Electromyography of the diaphragm in neuromuscular disease

mentioning

confidence: 99%

Phrenic nerve conduction studies in patients with chronic obstructive pulmonary disease

Podnar

Harlander

2013

Quantitative motor unit potential analysis in the diaphragm: A normative study

Podnar

Resman‐Gašperšič

2008

Although quantitative motor unit potential (MUP) analysis has an established role in other skeletal muscles, it has not been performed in the diaphragm. The aim of the present study was to test whether such studies are possible and to establish normative data. Twenty-nine healthy volunteers (15 men), aged 21-65 years (median, 33 years), were studied using standard concentric needle electrodes, and equipment with the facility for template-operated multi-MUP analysis. Needle electrodes were inserted into the right medial recess of the seventh to ninth intercostal spaces. During MUP sampling, subjects were asked to hold their breath in partial inspiration for 5 s. At least 20 MUPs were obtained in 28 subjects. Diaphragmatic MUPs were confirmed to be much smaller than those of limb muscles. We found diaphragmatic quantitative MUP analysis to be possible in healthy volunteers. However, further studies in patient groups are needed to establish the feasibility and clinical value of such studies.

Safety and pain in electrodiagnostic studies

London

2016

Discomfort is an unavoidable part of electrodiagnostic (EDX) studies. The most readily modifiable mediator of electromyography (EMG)-associated pain is muscle selection. Interventions that may reduce pain include vapocoolant spray, ibuprofen, and techniques such as slapping or stretching the skin. Needlestick injuries to health care workers carry the risk of transmitting bloodborne illnesses, but other infectious complications of EDX studies are very rare. EMG probably contributes to asymptomatic hemorrhage in approximately 1% of patients, but clinically significant bleeding has only been reported a few times. Therapeutic anticoagulation does not significantly increase this risk. With standard procedures, there have been no reports of patients developing cardiac arrhythmia from nerve conduction studies. No special precautions are necessary in patients with implantable cardiac devices or intravenous lines. There is a small risk of pneumothorax associated with EMG of the diaphragm and chest wall muscles. Several techniques have been suggested to improve the safety of diaphragm EMG. Muscle Nerve 55: 149-159, 2017.