Functional Electromyography: Provocative Maneuvers in Electrodiagnosis

Nerve conduction studies and EMG in carpal tunnel syndrome: Do they add value?
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Functional Electromyography: Provocative Maneuvers in Electrodiagnosis

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Loren M. Fishman Functional Electromyography , Hang J. Giuseppe Monetti Musculoskeletal Ultrasound Elastosonography 97, Frisch Systematic Musculoskeletal Examination , Springer Spinal Cord Monitoring and Electrodiagnosis , Devon I. Over the years, I have been frustrated by being unable to give these pain-sufferers a definite diagnosis that would lead to rational treatment. About five years ago, I decided to become a detective. For starters, I noticed that many of these patients had movement-related pain.

Sometimes, if they weren't moving or weren't in a specific position, there was no pain at all.

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Many had pain in some positions but not in others. As these patients with mysterious nerve pains came to me and left unsatisfied, I began to think about using the EMG differently than I had been taught in medical school.

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Epicontinental seas versus open-ocean settings: the kinetics of mass extinction and origination. In his third objection, Fowler incorrectly states that EDX are performed for financial gain. J Bone Joint. Journal articles Those examples are references to articles in scholarly journals and how they are supposed to appear in your bibliography. Lateral Scler. Electromyography and neuromuscular disorders : clinical-electrophysiological correlations. Buy Hardcover.

Hope for Medical Nomads I embarked on an original course, one I knew some of my colleagues might think was a radical departure. I began using the EMG in a new way. Instead of having the patient lie still while the test was being done, as is standard procedure, I had the patient assume different positions, especially painful ones, and tested nerve conduction in each of them.

I also tested nerve conduction in positions that are part of a good physical exam. Then I wrote up the significant results of how these investigations lead to diagnosis in a book called "Functional EMG: Provocative Maneuvers in Electrodiagnosis," recently published by Springer.

New use of an old EMG test has enabled me, as well as neurologists and other specialists in physical medicine and rehabilitation, to identify three conditions that are difficult or impossible to diagnose by any other means.

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  • Nerve conduction studies and EMG in carpal tunnel syndrome: Do they add value?;
  • [PDF] Functional Electromyography: Provocative Maneuvers in Electrodiagnosis Online Book.

It has been a breakthrough for many of my desperate patients. The new method I use right in my office has immediate results and may cost only about 20 percent of an MRI!

Why EMG Testing Is Important to Determine Nerve Injury

Using functional EMG testing to quantify neurological changes brought about by these maneuvers widens the scope, deepens the reach and refines the outcome of electromyography and of my ability to help frustrated patients who have become medical nomads, trudging from physician to physician to try to find out what's wrong. Diagnosing Spinal and Piriformis Problems and TOS The EMG method I have developed can successfully determine whether back pain and sciatica are caused by spinal stenosis or herniated disc, even when both are present at the same level.

Applying this method to my patient last Tuesday, it turned out he had a painful herniated disc, but one that didn't need surgery. A safe. The book then goes on to suggest a safe and scientific method for determining other functional maneuvers of value to the electromyographer and suggests means of validating one-time measures that may benefit the electromyographer in diverse clinical situations that are neither common nor predictable.

Some of these are as obvious as comparison with the unaffected limb in a carpal tunnel syndrome that only shows up in the flexed wrist; others require the use of standard deviations derived for other purposes, and depend upon the discretion of the clinician as well as the particular case. That was accomplished by or so. Is greater precision the only further goal, or might there be a second phase of experimentation and standardization for clinical benefit?

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Imaging studies and behavioral investigations comprise the other main streams of neurological knowledge. Yet as a set regimen of nerve conductions and muscle probings, EMG stops short of ways in which it might identify, characterize and follow progress or deterioration in a number of areas which are currently underexamined by all three major modes of neuroscience 3. Radiculopathy vs.

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Illustrations of the strategy and technique; chart of outcomes 6. Successful outcome in a reasonably persuasive majority of botulinum neurotoxin A and B injections into the scalenus anticus and medius gives additional credibility to the method 8. Because of lay-press articles about us, we have seen more than 12, patients purporting to have this diagnosis in the past 20 years.