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Needle Electromyography (needle + electromyography)

Distribution by Scientific Domains
Medical Sciences100%

Kinds of Needle Electromyography

  • concentric needle electromyography
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    Selected Abstracts

    Co-morbidity of Emery,Dreifuss muscular dystrophy and a congenital myasthenic syndrome possibly affecting the phenotype in a large Bedouin kindred

    EUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2007
    G. Ifergane
    Emery,Dreifuss muscular dystrophy (EDMD) is an X-linked humero-peroneal muscular dystrophy associated with contractures and cardiomyopathy. In a 90 member family, we found 11 affected male individuals, three of whom displayed areflexia and neurogenic electromyographic changes. Muscle biopsy performed in one case demonstrated type grouping suggestive of a neurogenic disorder. These three individuals and another family member, who suffers from mild, static limb weakness but is clinically and genetically unaffected by EDMD showed an abnormal incremental response of over 100% to tetanic stimulation. In contrast, one affected family member showed myopathic features on needle electromyography and no definite pathology in repetitive stimulation studies. The diagnosis of EDMD was established by demonstrating a 1712_1713insTGGGC mutation in the emerin gene. This family apparently expresses co-morbidity of EDMD with an exceptionally mild form of pre-synaptic congenital myasthenic syndrome resembling the Lambert,Eaton myasthenic syndrome (LEMS). The superimposed pre-synaptic disorder may have contributed to the development of the neurogenic features demonstrated in these patients. [source]

    Electromyographic sensitivity of peroneus tertius relative to abductor hallucis in assessment of peripheral neuropathy

    MUSCLE AND NERVE, Issue 4 2009
    Andrea J. Boon MD
    Abstract The objective of this study was to compare the sensitivity of needle electromyography of the abductor hallucis and peroneus tertius muscles in the diagnosis of mild length-dependent peripheral neuropathy (PN). Nerve conduction studies and needle examination were performed on 50 patients with clinical evidence of mild PN. Results demonstrated that the peroneus tertius is as sensitive and is more specific than the abductor hallucis. It is particularly useful when more proximal muscles, such as the tibialis anterior and medial gastrocnemius, are not yet involved. Muscle Nerve, 2009 [source]

    Neurophysiological testing in anorectal disorders

    MUSCLE AND NERVE, Issue 3 2006
    Jean-Pascal Lefaucheur MD, PhDArticle first published online: 15 JUL 200
    Abstract The neurophysiological techniques currently available to evaluate anorectal disorders include concentric needle electromyography (EMG) of the external anal sphincter, anal nerve terminal motor latency (TML) measurement in response to transrectal electrical stimulation or sacral magnetic stimulation, motor evoked potentials (MEPs) of the anal sphincter to transcranial magnetic cortical stimulation, cortical recording of somatosensory evoked potentials (SEPs) to anal nerve stimulation, quantification of electrical or thermal sensory thresholds (QSTs) within the anal canal, sacral anal reflex (SAR) latency measurement in response to pudendal nerve or perianal stimulation, and perianal recording of sympathetic skin responses (SSRs). In most cases, a comprehensive approach using several tests is helpful for diagnosis: needle EMG signs of sphincter denervation or prolonged TML give evidence for anal motor nerve lesion; SEP/QST or SSR abnormalities can suggest sensory or autonomic neuropathy; and in the absence of peripheral nerve disorder, MEPs, SEPs, SSRs, and SARs can assist in demonstrating and localizing spinal or supraspinal disease. Such techniques are complementary to other methods of investigation, such as pelvic floor imaging and anorectal manometry, to establish the diagnosis and guide therapeutic management of neurogenic anorectal disorders. Muscle Nerve, 2005 [source]

    Medial dorsal superficial peroneal nerve studies in patients with polyneuropathy and normal sural responses

    MUSCLE AND NERVE, Issue 3 2005
    Mark Kushnir MD
    Abstract We studied medial dorsal superficial peroneal (MDSP) nerves in 52 patients with clinical evidence of mild chronic sensorimotor polyneuropathy and normal sural nerve responses, in order to assess the diagnostic sensitivity and usefulness of MDSP nerve testing in electrodiagnostic practice. To determine the effect of age on MDSP nerve parameters, 98 normal subjects were also examined. Electrodiagnostic evaluation involved studies of motor nerve conduction in tibial, peroneal, and median nerves; sensory nerve conduction in sural, MDSP, median, and radial nerves; tibial and peroneal nerve F waves; H reflexes from the soleus muscles; and needle electromyography of gastrocnemius and abductor hallucis muscles. Among the patients, 49% had low-amplitude sensory responses in MDSP nerves and 57% had either slowing of sensory conduction velocity or no sensory responses on proximal stimulation. MDSP nerve amplitude, tibial nerve motor velocity, and H reflexes were the most sensitive for detection of mild chronic symmetrical axonal sensorimotor polyneuropathy. MDSP nerve testing should be included in the routine electrodiagnostic evaluation of patients with suspected polyneuropathy and normal sural nerve responses. Muscle Nerve, 2005 [source]

