When it is needed?1. A patient is complaining of numbness.2. A patient is complaining of tingling (paresthesias).3. A pati...
REACTION OF REGENERATION TEST F-G TEST Faradic response-innervated muscles Galvanic response- innervated /denervated W...
STRENGTH-DURATION CURVE
CHRONOXIE & RHEOBASE              1. The root word “rheo”               means current and “base”               means foun...
GALVANIC TWITCH-TETANUS RATIOTEST Continuous DC used1   :   3.5to 6.5 In denervation unity occurs, both happens with sa...
NERVE EXCITABILITY TEST MONOPHONIC PULSED CURRENT IS USED Between normal and affected side stimulation amplitude differe...
EMG-MUAP A motor unit is defined as one  motor neuron and all of the muscle fibers it  innervates. When a motor unit fire...
CMRR-common mode rejectionratioS1+n - S2+n   OUTPUT                        If output is less the CMRR is                 ...
 Biphasic/triphasic(90%)WAVEFORM    Polyphasic(10%)
EMG CIRCUIT                                           Filters-                                                        Rect...
ELECTRODES
MONOPOLAR NEEDLE
CONCENTRIC NEEDLE
BIPOLAR CONCENTRIC NEEDLE
NORMAL EMG
Spontaneous activity
ABNORMAL EMG
INDICATIONS Diseases of muscle,    Neuropathy nerve and NMJ           Myopathy                         Radiculopathy  ...
FINDINGS OF EMG fibrillation+ PSW-acute    High frequency unresolved nerve injury     dicharge- many causes Fasciculati...
FINDINGS OF EMG
Electrodiagnosis 1
Electrodiagnosis 1
Electrodiagnosis 1
Electrodiagnosis 1
Electrodiagnosis 1
Electrodiagnosis 1
Electrodiagnosis 1
Electrodiagnosis 1
Electrodiagnosis 1
Electrodiagnosis 1
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Electrodiagnosis 1

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Electrodiagnosis 1

  1. 1. When it is needed?1. A patient is complaining of numbness.2. A patient is complaining of tingling (paresthesias).3. A patient has pain.4. A patient has weakness.5. A patient has a limp.6. A patient has muscle atrophy.7. A patient has depressed deep tendon reflexes.8. A patient has fatigue.
  2. 2. REACTION OF REGENERATION TEST F-G TEST Faradic response-innervated muscles Galvanic response- innervated /denervated Wallarian degeneration and degeneration
  3. 3. STRENGTH-DURATION CURVE
  4. 4. CHRONOXIE & RHEOBASE  1. The root word “rheo” means current and “base” means foundation: thus the rheobase is the foundation, or minimum, current (stimulus strength) that will produce a response.  2. The root word “chrona” means time and “axie” means axis: chronaxie, then, is measured along the time axis and, thus, is a Duration that gives a response when the nerve is stimulated at twice the rheobase strength.
  5. 5. GALVANIC TWITCH-TETANUS RATIOTEST Continuous DC used1 : 3.5to 6.5 In denervation unity occurs, both happens with same intensity
  6. 6. NERVE EXCITABILITY TEST MONOPHONIC PULSED CURRENT IS USED Between normal and affected side stimulation amplitude difference chronoxie amplitude 0.3 ms 3.5mA 1.0 ms 2mA
  7. 7. EMG-MUAP A motor unit is defined as one motor neuron and all of the muscle fibers it innervates. When a motor unit fires, the impulse (called an action potential) is carried down the motor neuron to the muscle. The area where the nerve contacts the muscle is called the neuromuscular junction, or the motor end plate. After the action potential is transmitted across the neuromuscular junction, an action potential is elicited in all of the innervated muscle fibers of that particular motor unit. The sum of all this electrical activity is known as a motor unit action potential (MUAP)
  8. 8. CMRR-common mode rejectionratioS1+n - S2+n OUTPUT  If output is less the CMRR is high and the machine is more reliable
  9. 9.  Biphasic/triphasic(90%)WAVEFORM  Polyphasic(10%)
  10. 10. EMG CIRCUIT Filters- Rectifiers notch Preamplifier Amplifier –raw to Sound/oscSignal 1mV 50x filter, high 20-200x integrated illoscope pass, EMG lowpass
  11. 11. ELECTRODES
  12. 12. MONOPOLAR NEEDLE
  13. 13. CONCENTRIC NEEDLE
  14. 14. BIPOLAR CONCENTRIC NEEDLE
  15. 15. NORMAL EMG
  16. 16. Spontaneous activity
  17. 17. ABNORMAL EMG
  18. 18. INDICATIONS Diseases of muscle,  Neuropathy nerve and NMJ  Myopathy  Radiculopathy  Myelopathy
  19. 19. FINDINGS OF EMG fibrillation+ PSW-acute  High frequency unresolved nerve injury dicharge- many causes Fasciculation – problem  Large MUAP-chronic in nerve cell body or axonal injury due to new spinal cord terminal branches >5to7mV  Small MUAP-myopathy < 1mV
  20. 20. FINDINGS OF EMG
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