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Book Details
Abstract
Electromyography remains a main diagnostic tool within neurology. This issue of Neurologic Clinics addresses the most recent developments in the clinical application of EMG. Articles in this issue include: Nerve conduction studies: Basic Concepts and Patterns of Abnormalities; Needle Electromyography–Basic Concepts andInterpretation of Recorded Potentials;Electrodiagnostic Evaluation of Carpal TunnelSyndrome;Electrodiagnostic Evaluation of Ulnar Neuropathyand Other Upper Extremity Mononeuropathy; Lower Extremity Mononeuropathies;Electrodiagnostic Evaluation of Brachial Plexopathies; Evaluation ofRadiculopathies;Electrodiagnostic Approach to Motor NeuronDiseases;Electrophysiologic Findings in PeripheralNeuropathies; Evaluation of Neuromuscular Junction Disorders in the EMGLaboratory;Electrodiagnostic Findings inMyopathy;Electrodiagnostic Approach to CranialNeuropathies; Technical Issues with Nerve Conduction Studies and Needle EMG;andCoding and Reimbursement of ElectrodiagnosticStudies.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Clinical\rElectromyography | i | ||
| Copyright Page | ii | ||
| Table of Contents | v | ||
| Contributors | iii | ||
| Preface | xi | ||
| Chapter 1. Nerve Conduction Studies: Basic Concepts and Patterns of Abnormalities | 405 | ||
| BASIC CONCEPTS | 405 | ||
| TYPES OF NCSs | 407 | ||
| TECHNICAL ELEMENTS OF NCSs | 416 | ||
| SUMMARY | 424 | ||
| ACKNOWLEDGMENTS | 424 | ||
| REFERENCES | 424 | ||
| Chapter 2. Needle Electromyography: Basic Concepts and Patterns of Abnormalities | 429 | ||
| TECHNIQUE OF NEEDLE EXAMINATION | 429 | ||
| EMG WAVEFORM RECOGNITION | 433 | ||
| ELECTROMYOGRAPHIC POTENTIALS | 433 | ||
| SPONTANEOUS EMG WAVEFORMS | 434 | ||
| VOLUNTARY MUPs | 444 | ||
| ABNORMAL MUPs: CHANGES IN DISEASE | 448 | ||
| SUMMARY | 455 | ||
| SUPPLEMENTARY DATA | 455 | ||
| REFERENCES | 455 | ||
| Chapter 3. The Electrodiagnostic Approach to Carpal Tunnel Syndrome | 457 | ||
| THE GOLD STANDARD QUESTION AND THE ROLE OF ELECTRODIAGNOSTICS | 457 | ||
| THE ELECTRODIAGNOSTIC EVALUATION FOR CTS | 459 | ||
| SENSORY NERVE CONDUCTION STUDIES | 460 | ||
| MOTOR NERVE CONDUCTION STUDIES | 465 | ||
| THE ROLE OF ELECTROMYOGRAPHY—THE NEEDLE EXAMINATION | 469 | ||
| SPECIAL SITUATIONS | 470 | ||
| PUTTING IT ALL TOGETHER—A TREATMENT ALGORITHM | 473 | ||
| SUMMARY | 473 | ||
| ACKNOWLEDGMENTS | 473 | ||
| REFERENCES | 473 | ||
| Chapter 4. Electrodiagnostic Evaluation of Ulnar Neuropathy and Other Upper Extremity Mononeuropathies | 479 | ||
| ULNAR NEUROPATHY | 480 | ||
| ULNAR NEUROPATHY AT THE ELBOW | 480 | ||
| ULNAR NEUROPATHY AT (OR DISTAL TO) THE WRIST | 487 | ||
| MEDIAN NEUROPATHY IN THE UPPER ARM AND FOREARM | 489 | ||
| RADIAL NEUROPATHY | 492 | ||
| MUSCULOCUTANEOUS NEUROPATHY | 495 | ||
| AXILLARY NEUROPATHY | 497 | ||
| SUPRASCAPULAR NEUROPATHY | 498 | ||
| LONG THORACIC NEUROPATHY | 498 | ||
| SUMMARY | 500 | ||
| REFERENCES | 500 | ||
