Nerve Conduction Testing and Electromyography for the Physical Therapist: Techniques, Interpretation and Differential Diagnosis

This book was developed to assist physical therapy students and clinicians in learning the techniques, interpretation and use of electroneuromyography evaluation in the differential diagnosis of patients with neuromuscular disorders. It provides the physiological basis and techniques of this diagnostic test through the use of nerve conduction studies and needle electromyography. Readers will learn the application of these techniques to the upper and lower extremities, plus the interpretation of results/reports through case studies. Differential diagnosis of abnormalities that are distributed throughout the neuromuscular system will be presented. Knowledge of basic anatomy related to peripheral nerve and root distributions is being assumed.
Table of Contents
CHAPTER ONE 1
Introduction to Electrophysiological Evaluation - Peripheral Nerve and Muscle 1
CHAPTER TWO 17
Instrumentation used in Electroneuromyography Examinations 17
CHAPTER THREE 23
Upper Extremity Motor Nerve Conduction Studies & Sensory Nerve Action Potential's (SNAP's) 23
Motor Nerve Conduction Studies - Overview 23
Sensory Nerve Conduction Studies 42
CHAPTER FOUR 53
Lower Extremity Motor Nerve Conduction Studies & Sensory Nerve Action Potential's 53
Motor Nerve Conduction Studies 54
Sensory Nerve Conduction Studies 61
CHAPTER FIVE 66
Advanced Techniques of Nerve Studies - Late Responses 66
Somatosensory Evoked Potentials (SSEP's) 66
Brainstem Auditory Evoked Potentials (BAER's) 69
Visually Evoked Potentials (VEP's) 69
H- Reflex 70
F- Wave Testing 72
Repetitive Nerve Stimulation - Myasthenia Gravis 73
CHAPTER SIX 78
Diagnostic Electromyography 78
CHAPTER SEVEN 92
Problem Solving in Electroneuromyography and Case Studies 92
Case Study # 1: Carpal Tunnel Syndrome 95
Case Study # 2: Age 5 - Duchenne MD (DMD) 96
Case Study # 3: Suspected L5 Root Compression 97
Case Study # 4: Suspected Peripheral Polyneuropathy 99
Case Study #5: EMG Report #1 100
Case Study #6: EMG Report #2 102
Case Study #7: EMG Report #3 103
Case Study #8: Gun Shot Wound to the Cauda Equina, L1 - L2. 105
Case #9: Anterior Glenohumeral Joint Dislocation 107
Case #10: Mid Humeral Fracture 107
Case #11: Multiple Sclerosis 107
Case #12: Isolated Scapula Winging 107
Case #13: Idiopathic Bell's Palsy 107
Appendix A 111
Anatomical Correlates and Associated Impairments 111
Appendix B 113
Common Causes of Peripheral Neuropathies 113
Appendix C 114
Upper Extremity - Root and Peripheral Nerve Innervations 114
Lower Extremity - Root and Peripheral Nerve Innervations 115
References 116