Revised, updated, and expanded second edition of the premier learning guide for residents, McLean EMG Guide emphasizes skills and concepts required for success in mastering basic electrodiagnostic techniques. This step-by-step approach to performing and interpreting EMG and nerve conduction studies will prepare trainees, fellows, and attendings to meet the challenges encountered in daily practice with confidence.
The book is broken into short formatted chapters covering instrumentation, basic nerve conduction and needle EMG techniques, interpretation, applications for common clinical problems, and a new chapter on ultrasound. The procedures are laid out as illustrated tables with specifics for lead placement, stimulation, sample waveforms, and photographs to guide electrodiagnostic set-ups. Clinical presentation, anatomy, recommended studies, normal values, pearls and tips, and key findings are presented throughout in bulleted text for a thorough, more focused guidebook. Multiple choice questions and answers with rationales reinforce learning for those wishing to review concepts through self-guided assessment.
Key Features
Updates to all chapters with new figures and diagrams and more multiple-choice questions with answers
Brand new chapter on the use of ultrasound with electrodiagnosis
Checklists with key steps and takeaways for each study
Clear, easy-to-understand tables and photos illustrate each set-up and study
Codifies what you need to know to make a diagnosis in the EMG laboratory
Print purchase includes on-line access to the full contents for mobile or desktop use
Author(s): Samuel K. Chu, Prakash Jayabalan, Christopher J. Visco
Edition: 2
Publisher: Demos Medical
Year: 2019
Cover
Title
Copyright
Contents
Contributors
Preface
Section I: Introduction
Chapter 1: Introduction to Electrodiagnostics
Basic Principles of Electrodiagnostics
Basic Logistical Details for Your First Day Performing Electrodiagnostics
Basic Construction of an Electrodiagnostic Consult
Explanation of Findings
Additional Readings
Chapter 2: Instrumentation
Introduction
The Electrodes
The Signals
The Displays
The Stimulator
Questions
Chapter 3: Systematic Approach to Learning and Performing Nerve Conduction Studies
Introduction
Nerve Conduction Study Checklist
Prestudy Checklist
Preshock Checklist
Shock Checklist
Review During the Nerve Conduction Studies
After the Nerve Conduction Studies
Common Nerve Conduction Study Troubleshooting
Continued Learning for Nerve Conduction Studies
Additional Readings
Section II: Nerve Conduction Studies
Chapter 4: Upper Limb Motor Studies
Introduction
Median Nerve
Ulnar Nerve
Radial Nerve
Normal Value Range
Questions
Chapter 5: Upper Limb Sensory Studies
Introduction
Median to Index or Middle Finger
Ulnar to Little Finger
Questions
Additional Readings
Chapter 6: Lower Limb Motor Studies
Introduction
Fibular (Peroneal) to Extensor Digitorum Brevis
Tibial to Abductor Hallucis
Reference Values
Questions
Reference
Chapter 7: Lower Limb Sensory Studies
Introduction
Sciatic Nerve
Sural Nerve
Superficial Fibular (Peroneal) Nerve
Saphenous
Lateral Femoral Cutaneous Nerve
Questions
Additional Readings
References
Chapter 8: F-Waves
Introduction
Anatomy
Electrodiagnostic Approach
Limitations
Questions
References
Chapter 9: H-Reflexes
Introduction
Anatomy
Electrodiagnostic Approach
Questions
Additional Reading
Section III: Needle EMG
Chapter 10: Basic EMG Technique
Introduction
Prestudy Checklist
Reducing Anxiety and Discomfort of the Needle Examination
Procedure Protocol
Questions
Additional Readings
Chapter 11: Basic Approach to EMG Waveform Recognition
Introduction
Basic Approach
Questions
Additional Readings
Chapter 12: Motor Unit Action Potential Analysis
Introduction
Overview of the Motor Unit Action Potential
Motor Unit Morphology
Changes in MUAP Characteristics and Morphology in Disease
Questions
Chapter 13: Recruitment
Introduction
Overview of Recruitment
Basics of Recruitment Analysis
Clinical Utility of Recruitment Analysis
Stepwise Approach to Recruitment Assessment
Maximal Activation-Interference Pattern
Recruitment Findings in Neuropathic Processes
Recruitment Findings in Myopathic Processes
Questions
Additional Readings
Section IV: Important Concepts for Interpreting Studies
Chapter 14: Orthodromic and Antidromic Nerve Conduction Studies
Introduction
Motor Nerve Conduction Studies
Sensory Nerve Conduction Studies
Considerations for Sensory Nerve Conduction Studies
Questions
References
Chapter 15: Temporal Dispersion and Phase Cancellation
Introduction
Basic Concepts
Questions
References
Chapter 16: Interpreting Studies
Introduction
Nerve Conduction Study Interpretation
Needle EMG Interpretation