    Morvan's syndrome: Clinical, laboratory, and in vitro electrophysiological studies

    MUSCLE AND NERVE, Issue 2 2004
    Wolfgang N. Löscher MD
    Abstract Morvan's syndrome is a rare disorder characterized by neuromyotonia, hyperhidrosis, and central nervous system dysfunction. We report a patient with features of this syndrome, but who initially presented with breathing difficulties. Concentric needle electromyography showed an abundance of myokymic and neuromyotonic discharges. Exercise tests and repetitive nerve stimulation showed a decrement,increment response of compound muscle action potentials. Antibodies against voltage-gated potassium channels were not detected on repeated testing, but the presence of oligoclonal bands in the cerebrospinal fluid (CSF) suggested an autoimmune etiology. At follow-up over 3 years, no cancer was found. Electrophysiological in vitro studies of effects of patient serum and CSF on rat nerves provided no evidence of altered voltage-gated sodium or potassium conductances. We conclude that putative humoral factors do not block ion channels acutely but may cause channel dysfunction with chronic exposure. Muscle Nerve 30: 157,163, 2004 [source]

    Iatrogenic complications and risks of nerve conduction studies and needle electromyography

    MUSCLE AND NERVE, Issue 5 2003
    Amer Al-Shekhlee MD
    Abstract Electrodiagnostic procedures are routinely performed in patients with a variety of neuromuscular disorders. These studies are generally well tolerated and rarely thought to be associated with any significant side effects. However, needle electromyography is an invasive procedure and under certain situations has the potential to be associated with iatrogenic complications, including bleeding, infection, nerve injury, pneumothorax, and other local trauma. Similar complications are possible if needles are used for either stimulating or recording. In addition, like all other electrical devices and monitoring equipment connected to patients, electrodiagnostic testing carries the risk of stray leakage currents that under certain circumstances can result in electrical injury, especially in patients in the intensive care setting. Similarly, certain precautions are required during nerve conduction studies (NCS) in patients with pacemakers and other similar cardiac devices. In this review, we address the known and theoretical complications of NCS and needle electrode examination, and the possible methods to avoid such hazards. Muscle Nerve 27: 517,526, 2003 [source]

    New attempts to quantify concentric needle electromyography

    MUSCLE AND NERVE, Issue S11 2002
    Masahiro Sonoo MD, PhDArticle first published online: 4 JUN 200
    Abstract Quantitative motor unit potential (MUP) analysis, which is a leading method of quantitative evaluation of concentric needle electromyography, has several inherent limitations. First, the most essential features of neurogenic or myogenic changes manifest as recruitment abnormalities, rather than as changes in MUP morphology. Second, two factors related to MUP sampling, focusing and level of contraction, greatly influence the parameters of sampled MUPs. Third, the MUP duration, considered to be the cardinal parameter in MUP analysis, has several drawbacks, including low stability and low discriminant sensitivity. We developed a new MUP parameter, the size index (SI), which is calculated from the MUP amplitude and area/amplitude ratio (thickness). The SI remained almost constant during electrode movements, as demonstrated by manual scanning of MUPs. It is a stable and robust parameter and achieved an extremely high ability to discriminate between normal and large neurogenic MUPs. It identifies features related to the sound produced by the MUP on the audio monitor, which is often used by trained electromyographers for qualitative assessments of MUPs. © 2002 Wiley Periodicals, Inc. Muscle Nerve Supplement 11: S98,S102, 2002 [source]

