Abstract
After the nerve conduction studies are completed, the electrodiagnostic evaluation moves on to the needle electromyography (EMG) examination. Like the nerve conduction studies, each needle EMG study must be individualized based on the clinical findings and differential diagnosis and modified as the test proceeds and more data are obtained. For each study, a balance must be reached between the need to study a sufficient number of muscles to reach or exclude a diagnosis and the limits of the patient’s ability to tolerate the examination. If there is any indication that the patient might not tolerate or complete the entire examination, the most important muscles should be sampled first. A successful study requires not only knowledge of anatomy and physiology but also sound EMG technique and good patient rapport. Two competing influences make the needle EMG study especially demanding. First, many of the abnormalities found on the needle study are subtle. At the same time, however, the range of normal findings is quite large and varies with age and with the muscle being studied. Although the basics of the needle EMG study such as needle placement and recognition of certain types of abnormal spontaneous activity can usually be learned in a short time, it is not unusual for it to take years to master recognition of many of the uncommon and subtle needle EMG findings
Published Version
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