Questions
Chapter 17: Common Anomalies
Introduction
Anatomy
Martin–Gruber Anastomosis
Marinacci Anomaly
Riche–Cannieu Anomaly
All-Ulnar Hand
Accessory Fibular Nerve
Questions
References
Section V: Common Clinical Entities
Chapter 18: Carpal Tunnel Syndrome
Introduction
Clinical Presentation
Anatomy of the Carpal Tunnel
Electrodiagnostic Approach
Assessing the Severity of Carpal Tunnel Syndrome
Questions
References
Chapter 19: Ulnar Neuropathy at the Elbow
Introduction
Clinical Presentation
Anatomy
Electrodiagnostic Approach
Questions
References
Chapter 20: Radial Neuropathy
Introduction
Clinical Presentation
Anatomy
Electrodiagnostic Approach
Recovery in Radial Neuropathy
Questions
Additional Readings
References
Chapter 21: Anterior Interosseous Nerve Lesions
Introduction
Anatomy
Pathophysiology
Clinical Presentation
Electrodiagnostic Approach
Questions
References
Chapter 22: Fibular (Peroneal) Neuropathy
Introduction
Clinical Presentation
Electrodiagnostic Approach
Questions
Additional Readings
Chapter 23: Tibial Neuropathy
Introduction
Clinical Presentation
Basic Anatomy
Electrodiagnostic Approach
Trade Secrets
Additional Readings
References
Chapter 24: Femoral Neuropathy
Introduction
Clinical Presentation
Anatomy
Electrodiagnostic Approach
Questions
References
Chapter 25: Lumbosacral Radiculopathy
Introduction
Clinical Presentation
Anatomy
Electrodiagnostic Approach
Nerve Conduction Studies
Late Responses
Electromyography
Summary
Questions
References
Chapter 26: Cervical Radiculopathy
Introduction
Clinical Presentation
Anatomy of The Cervical Spine
Spinal Nerves
Electrodiagnostic Approach
Questions
References
Chapter 27: Facial Nerve and Blink Studies
Introduction
Clinical Presentation
Anatomy
Electrodiagnostic Approach
Questions
Additional Readings
References
Chapter 28: Repetitive Stimulation and Neuromuscular Junction Disorders
Introduction
Clinical Presentation
Electrodiagnostic Approach
Questions
Additional Reading
Chapter 29: Peripheral Neuropathy
Introduction
Clinical Presentation
Electrodiagnostic Approach
Summary
Questions
References
Chapter 30: Brachial Plexopathy
Introduction
Clinical Presentation
Anatomy
Electrodiagnostic Approach
Summary
Questions
References
Chapter 31: Motor Neuron Disease
Introduction
Anatomy
Clinical Presentation
Electrodiagnostic Approach
Nerve Conduction Studies
Electromyography
Other Diagnostic Testing
Questions
References
Chapter 32: Myopathy
Introduction
Clinical Presentation
Electrodiagnostic Approach
Nerve Conduction Studies
Electromyography
Other Diagnostic Testing
Questions
Chapter 33: The Use of Ultrasound With Electrodiagnosis
Introduction
Advantages of Using Ultrasound with Electrophysiologic Techniques
Advantages of Ultrasound over Other Imaging Techniques
Principles of Imaging Peripheral Nerves with Ultrasound
Imaging Strategies to Improve Visualization of Peripheral Nerves
Sonographic Features of Peripheral Nerve Pathology
Principles of Imaging Muscle for Neuromuscular Assessment with Ultrasound
When Assessing for Neuromuscular Muscle Pathology, Inspect for:
Ultrasound as an Adjunct to Electrodiagnostic Techniques can be Used
Questions
Additional Readings
Section VI: Checklists and Answers
Chapter 34: Checklists
Upper Limb Motor Nerve Conduction Studies
Upper Limb Sensory Nerve Conduction Studies
Lower Limb Motor Nerve Conduction Studies
Lower Limb Sensory Nerve Conduction Studies
Delayed Responses
Electromyography
Radiculopathy Screens
Chapter 35: Answers to Multiple-Choice Questions
Instrumentation (Chapter 2)
Upper Limb Motor Studies (Chapter 4)
Upper Limb Sensory Studies (Chapter 5)
Lower Limb Motor Studies (Chapter 6)
Lower Limb Sensory Studies (Chapter 7)
F-Waves (Chapter 8)
H-Reflexes (Chapter 9)
Basic EMG Technique (Chapter 10)
Basic Approach to EMG Waveform Recognition (Chapter 11)
Motor Unit Action Potential Analysis (Chapter 12)
Recruitment (Chapter 13)
Orthodromic and Antidromic Nerve Conduction Studies (Chapter 14)
Temporal Dispersion and Phase Cancellation (Chapter 15)
Interpreting Studies (Chapter 16)
Common Anamolies (Chapter 17)
Carpal Tunnel Syndrome (Chapter 18)
Ulnar Neuropathy at the Elbow (Chapter 19)
Radial Neuropathy (Chapter 20)
Anterior Interosseous Nerve Lesions (Chapter 21)
Fibular (Peroneal) Neuropathy (Chapter 22)
Femoral Neuropathy (Chapter 24)
Lumbosacral Radiculopathy (Chapter 25)
Cervical Radiculopathy (Chapter 26)
Facial Nerve and Blink Studies (Chapter 27)
Repetitive Stimulation and Neuromuscular Junction Disorders (Chapter 28)
Peripheral Neuropathy (Chapter 29)
Brachial Plexopathy (Chapter 30)
Motor Neuron Disease (Chapter 31)
Myopathy (Chapter 32)
The Use of Ultrasound With Electrodiagnosis (Chapter 33)
Index