    Non-neurogenic urinary retention (Fowler's syndrome) in two sisters

    NEUROUROLOGY AND URODYNAMICS, Issue 7 2006
    Simon Podnar
    Abstract Aims To report for the first time occurrence of obstructed voiding due to excessive activity of the urethral sphincter (US) muscle in two sisters with polycystic ovaries (Fowler's syndrome). Methods In both patients precise micturition history was obtained. In addition, clinical neurological and gynecological examinations, cystometry, urethral pressure profile measurements, gynecological ultrasound, measurement of gonadotropic hormone levels, and concentric needle electromyography (EMG) of the US muscle were performed. Results Both sisters reported symptoms of severely obstructed voiding. Clinical examination, and filling cystometries were normal. Urethral pressures were increased (99,134 cm water). The first sister was not able to void, and the urinary flow was slow and intermittent in the second on voiding studies. Profuse complex repetitive discharges and decelerating burst activity were found on concentric needle EMG of the US in both of them. Both sisters had increased LH/FSH ratio (2.96 and 2.64), and ultrasonographic abnormalities compatible with polycystic ovaries. Conclusions Diagnosis of Fowler's syndrome was made in both sisters. Due to very low incidence rate of this syndrome (0.2/100.000 per year), we think that it is highly unlikely to find it in two sisters just by chance. We suggest that the probable explanation is a genetic predisposition to polycystic ovaries, with which this condition has been shown to be associated. Neurourol. Urodynam. 25:739,741, 2006. © 2006 Wiley-Liss, Inc. [source]

    Protocol for clinical neurophysiologic examination of the pelvic floor

    NEUROUROLOGY AND URODYNAMICS, Issue 6 2001
    Simon Podnar
    Abstract Clinical neurophysiologic examination of the pelvic floor is performed worldwide, but there is no consensus on the choice of tests, nor on technical details of individual methods. Standardized methods are, however, necessary to obtain their valid application in different laboratories for the purpose of collection of normative data, comparison of patient data and organization of multi-center studies. It is proposed that in patients with suspected "lower motor neuron" type lesions concentric needle electromyography (CNEMG) is the most informative test to detect pelvic floor denervation/reinnervation, and the external anal sphincter (EAS) muscle is the most appropriate muscle to be examined (either in isolation,when a selective lesion is suspected,or in addition to examination of other muscles). An algorithm consisting of standardized tests including a standardized approach to CNEMG examination of the EAS is presented. The proposed electrophysiologic assessment consists of a computer-assisted analysis of denervation and reinnervation features of the CNEMG signal, a qualitative assessment of reflex and voluntary activation of EAS motor units, and of electrical (or mechanical) elicitation of the bulbocavernosus reflex in those patients in whom manual anogenital stimulation failed to elicit a robust response in the EAS. The proposed protocol could serve as a basis for further studies on validity, sensitivity and specificity of electrophysiologic assessment in patients with different types of "lower motor neuron" involvement of pelvic floor muscles and sacral dysfunction. Neurourol. Urodynam. 20:669,682, 2001. © 2001 Wiley-Liss, Inc. [source]

    Physical Medicine and Rehabilitation (87)

    PAIN PRACTICE, Issue 1 2001
    A.J. Haig
    Paraspinal electromyography in high lumbar and thoracic lesions. (University of Michigan, Ann Arbor, MI) Am J Phys Med Rehabil 2000;79:336,342. This study aimed to use needle electromyography in the paraspinal muscles to localize the root level of a radiculopathy. Nine cases of clinically proven, isolated high lumbar or thoracic disk herniations of patients who underwent MiniPM were collected. Four were from a prospective study of 114 persons with low back pain (MiniPM had 100% sensitivity to magnetic resonance imaging-documented high disks). In the most medial "S" column, mean MiniPM scores were 0.7 for the level above the radiologically documented lesion (3.1 at the lesion and 1.6, 1.6, and 1.1 at the 3 spinous processes below the lesion). Similar numbers were obtained in the "M" column (slightly lateral), with no significant differences between S and M. Differences were significant between and at the level of the lesion for S (P < 0.06) and M (P < 0.01), and between the lesion level and 3 levels below for the M column (P < 0.01). Conclude that paraspinal electromyography has a higher than previously reported sensitivity for high lumbar lesions. Electromyography using MiniPM can localize some radiculopathies. The individual cases suggest that, consistent with the anatomy of the caudi equina, thoracic lesions and lateral lumbar lesions denervate only at 1 level, but more central lumbar lesions also denervate distally innervated paraspinal muscles. Comment by Miles Day, MD. This study is designed to assess the sensitivity of many MiniPM for higher-level rediculopathies, ie, lower thoracic and high lumbar, and to determine if findings are specific to the root level involved. The MiniPM is thought to assess the multifidus portion of the paraspinal muscles that are innervated from L2 to the sacrum. The clinical protocol tests the paraspinal extensively and provides a numerica score, thus eliminating some subjectivity of the EMG. The study demonstrates that MiniPM has good sensitivity for high lumbar and thoracic lesions and provides information on the level of the lesion independent of limb EMG. After reviewing the study, I agree with the authors that MiniPM is in itself not diagnostic for radiculopathy, but is only an additional test to help support other neuro physiological studies when evaluating for radiculopathy. It is not specific for diagnosing radiculopathy. [source]