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Electromyography

Electromyography. Nerve conduction study (NCS) Electromyography (EMG) Evoked potential study (EP). Abnormal Wave. B. Amplitude (uV). A. Decreased amplitude: axonal/neuronal damage ;axono-/neuronopathy Prolonged latency, decreased velocity: myeline damage ;demyelination. -. C. +.

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Electromyography

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  1. Electromyography • Nerve conduction study (NCS) • Electromyography (EMG) • Evoked potential study (EP)

  2. Abnormal Wave B Amplitude (uV) A Decreased amplitude: axonal/neuronal damage ;axono-/neuronopathy Prolonged latency, decreased velocity: myeline damage ;demyelination - C + Latency (msec)

  3. Nerve Conduction Study • Motor NCS • Sensory NCS • Reflex study • F-wave • H-reflex • Blink reflex • Repetitive nerve stimulation study

  4. Electromyography • Needle EMG • Conventional needle EMG • Quantitative EMG • Single Fiber EMG • Surface EMG

  5. Mortor NCS

  6. Axonal degeneration vs Demyelination • Charater Axonal Demyelinating NCV N  Amplitude  N or CB Duration N Dispersion() F-latency 

  7. F-wave, H-reflex

  8. Blink reflex

  9. RNS

  10. Electromyography • Insertional activity • Spontaneous activity • Positive sharp wave • Fibrillation potential • Fasciculation • Motor unit potential • Recruitment

  11. Amplitude • Duration • Phase

  12. Neuropathy vs Myopathy • Character Neuropathy Myopathy IA   SPA (+) (+)(-) MUP amp   duration   phase   Recruitment  

  13. Clinical utility of EMG and NCS • - Peripheral neuropathy: DM, Entrapment neuropathy, Radiculopathy, Guillain-Barre syndrome (AIDP), CIDP • - Motor neuron disease: ALS, PLS • - Myopathy: inflammaotory polymyositis, dermatomyositis • Neuromuscular junction disoder (Myasthenia gravis, Lambert-Eaton syndromes): Repetitive nerve stimulation test (Jolly test) - Autonomic function test and sphincter EMG: MSA vs. IPD • - Blink reflex and facial NCS: Bell’s palsy, Trigeminal neuralgia, Blephalospasm

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