Nerve Conduction Study Testing

Electromyography (EMG) is a separate entity. EMG is more subjective than nerve conduction study (NCS). There remains a debate about which patients should be subjected to EMG. Dr. Ichtertz feels that right now this is an argument more to support the practice of special interest groups rather than a practical matter for the benefit of the patient. He believes EMG is most appropriately used in the setting of patients with atypical sensory or motor dysfunction patterns. Sensory disturbance in association with weakness, more likely referable to more than one nerve, brings out the need to separate peripheral nerve entrapment from a ruptured disk in the neck or lower back. This is particularly important when physical examination alone doesn't allow the distinction. EMG is also considered painful by many of the patients who undergo it, even though very tiny sterile needles are used.

This technique involves inserting the needles into muscles of the limb being tested. It is usually performed on both right and left sides for comparison while monitoring the response of the muscles on an oscilloscope. There is also monitoring for an audible noise pattern created by the muscle stimulation while the examiner stimulates the peripheral nerves. This sounds a lot like listening to a Geiger counter. The findings can be used to narrow down and confirm a diagnosis and it is most useful in patients with other than straightforward nerve entrapment syndromes. Therefore, it is generally not necessary in someone with carpal or cubital tunnel syndrome.