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29/11/2018

Guidelines for Electrodiagnostic Medicine Consultations By S. Khosrawi MD Physiatrist 29/11/2018

neuromuscular examination EDX consultation evaluates nerve and muscle function and is a direct extension of the clinical history and neuromuscular examination 29/11/2018

EDX studies are a supplement to, not a replacement for, a careful history and physical examination by the referring physician and by the EDX physician as part of the EDX consultation 29/11/2018

EDX consultation provides helpful information to evaluate the integrity and function of motor, sensory and autonomic neurons, nerve roots, brachial and lumbar plexi, peripheral nerves, neuromuscular junction, and muscles And sometimes CNS 29/11/2018

lower motor neuron lesions , Main purposes: Is there any lower motor neuron lesions , or not ? If yes , Where ? 29/11/2018

numbness, paresthesia dysautonomia fatigability weakness atrophy pain 29/11/2018

EDX studies are not helpful when pain results from disease or injury that does not effect nerve or neuromuscular function EDX studies are also generally less helpful when weakness or sensory loss is due to central nervous system disease 29/11/2018

Inconclusive diagnosis Rapidly evolving disease Course of the disease Clinical situations where appropriate medical management requires repeat testing Second diagnosis Inconclusive diagnosis Rapidly evolving disease Course of the disease Unexpected course Change in course Recovery from injury 29/11/2018

Acceptable tests per 12-month period: Clinical situations where appropriate medical management requires repeat testing Second diagnosis Inconclusive diagnosis Rapidly evolving disease Course of the disease Unexpected course Change in course Recovery from injury Acceptable tests per 12-month period: Two for CTS,radiculopathy,PNP,myopathy,& NMJ disorders Three for motor neuronopathy , plexopathy & trauma But repeat EDX testing is NOT necessary in 80% of all cases 29/11/2018

Instrumentation 29/11/2018

Neuropathic Process NCS Axonal Demyelinating Latency NCV Amplitude 29/11/2018

Radiculopathy or Plexopathy H-reflex Late responces F-wave 29/11/2018

EMG 29/11/2018

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THE END 29/11/2018

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