Basic Principles of Electrodiagnostic Medicine

S.Mansoor Rayegani, M.DProfessor Of Physical Medicine And

Rehabilitation.Shahid Beheshti Medical University

PM&R research center

DefinitionEMG, EMG/NCV, EMG/NCS, Electrodiagnosis, Electrodiagnostic medicine consultation.

A specific branch of medicine practiced by a physician using history, physical examination, lab study, imaging and performing special electrodiagnostic tests including NCS, EMG and/or EP for diagnosis and treatment of PNS and CNS disorders.

C.N.S

CortexcerebellumMidbrain BrainstemMedullaSpinal cord

PNS

Motor neuronRootPlexusNerveNMJMuscle

Specific Diagnostic Tools NCS: latency, NCV, amplitude -Motor/Sensory/F, H responses, RST

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EMG (Needle EMG) -Spontaneous activities; Fibr., PSW -MUAP

EP: VEP, ABR, SEP, MEP

Disease diagnosed by EDX

CNS demyelinating disorders, MSMyelopathyMotor Neuron DiseaseRadiculopathyPlexopathyPNP (Axonal, Demyelinating)

Entrapment syndromes (CTS…)

NMJ dis.Myopathy (dystrophic, inflammatory,

myotonic)

Electrodiagnostic medicine steps Hx , P/E, Lab., ImagingDDxNCSEMG (muscle needling)Impression & judgmentSuggestions

Components of report

Demographic data

Clinical information

Body of report

Findings and description

Impression(EDX, Clinical??)

Comment/recommendation/suggestion.

Hints…

Highly Practitioner Dependent, It Is Not a TEST But a Consultation..

Physiologic and Not Anatomic Evaluation

More Specific to SensitiveTime Dependent ProcessSomewhat painful!