| Chapter 5. Electrodiagnostic Evaluation of Lower Extremity Mononeuropathies | 505 | ||
| GENERAL COMMENTS | 505 | ||
| LOWER EXTREMITY NERVE ANATOMY | 511 | ||
| CLINICAL VIGNETTES: THE FLOPPY FOOT | 512 | ||
| CLINICAL VIGNETTES: THE BUCKLING KNEE | 520 | ||
| CLINICAL VIGNETTE: THE PAINFUL FOOT | 525 | ||
| SUMMARY | 527 | ||
| ACKNOWLEDGMENTS | 527 | ||
| REFERENCES | 527 | ||
| Chapter 6. Electrodiagnosis of Peripheral Neuropathy | 529 | ||
| CONFIRMATION OF PERIPHERAL NERVE DISEASE | 529 | ||
| DETERMINATION OF TYPE OF NERVE FIBER INVOLVED | 531 | ||
| ASSESSMENT OF THE DISTRIBUTION OF NERVE INVOLVEMENT | 532 | ||
| DEFINING THE PATHOPHYSIOLOGIC PROCESS OF A NEUROPATHY | 535 | ||
| DEFINING THE SEVERITY OF FIBER INVOLVEMENT | 541 | ||
| MONITORING RECOVERY OR TREATMENT EFFECT | 541 | ||
| PLANNING THE EDX STUDY | 542 | ||
| NORMAL EDX STUDIES AND NEUROPATHY | 542 | ||
| SELECTED NEUROPATHIES | 543 | ||
| SUMMARY | 547 | ||
| REFERENCES | 547 | ||
| Chapter 7. Electrodiagnostic Assessment of the Brachial Plexus | 551 | ||
| ANATOMY OF THE BRACHIAL PLEXUS | 552 | ||
| THE CLASSIFICATION OF BRACHIAL PLEXUS LESIONS | 555 | ||
| ELECTRODIAGNOSTIC MANIFESTATIONS OF THE VARIOUS PATHOPHYSIOLOGIC SUBTYPES | 556 | ||
| ELECTRODIAGNOSTIC ASSESSMENT OF THE BRACHIAL PLEXUS | 561 | ||
| ASSESSMENT OF INDIVIDUAL BRACHIAL PLEXUS ELEMENTS | 562 | ||
| AN APPROACH TO THE ELECTRODIAGNOSTIC ASSESSMENT OF THE BRACHIAL PLEXUS | 571 | ||
| SUMMARY | 574 | ||
| CASE VIGNETTES | 574 | ||
| SUMMARY OF CASES | 579 | ||
| REFERENCES | 579 | ||
| Chapter 8. Approach to the Patient with Suspected Radiculopathy | 581 | ||
| ANATOMY AND PATHOPHYSIOLOGY | 582 | ||
| NERVE CONDUCTION STUDIES | 583 | ||
| THE NEEDLE ELECTRODE EXAMINATION | 589 | ||
| OTHER RADICULAR DISORDERS | 598 | ||
| SUMMARY | 601 | ||
| REFERENCES | 601 | ||
| Chapter 9. The Electrophysiology of the Motor Neuron Diseases | 605 | ||
| SUMMARY | 606 | ||
| EMG IN ALS | 607 | ||
| EARLIEST CHANGES ON EMG IN ALS | 608 | ||
| SUMMARY | 611 | ||
| OTHER MOTOR NEURON DISORDERS | 611 | ||
| SUMMARY | 614 | ||
| OTHER MIMIC SYNDROMES | 614 | ||
| SUMMARY | 616 | ||
| SUMMARY | 618 | ||
| REFERENCES | 618 | ||
| Chapter 10. Evaluation of Neuromuscular Junction Disorders in the Electromyography Laboratory | 621 | ||
| THE NEUROMUSCULAR JUNCTION | 622 | ||
| REPETITIVE NERVE STIMULATION TESTING | 623 | ||
| RNS FINDINGS IN DISEASE | 629 | ||
| NEEDLE EMG IN NEUROMUSCULAR JUNCTION DISORDERS | 631 | ||
| SINGLE-FIBER ELECTROMYOGRAPHY | 632 | ||
| SUMMARY | 636 | ||
| REFERENCES | 636 | ||
| Chapter 11. Electrodiagnostic Approach to the Patient with Suspected Myopathy | 641 | ||
| CLINICAL FEATURES OF MYOPATHY | 641 | ||
| ASSOCIATED NONMUSCLE FEATURES AND FAMILY HISTORY | 644 | ||
| LABORATORY TESTING | 645 | ||
| ELECTRODIAGNOSTIC TESTING | 646 | ||
| PATTERNS OF EMG FINDINGS IN MYOPATHIES | 652 | ||
| SUMMARY | 658 | ||
| REFERENCES | 658 | ||
| Chapter 12. Electrodiagnostic Approach to Cranial Neuropathies | 661 | ||
