Electromyography (EMG) is a technique for evaluating and recording the electrical activity produced by nerves and muscles. Interpreting EMG is a mandatory skill for neurologists and rehabilitation specialists. This textbook provides the reader with a detailed discussion of the concepts and principles underlying electrodiagnostic medicine. It is written for an audience without pre-existing knowledge in this discipline, including beginner technicians and physicians in training. It is an ideal review for seasoned practitioners and those preparing for board examinations. It begins with a review of the foundational sciences and works through the field in twenty chapters, including a large number of case studies demonstrating correct application and interpretation. Appendices of information frequently required in the EMG laboratory, such as Nerve Conduction Study techniques and their age-related normal values, anatomic regions assessed by each NCS and needle EMG studies, safety issues, and other important topics, are also included.
Part I. Introductory Chapters: 1. Basic electricity and electrical concepts pertinent to EDX medicine; 2. Instrumentation; 3. Anatomy and physiology of neurons; 4. Anatomy and physiology of the neuromuscular junction; 5. Anatomy and physiology of muscle; Part II. Nerve Conduction Studies: 6. Electrodes and nerve conduction study basics; 7. Motor nerve conduction studies; 8. Sensory nerve conduction studies; 9. The NCS manifestations of various pathophysiologies; 10. The utility of NCS for lesion localization and characterization; 11. Late responses and blink reflexes; 12. Repetitive nerve stimulation studies and their manifestations; Part III. Needle EMG: 13. The needle electrode examination (Needle EMG); 14. The Needle EMG manifestations of pathology; 15. Single fiber EMG and macro EMG; Part IV. Other Pertinent Information: 16. Assessment, prognosis, and initial management of peripheral nerve injuries; 17. The EDX Manifestations of Disorders at Various Levels of the Neuraxis; 18. Common pitfalls and their resolution; 19. Safety issues; 20. Nontechnical issues, the patient encounter, and the EDX report; Part V. Case Studies in Electrodiagnostic Medicine: Case 1 through Case X; Part VI. Appendices: Appendix 1. Anatomy of the brachial and lumbosacral plexuses; Appendix 2. Anatomy of the major upper and lower extremity nerves; Appendix 3. The myotomes of the upper and lower extremities; Appendix 4. The SNAP, CMAP, and needle EMG domains of the brachial plexus; Appendix 5. The sensory and motor NCS techniques used in our EMG laboratories; Appendix 6. The age-related, normal control values for the sensory and motor NCS; Appendix 7. Our screening sensory NCS, motor NCS, and needle EMG studies; Appendix 8. The advantages and disadvantages of the EDX test components; Appendix 9. Needle EMG findings with lesions at various levels of the neuraxis.