Stimulus duration and pain in nerve conduction studies

Tamura, Akiko; Sonoo, Masahiro; Hoshino, Satoshi; Iwanami, Tomoko; Shimada, Hiroyuki; Miki, Takami; Shimizu, Teruo

doi:10.1002/mus.23446

Cited by 7 publications

(7 citation statements)

References 8 publications

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“…For patients, however, the full protocol may be demanding, since electric stimulation and concentric needle-examination are often regarded as painful. Healthy volunteers scored the pain with a supramaximal-stimulated nerve conduction studies (NCS) of the median nerve on a numerical scale (0–10) with an average of 3.5 but a maximum of 7.0 (6). In children, EMG examination is often regarded as painful as venapuncture (7).…”

Section: Introductionmentioning

confidence: 99%

The Diagnostic Sensitivity for Ulnar Neuropathy at the Elbow Is Not Increased by Addition of Needle EMG of ADM and FDI When Nerve Conduction Studies Are Normal

et al. 2019

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Introduction: The main objective of this study was to investigate whether electromyography (EMG) has additional value in the confirmation of the clinical diagnosis of ulnar nerve entrapment at the elbow (UNE) if nerve conduction studies (NCS) are normal.Methods: A prospective cross-sectional cohort observational study was conducted among patients with the clinical suspicion of UNE. A total of 199 arms were included, who were examined according to a standard neurophysiological protocol, i.e., NCS and EMG relevant to the ulnar nerve.Results: NCS were normal in 76 (38.2%) arms. No abnormal spontaneous muscle fiber activity was found with EMG in any of these cases. In 9 arms with normal NCS (11.8%), isolated abnormal MUAP configurations were found with EMG. Of these nine arms one UNE was diagnosed clinically, in which additional ultrasound and repeated NCS/EMG were negative. One had already been diagnosed with neuralgic amyotrophy and one with CTS. The other 6 arms had additional diagnostics which did not reveal an UNE.Conclusion: EMG as part of the standard neurophysiological protocol exclusively in the confirmation of the clinical diagnosis of UNE has limited added value if NCS are normal in a high prior-odds setting. However, removing EMG may prevent detecting concomitant and/or additional differential diagnoses.

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Section: Introductionmentioning

confidence: 99%

The Diagnostic Sensitivity for Ulnar Neuropathy at the Elbow Is Not Increased by Addition of Needle EMG of ADM and FDI When Nerve Conduction Studies Are Normal

et al. 2019

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“…Velocity of nerve conduction increases with increase in temperature. Tamura A, Sonoo M, Hoshino S, et al 10 The nerve conduction velocity increases with age until adulthood and it starts to decline after around 60 years of age. As height of the individual increases the distal conduction of the impulse slows down due to axonal tapering and lesser myelination.…”

Section: Discussionmentioning

confidence: 99%

Nerve Conduction Velocity Studies in Patients With Diabetes Mellitus (Type 2)

Munagavalasa¹,

Nalli²

2019

jebmh

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BACKGROUND Nerve conduction velocity study is a tool to assess the functional status of the sensory as well as motor nerves under physiological and pathological background. This study is done in association with the department of neurology where most of the cases were due to neuropathy caused by diabetes mellitus. METHODS The present study is a prospective study. It includes 40 patients suffering from type 2 diabetes mellitus of less than 2 years duration. These patients include both men and women in the age group of 45 to 55 years. Nerve conduction velocity study test is performed on them with the help of electromyogram. RESULTS According to this study, the nerve conduction velocity tests show abnormal nerve conduction in the motor nerves than in the sensory nerves. It also shows that neuropathy with decreased nerve conduction velocity is observed in the lower limbs frequently. CONCLUSIONS Nerve conduction velocity test is a simple and non-invasive test to diagnose neuropathy. It is useful in the prevention, detection and management of neuropathies.

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“…[41][42][43][44] We established control values of singlefiber EMG in a Japan multicenter collaborative study. 45 We have also published several studies on nerve conduction studies (NCS), among which anodal stimulation in NCS 46,47 and the relationship between pain and stimulus duration 48 are interesting topics. We…”

Section: Studies On Edxmentioning

confidence: 99%

Education on neuromuscular electrodiagnosis and neurological symptomatology

Sonoo

2023

Neurology & Clinical Neurosc

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Neurological symptomatology is a crucial component of neurological expertise. The committee for fostering board‐certified neurologists in the Japanese Society of Neurology (JSN) has hosted an educational activity for residents before the board examination, “The seminar for fostering board‐certified neurologists” since 2004. In particular, the autumn seminar has been characterized by small group hands‐on of neurological examinations and the evaluations of higher brain function. Besides this, hands‐on seminar of neurological examinations by regional branches has been promoted by the JSN. In the Kanto Ko‐shin‐etsu branch, “The first hands‐on seminar of neurological examinations” started in 2023 after a 3‐year‐suspension due to COVID‐19. The most important educational activities in neuromuscular electrodiagnosis (EDx) is the “Neuromuscular diagnostics seminar” hosted since 2004 by the Japanese Society of Clinical Neurophysiology (JSCN). The majority of tutors and participants are neurologists. This seminar is also characterized by small‐group, hands‐on workshops. We have also run the overseas seminar, “Tokyo Super EMG hands‐on,” since 2013. These have undoubtedly contributed to enhancing the level of neuromuscular electrodiagnosis not only in Japan but also in other Asian countries. I have conducted studies on neurological symptomatology and neuromuscular electrodiagnosis, which are directly linked to enhancing clinical practice of neurologists through educational activities such as review articles or lectures. Due to the fact that symptomatology is crucial in neurological expertise, neurology is a basic specialty around the world except in Japan. In 2018, the JSN decided to aim to make neurology a basic specialty and continues to make efforts to attain this goal.

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Stimulus duration and pain in nerve conduction studies

Abstract: As a common duration for motor NCS, 0.2 ms seems appropriate, because the tibial nerve stimulation was more painful than the median nerve stimulation.

Cited by 7 publications

References 8 publications

The Diagnostic Sensitivity for Ulnar Neuropathy at the Elbow Is Not Increased by Addition of Needle EMG of ADM and FDI When Nerve Conduction Studies Are Normal

The Diagnostic Sensitivity for Ulnar Neuropathy at the Elbow Is Not Increased by Addition of Needle EMG of ADM and FDI When Nerve Conduction Studies Are Normal

Nerve Conduction Velocity Studies in Patients With Diabetes Mellitus (Type 2)

Education on neuromuscular electrodiagnosis and neurological symptomatology

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