| BLINK REFLEX: OVERVIEW AND TECHNIQUE | 661 | ||
| INTERPRETATION OF THE BLINK REFLEX | 663 | ||
| JAW JERK (MASSETER REFLEX): OVERVIEW AND TECHNIQUE | 667 | ||
| INTERPRETATION OF THE MASSETER REFLEX | 668 | ||
| MASSETER INHIBITORY REFLEX: OVERVIEW AND TECHNIQUE | 670 | ||
| INTERPRETATION OF THE MASSETER INHIBITORY REFLEX | 670 | ||
| TRIGEMINAL MOTOR NERVE STIMULATION: OVERVIEW AND TECHNIQUE | 671 | ||
| INTERPRETATION OF REPETITIVE TRIGEMINAL MOTOR STUDIES | 671 | ||
| FACIAL MOTOR NERVE CONDUCTION STUDIES: OVERVIEW AND TECHNIQUE | 672 | ||
| INTERPRETATION OF FACIAL MOTOR CONDUCTION STUDIES | 673 | ||
| ACCESSORY MOTOR NERVE CONDUCTION STUDIES: OVERVIEW AND TECHNIQUE | 675 | ||
| INTERPRETATION OF ACCESSORY MOTOR NERVE CONDUCTION STUDIES | 676 | ||
| NEEDLE EXAMINATION OF CRANIAL INNERVATED MUSCLES OVERVIEW | 678 | ||
| TRIGEMINAL NERVE (MUSCLES OF MASTICATION) | 678 | ||
| FACIAL NERVE (MUSCLES OF FACIAL EXPRESSION) | 678 | ||
| VAGUS NERVE (LARYNGEAL MUSCLES) | 679 | ||
| SPINAL ACCESSORY NERVE (STERNOCLEIDOMASTOID AND TRAPEZIUS) | 679 | ||
| HYPOGLOSSAL NERVE (TONGUE) | 679 | ||
| SUMMARY | 680 | ||
| ACKNOWLEDGMENTS | 680 | ||
| REFERENCES | 680 | ||
| Chapter 13. Technical Issues and Potential Complications of Nerve Conduction Studies and Needle Electromyography | 685 | ||
| TECHNICAL PROBLEMS DURING NCS | 686 | ||
| RISKS OF NCS | 703 | ||
| TECHNICAL PITFALLS OF NEEDLE EMG | 704 | ||
| POTENTIAL RISKS DURING NEEDLE EMG | 706 | ||
| SUMMARY | 708 | ||
| REFERENCES | 708 | ||
| Chapter 14. Coding and Reimbursement of Electrodiagnostic Studies | 711 | ||
| RESULTS, TESTING, INTERPRETATION, AND REPORT | 712 | ||
| INTRODUCTION TO THE SECTION ON NEUROLOGY AND NEUROMUSCULAR PROCEDURES | 712 | ||
| ADD-ON CODES | 712 | ||
| NERVE CONDUCTION STUDIES, REFLEX AND LATE RESPONSE TESTING | 712 | ||
| EMG | 720 | ||
| NEUROMUSCULAR JUNCTION TESTING | 724 | ||
| BOTULINUM TOXIN INJECTIONS | 724 | ||
| CPT CODE MODIFIERS | 727 | ||
| PHYSICIAN SUPERVISION OF DIAGNOSTIC TESTING | 728 | ||
| ADDITIONAL INFORMATION ON CPT CODES FOR NEUROLOGIC PROCEDURES | 728 | ||
| REVISING CPT CODES AND RELATIVE VALUE UNITS FOR NEUROLOGIC PROCEDURES | 729 | ||
| REFERENCES/RESOURCES | 729 | ||
| ACKNOWLEDGMENTS | 730 | ||
| Chapter 15. A Day in the EMG Laboratory: Case Studies of 10 Patients with Different Clinical Problems | 731 | ||
| CASE 1. A HOSPITAL VOLUNTEER WITH HAND NUMBNESS | 731 | ||
| CASE 2. A COMPUTER PROGRAMMER WITH A NUMB PINKY AND WEAK HAND | 733 | ||
| CASE 3. A CANCER PATIENT WITH TINGLING TOES | 736 | ||
| CASE 4. A WOMAN WITH PAINLESS, PROXIMAL WEAKNESS | 738 | ||
| CASE 5. A GOLFER WITH NECK PAIN | 740 | ||
| CASE 6. A TRAVELING BUSINESSMAN WITH LEG PAIN | 742 | ||
| CASE 7. A WOMAN WITH WRIST DROP | 744 | ||
| CASE 8. A MAN WITH ARM PAIN AND WEAKNESS AFTER YARD WORK | 747 | ||
| CASE 9. A MAN WITH POSTOPERATIVE DIPLOPIA, DYSARTHRIA, AND FATIGUE | 750 | ||
| CASE 10. A VETERINARIAN WITH PROGRESSIVE WEAKNESS | 753 | ||
| SUMMARY | 755 | ||
| REFERENCES | 755 | ||
| Index | 757 |