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Electrodiagnostic Testing (EMG/NCS).Dr. Melissa Thibault joined the practice in 2004, bringing the specialty of electrodiagnostic medicine (EMG and nerve conduction studies). In 2011, the Electrodiagnostic Lab was the first lab accredited by the American Association of Neuromuscular and Electrodiagnositc Medicine (AANEM) in New York State with exemplary status. It remains the only accredited lab in our region.
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EMG & NCS can help you diagnose
Focal problem - "My hand/foot is numb and weak"
-cervical/lumbar radiculopathy "nerve root"
-brachial/lumbosacral plexopathy
-mononeuropathy (carpal tunnel syndrome, ulnar neuropathy at the elbow, other nerves)
Polyneuropathy - "My toes are numb"
-axon loss
-demyelination
-axon loss and demyelination
Generalized motor weakness - "It's hard to get out of a chair"
-ALS
-Neuromuscular junction
-Myopathy
-cervical/lumbar radiculopathy "nerve root"
-brachial/lumbosacral plexopathy
-mononeuropathy (carpal tunnel syndrome, ulnar neuropathy at the elbow, other nerves)
Polyneuropathy - "My toes are numb"
-axon loss
-demyelination
-axon loss and demyelination
Generalized motor weakness - "It's hard to get out of a chair"
-ALS
-Neuromuscular junction
-Myopathy
What occurs during the electrodiagnostic evaluation?
During the electrodiagnostic appointment, Dr. Thibault will evaluate your nerve and muscle function. It is a direct extension of the clinical neuromuscular examination. The test will provide you with helpful information for the evaluation of motor and sensory nerves, nerve roots, brachial and/or lumbar plexus, peripheral nerves, neuromuscular junction, and muscles.
Typically nerve conduction studies are done first. Electrodes will be places on the arm, hand, leg or foot of interest and then a nerve will be stimulated. This feels like a rubber band snapping on the skin. Once the appropriate nerves have been stimulated Dr. Thibault will switch to electromyography (EMG). During EMG, a skinny needle (like an acupuncture needle) is used to read electrical activity of muscles. This feels like a dull toothache. Multiple muscles are sampled in the limb being tested and often in the neck or back.
Ultrasound may be used to supplement the electrodiagnostic exam. Since 2011, Physiatry & Rehabilitation Medicine, PC has the only electrodiagnostic lab in our region equipped to use neuromuscular ultrasound.
Typically nerve conduction studies are done first. Electrodes will be places on the arm, hand, leg or foot of interest and then a nerve will be stimulated. This feels like a rubber band snapping on the skin. Once the appropriate nerves have been stimulated Dr. Thibault will switch to electromyography (EMG). During EMG, a skinny needle (like an acupuncture needle) is used to read electrical activity of muscles. This feels like a dull toothache. Multiple muscles are sampled in the limb being tested and often in the neck or back.
Ultrasound may be used to supplement the electrodiagnostic exam. Since 2011, Physiatry & Rehabilitation Medicine, PC has the only electrodiagnostic lab in our region equipped to use neuromuscular ultrasound.
Indicators of a high quality electrodiagnostic evaluation
Presence of a history, physical examination, and provision of a differential diagnosis.
Includes both EMG and NCS in the majority of cases. NCS and EMG performed in real time by a neurologist or physical medicine and rehabilitation (PMR) physician trained in electrodiagnostic medicine. Avoids unnecessary testing, not excessive numbers of tests performed. How you should prepare for the testsTell Dr. Thibault if you are taking aspirin, blood thinners (like coumadin, plavix, xarelto, eliquis, brillinta), have a pacemaker/defibrillator/brain or spinal cord stimulator, have hemophilia or other bleeding disorder (low platelets/thrombocytopenia). If you are on coumadin, have an INR sent to our office within a week of your appointment.
Take a bath or shower to remove oil from your skin. Do not use body lotion on the day of the test. If you have myasthenia gravis, ask Dr. Thibault if you should take any medications before the test. |
