Nerve Facts
“I never knew how hard it could be to button a shirt without feeling my fingers.” As I work with patients experiencing nerve damage, conversations often turn in this direction. Our bodies are incredibly complex, and yet most of the time they function very well. It is easy to take this for granted. After […]
What do you Expect with an Ulnar Nerve Injury?
A patient comes to see you with numbness and tingling of the right ring and little fingers. As you are an astute clinician you infer that the patient either has an ulnar nerve injury or a possible C8 cervical radiculopathy, but how do you know exactly where the likely cause of injury is? A careful […]
What do you Expect with a Radial Nerve Injury?
A patient comes to see you with wrist drop. As you are an astute clinician you infer that the patient has a radial nerve injury, but how do you know where the likely cause of injury is? A thoughtful and thorough clinical exam should shed some light on the situation. Wrist Drop. Image source: Flickr […]
It Takes Two to Tango: Why EMG and NCS Always Go Together
If you have read many of my articles, you have probably noticed that I like to refer to electrophysiologic testing as “EMG/NCS.” Although this acronym is much shorter than the tests’ other names (like “electrophysiologic testing”) it is still a bit of a mouthful, and many people prefer to shorten it even further to simply […]
The Effect of Monochromatic Infrared Energy on Sensation in Patients with Diabetic Peripheral Neuropathy
Based on 5.07 monofilament testing there was no statistical difference in lower extremity sensitivity when using monochromatic infrared energy as compared to a placebo. This study is an underpowered, negative trial due to its small sample size and inclusion of the null value. Clinical judgments prove difficult to determine due to sample size. Level of […]
How Well Do You Know Your Nerves?
Evaluating the neuroanatomy of any patient is an important part of the clinical exam that is vital in making an accurate diagnosis. Just because a patient cannot raise their arm above their shoulder does not inherently mean their ailment is a musculoskeletal shoulder issue. There should be a list of possible diagnosis that need to […]
When the EMG Comes back Normal: What Else Could be Going On?
Several weeks ago I published a blog describing the kinds of neurologic disorders revealed by electromyography and nerve conduction studies (EMG/NCS) in patients who are suspected of carpal tunnel syndrome (CTS) on clinical grounds. In most of these patients, EMG/NCS serves to confirm the presence of median nerve pathology and to describe how severe it […]
An Electromyographer’s Look at Hereditary Neuropathy with Liability to Pressure Palsy
Hereditary neuropathy with liability to pressure palsy (HNPP) or tomaculous neuropathy shares a molecular genetic relationship with Charcot Marie Tooth Disease type I (CMTI) in an autosomal dominant manner1. Most cases of CMT1A are caused by the duplication of 1.5mb in chromosome 17p11.2, while upwards of 85% of all HNPP cases are a result of […]
Taking the Mystery Out of an EMG/NCS Report – Part 2
In Part One of this article, I discussed the basics of nerve conduction studies and waveform analysis. In Part Two, I will cover principles of needle electromyography (EMG), specific diseases and injuries that relate to hand therapy, and how EMG/NCS findings relate to outcomes for certain injuries and surgeries of the upper extremities. The needle EMG examination is […]
If It Quacks Like a Duck…Is it Always a Duck? EMG/NCS Findings in Patients with “Carpal Tunnel” Symptoms
You’ve probably heard the expression, “measure twice, cut once.” Nowhere is that adage truer than in the field of medicine. Electromyography and nerve conduction studies (EMG/NCS) are part of the measurement process which helps physicians provide the most accurate diagnosis and appropriate treatment for symptoms which can sometimes be rather vague. Take carpal tunnel syndrome […]
