Iatrogenic complications and risks of nerve conduction studies and needle electromyography

Abstract

Electrodiagnostic procedures are routinely performed in patients with a variety of neuromuscular disorders. These studies are generally well tolerated and rarely thought to be associated with any significant side effects. However, needle electromyography is an invasive procedure and under certain situations has the potential to be associated with iatrogenic complications, including bleeding, infection, nerve injury, pneumothorax, and other local trauma. Similar complications are possible if needles are used for either stimulating or recording. In addition, like all other electrical devices and monitoring equipment connected to patients, electrodiagnostic testing carries the risk of stray leakage currents that under certain circumstances can result in electrical injury, especially in patients in the intensive care setting. Similarly, certain precautions are required during nerve conduction studies (NCS) in patients with pacemakers and other similar cardiac devices. In this review, we address the known and theoretical complications of NCS and needle electrode examination, and the possible methods to avoid such hazards.

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

“…They are useful in determining the level of a radiculopathy, determining its chronicity, and degree of severity, particularly when the patient's history and physical examination are inadequate for the diagnosis [4] or in differentiating disease processes that are clinically indistinguishable [5]. This procedure has few if any serious complications [6].…”

Utility of Nerve Conduction Studies for Carpal Tunnel Syndrome by Family Medicine, Primary Care, and Internal Medicine Physicians

“…However, an analysis of a health insurance claims database showed that, in 1999, as many as one quarter of electrodiagnostic procedures were performed by physicians with other backgrounds. 1 nEMG causes significant patient discomfort, 2 has a risk of adverse events, 2 and is subjective. 3 It is therefore often performed by physicians with specific training.…”

Evaluation of Laplacian Diaphragm Electromyographic Recordings in a Static Inspiratory Maneuver

“…Respiratory muscles' activity can be assessed by means of intraesophageal electrodes [2] and intramuscular electrodes [3]. However, these techniques have the disadvantage of being invasive and cumbersome for patients [4] with the potential risk of an iatrogenic pneumothorax [5]. Surface electromyography (sEMG), a non-invasive diagnostic tool for measuring muscle electrical activity, is a practical alternative for evaluation of muscle diaphragm function.…”