Electrodiagnostic medicine

Adam Mullan, M.D.
Physical Medicine and Rehabilitation
Andrews Institute for Orthopaedics & Sports Medicine
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 Q: What is electrodiagnostic medicine and why it is important to patients?
Adam Mullan, M.D.: Electrodiagnostic medicine is not only helpful for me to try to diagnose where a nerve may be pinched in the spine or in the arm or leg, but it can also be very helpful for surgeons planning the appropriate operative technique. A lot of times it can be unclear whether or not somebody's coming in with carpal tunnel syndrome or a radiculopathy (also known as a pinched nerve). Using an electromyography (EMG), we're able to distinguish between peripheral nerve entrapments or pinched nerves in the neck or elsewhere.
 Q: What can a patient expect the day of an electrodiagnostic study?
Adam Mullan, M.D.: On the day of an electrodiagnostic study, a technician will take their history and review their medications. Then I will come into the room and the patient will be examined, we’ll discuss some of the symptoms they are having, whether or not there's weakness, how long the symptoms have been present and then we'll prepare them for the test. We use stickers here in this clinic where we can actually record the electrical activity in the muscle. We then trace the nerves up the arm or the lower limb and use a stimulator to send an electrical impulse along the nerve. So the patient can expect a little bit of shocking during the procedure. It's not the most comfortable procedure but it is very well tolerated. Once nerve conduction study has been completed, we go ahead and use a needle to check a number of muscles that are usually predetermined or can vary based on the presenting complaints and that will typically be in the arm. Then we'll move our way up closer to the spine. Once all that has been completed, ideally were able to pinpoint if this is a lesion of a nerve distally in the wrist or elbow or more proximally up in the neck or lower back.
 Q: What can a patient expect after an electrodiagnostic study?
Adam Mullan, M.D.: Following the electrodiagnostic study, you typically can expect some soreness in the muscles that have been tested with the needle, but there are no lasting effects related to the study. I generally recommend patients use ice on areas that are sore or if they're capable taking Tylenol as needed for soreness.¬


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