board") has
authorized this Amendment to the Plan, whereby additional shares of Company
Common Stock, par value $.0001 per share, shall be made available for issuance
for the purpose of providing an incentive to Company employees, officers,
consultants and directors;

          WHEREAS, the Board has taken such action to benefit the Company as a
whole and has acted in accordance with the authority permitted under the 1996
Amendments to the Securities Exchange Act of 1934, as amended.

          NOW THEREFORE, the Plan is hereby amended as follows: the first clause
of the first sentence of Section 4.1 of the Plan, providing that, "The maximum
number of Shares that may be made the subject of Options and Awards granted
under the Plan is 4,140,000;" is hereby deleted, and replaced with the following
clause: "The maximum number of Shares that may be made the subject of
Options and Awards granted under the Plan is 5,040,000;"

          All other provisions of the Plan, including without limitation, the
other provisions of Section 4.1, shall remain in full force and effect.

                                    *  *  *

<TABLE> <S> <C>

<PAGE>
 
<ARTICLE> 5
<MULTIPLIER> 1,000
       
<S>                             <C>
<PERIOD-TYPE>                   3-MOS
<FISCAL-YEAR-END>                          DEC-31-1998
<PERIOD-END>                               MAR-31-1998
<CASH>                                          37,513
<SECURITIES>                                         0
<RECEIVABLES>                                    2,879
<ALLOWANCES>                                     (364)
<INVENTORY>                                      3,004
<CURRENT-ASSETS>                                44,541
<PP&E>                                          26,480
<DEPRECIATION>                                (15,324)
<TOTAL-ASSETS>                                  57,805
<CURRENT-LIABILITIES>                           10,511
<BONDS>                                          7,446
                                0
                                          0
<COMMON>                                             3
<OTHER-SE>                                      39,845
<TOTAL-LIABILITY-AND-EQUITY>                    57,805
<SALES>                                              0
<TOTAL-REVENUES>                                 2,574
<CGS>                                                0
<TOTAL-COSTS>                                    3,120
<OTHER-EXPENSES>                                     0
<LOSS-PROVISION>                                     0
<INTEREST-EXPENSE>                                 371
<INCOME-PRETAX>                                (7,657)
<INCOME-TAX>                                         0
<INCOME-CONTINUING>                            (7,657)
<DISCONTINUED>                                       0
<EXTRAORDINARY>                                      0
<CHANGES>                                            0
<NET-INCOME>                                   (7,657)
<EPS-PRIMARY>                                   (0.25)
<EPS-DILUTED>                                      0.0
        

</TABLE>


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