Subject: Re: EMG test
Forum: The Neurology and Neurosurgery Forum
Topic Area:
Posted by CCF Neurology MD on January 24, 1998 at 04:54:49:
In Reply to: EMG test posted by Nidal Issa on January 23, 1998 at 18:56:25:

: Hello

What is an EMG test ? can it tell if a root
nerve is damaged or is it still good but
compressed?

Also can triger point injections if the nerve is
encapsulated with scar tissue?

what other methods to relief the nerve from scar
tissue? tell me all my options .. please

REGARDS

Dear Nidal:

The conventional EMG test consists of two parts, the nerve conduction study and the needle examination. The first part involves delivering electrical shocks to nerves and studying how they conduct signals. The second part involves observation of electrical activity inside various muscles of one or more extremities with the help of a small needle electrode which is inserted at various sites. The EMG examination is the most definitive test for diagnosing damage or compression of peripheral nerves or nerve roots. The test also has several other applications, such as the study/diagnosis of diffuse nerve or muscle disease.
The EMG examination is performed by neurologists with special expertise in the speciality. Each test has to be specifically tailored to answer the specific diagnostic question for each individual patient. An inappropriately designed study may not answer the question at hand at all.
The EMG test is not pleasant for the patient, but it is only the exceptional patient who can not tolerate it.
The distinction between "damaged" = axonal and just "compressed" = ?demyelinating nerve lesions is important and can be addressed by an EMG.

Trigger points (as a sign) usually indicate the diagnosis of what some authorities call "fibromyalgia". This is a somewhat controversial disease entity. The conventional EMG examination is NORMAL in fibromyalgia, and is thus helpful in excluding more serious neuromuscular conditions (such as myositis, nerve/root compression, and others) that are in the clinical differential diagnosis of fibromyalgia.
There are indeed some experts who believe that trigger point steroid/local anesthetic injections are effective in the treatment of fibromyalgia, but this is not a universal opinion.

Nerve or nerve root compression from scarring or otherwise is not a part of the picture of fibromyalgia. Such compression, if present and demonstrated on EMG, can potentially benefit from surgical decompression or other local measures.

I suggest that you seek an opinion from a neuromuscular specialist in an academic neurology department near you. If you live near Cleveland, I recommend Drs. Shields, Levin, or Mitsumoto at the Cleveland Clinic. The numebr to call for appointments is (216)444-5559, or (800)223-2273 toll-free.
Good luck!

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