Needle EMG muscle identification: A systematic approach to needle EMG examination

Menkes, Daniel L.; Pierce, R. M.

doi:10.1016/j.cnp.2019.08.003

Cited by 18 publications

(7 citation statements)

References 6 publications

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“…It may also be difficult with patients with infectious conditions or skin lesions. Finally, needle EMG requires a skilled examiner [ 23 ]. DSEPs are used to evaluate abnormalities of the somatosensory tract, which extends from the peripheral dermatome to the cerebral cortex, and are much less invasive than needle EMG.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Implication and Clinical Relevance of Dermatomal Somatosensory Evoked Potentials in Patients with Radiculopathy: A Retrospective Study

Won

et al. 2021

Pain Research and Management

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Objective. Dermatomal somatosensory evoked potentials (DSEPs) are used to evaluate abnormalities of the somatosensory tract. There have been some studies on the diagnostic value of DSEP in radiculopathy, but it is still controversial. The purpose of our study is to evaluate the diagnostic implication and clinical relevance of DSEPs in patients with radiculopathy by comparing DSEP findings to radiculopathy symptoms and intervertebral foramen (IVF) or spinal canal stenosis in lumbar magnetic resonance imaging (MRI). Methods. This retrospective study reviewed the medical records of patients (n = 59) who were examined by DSEP (each L4 and L5 dermatome) and lumbar MRI. Radiculopathy symptoms and DSEPs results were compared. For the evaluation of IVF and spinal canal size, sagittal (each bilateral L4/5 and L5/S1 IVF) and axial MR images were selected at the most stenotic level. The sizes of the IVF and spinal canal were measured by the pixel counts of selected MR images. In addition, stenosis severity was morphologically graded on a 4-point scale. DSEP results were compared with the size and grade of the IVF or spinal canal stenosis. Results. DSEPs showed high sensitivity for radiculopathy symptoms. The IVF size at L4/5 and L5/S1 (pixel counts) was significantly related to either L4 or L5 dermatomal somatosensory pathway dysfunction, respectively. However, spinal stenosis (pixel counts and grade) and IVF stenosis grade were not significantly related to DSEPs. Conclusion. This paper could be helpful in the electrophysiologic diagnosis of lumbar radiculopathy.

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Section: Discussionmentioning

confidence: 99%

Diagnostic Implication and Clinical Relevance of Dermatomal Somatosensory Evoked Potentials in Patients with Radiculopathy: A Retrospective Study

Won

et al. 2021

Pain Research and Management

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“…In this approach, the SA is identified by palpating or visually observing the pectoralis major (PM) anteriorly, and LD posteriorly, to avoid placing a needle into these muscles. Clinically, it is often difficult to clearly discern the PM and LD, especially when the patient is obese or the muscles are not sufficiently bulky to palpate 8 . Erroneous insertion into the external oblique abdominis muscle located anteroinferior to the SA is also possible.…”

Section: Introductionmentioning

confidence: 99%

Optimal needle electromyography approach to the serratus anterior muscle

et al. 2023

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Introduction/AimsThere are two conventional needle electromyography (EMG) approaches to the serratus anterior (SA), both of which can result in erroneous insertion into adjacent structures such as the latissimus dorsi (LD), teres major, or external oblique abdominis muscles and pose a risk of long thoracic nerve (LTN) injury. Therefore, we identified a novel needle insertion point for the SA in cadavers that avoids other muscles and LTN injury.MethodsThis study included 17 cadavers: 12 to devise the new method and 5 to verify its accuracy. Novel landmarks were the inferior angle of the scapula (I), sternal notch (S), and xiphoid process (X). The relationships of the LD, pectoralis major (PM), SA, and LTN were determined relative to these landmarks.ResultsWhen inserting a needle into the proximal one third along the line connecting points I and X, there were adequate safety margins around the LD, PM, and LTN, and the new method had excellent accuracy.DiscussionCompared to the conventional midaxillary method, our novel method improved the accuracy of needle EMG of the SA. Follow‐up studies using clinical imaging techniques are needed to verify whether above findings are equally applicable in living subjects.

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“…The guidelines for EDX have special recommendations for dealing with patients receiving anticoagulation ( American Association of Electrodiagnostic Medicine. Guidelines in electrodiagnostic medicine, 1999 , Menkes and Pierce, 2019 , Stålberg et al, 2019 , Tankisi et al, 2020 ). These include performing coagulation tests, using small diameter needles, and avoiding deep or non-compressible muscles (e.g.…”

Section: Introductionmentioning

confidence: 99%

Needle EMG induced muscle bleeding complication after guideline approved discontinuation of anticoagulation

Bartl

Krahn

Riggert

et al. 2021

Clinical Neurophysiology Practice

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Needle EMG muscle identification: A systematic approach to needle EMG examination

Abstract: HighlightsThe article discusses standard EMG examination techniques.Special clinical and safety concerns, (e.g. bleeding diatheses) are addressed.The complementary role of ultrasound is reviewed.

Cited by 18 publications

References 6 publications

Diagnostic Implication and Clinical Relevance of Dermatomal Somatosensory Evoked Potentials in Patients with Radiculopathy: A Retrospective Study

Diagnostic Implication and Clinical Relevance of Dermatomal Somatosensory Evoked Potentials in Patients with Radiculopathy: A Retrospective Study

Optimal needle electromyography approach to the serratus anterior muscle

Needle EMG induced muscle bleeding complication after guideline approved discontinuation of anticoagulation

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