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2. Guidelines for Electrodiagnostic Medicine Consultations
By S. Khosrawi MD
Physiatrist
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3. neuromuscular examination
EDX consultation evaluates nerve and muscle function and is a direct extension of the clinical history
and
neuromuscular examination
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4. 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
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5. 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
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6. lower motor neuron lesions ,
Main purposes:
Is there any
lower motor neuron lesions ,
or not ?
If yes , Where ?
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7. numbness, paresthesia dysautonomia
fatigability
weakness
atrophy
pain
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8. 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
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9. 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
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10. 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
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11. Instrumentation
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12. Neuropathic Process NCS Axonal Demyelinating Latency NCV Amplitude
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13. Radiculopathy or
Plexopathy
H-reflex
Late responces
F-wave
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14. EMG
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18. THE END
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