Today we will tell you what is the ENMG of the upper and lower extremities. In addition, you will learn how the procedure is carried out, in what cases it is assigned and how much it costs.
Electroneuromyography of the lower extremities (or upper) is a diagnostic method by which the functions of the peripheral nervous system are controlled. Using electrical impulses, specialists can quickly determine the location, extent and cause of violations of their conduct.
ENMG of the lower extremities is a well-proven method of functional diagnostics. Its main objectives are:
Electroneuromyography of the lower extremities (the price of this procedure is presented below) is often used treating doctor for setting and clarifying the diagnosis (a wide range of diseases of the peripheral nervous system). In addition, this method is used to determine the tactics of further therapy, the prognosis of the development of the disease.
So, ENMH of the lower extremities is performed in the following cases:
The diagnostic method presented includes:
After carrying out ENMG of the lower extremities (or upper) by the specialist, a conclusion is written where it is indicated degree, localization, as well as the pathogenetic type (if any) of the lesion of the peripheral nerve system.
It should be specially noted that the health of certain internal organs depends on the state of the individual elements of the nervous peripheral system. In this regard, the presented method is very often used to diagnose urological, endocrinological and other diseases.
Electroneuromyography involves the investigation of impulses along nerve fibers. As for electromyography, this is only a kind of registration of electrical activity, which arises from the reduction of muscle tissue.
Although in practice, the modern algorithm for such a study does not provide EMG implementation in isolation, that is, without studying the speed of carrying out pulses along nerve fibers.
That is why, when the attending doctor suggests the patient to do electromyography, the latter can safely be recorded on ENMG.
This procedure is carried out using a special device - the myograph. It registers the nature of contractions of muscle tissue and the degree of conduction of nerve fibers.
For this, the patient is placed on a special couch, and then applied to certain areas his feet sensors, which later evaluate and transmit to the screen the data on neuromuscular impulses.
In other words, such a device determines the state of the motor and sensory nerves of the legs, which further facilitates the diagnosis and the choice of the necessary therapy.
Electroneuromyography of the lower extremities, the price of which depends directly on the chosen method of diagnosis, is divided into three different types:
Thus, the use of all three methods makes it possible to quickly and reliably assess the state of the human neuromuscular system. In addition, these methods help to diagnose the stage, degree and level of the pathological process, as well as to determine the existing deviation.
Electroneuromyography is prescribed by doctors individually and depends on the delivered (often inconclusive) diagnosis. On average, this procedure lasts for 60 minutes.
In most cases, clinic specialists, where ENMG is performed, use only disposable electrodes for research. In this case, the conclusion is given to the patient on the hands on the day of the procedure.
How much does a procedure like lower limb ENMG cost? The price of this study varies depending on what kind of species it is used:
It should be specially noted that all these prices are conditional and can vary significantly in different medical institutions.
A source: http://.ru/article/146973/elektroneyromiografiya-enmg-nijnih-konechnostey-tsena-naznachenie-i-primenenie-kak-delayut-enmg
Modern medicine is far advanced in the study of the human body and in the identification of various pathologies. Early diagnosis saves not only health, but life.
The procedure consists of two methods:
If a pathology occurs, communication is disrupted, the signal is not transmitted correctly, and a feeling of numbness or tingling may appear. With complete absence of impulse, a case of limb paralysis can be identified.
ENMG of the lower extremities allows:
The procedure has many indications for use:
The procedure allows to reveal pathologies in the work of the nerves of the feet when:
The essence of this procedure is to secure the electrodes on the skin surface of the patient's legs. The method is a study of independent muscle contractions and evaluation of signals of the peripheral nervous system.
With this method, ENMG uses sensors with small needles that are inserted into the muscles of the legs. The study causes a slight discomfort, a feeling of itching or burning, but gives the most accurate result about the state of the nervous system.
Signals are sent to the muscles through the sensors, and the device registers forced contractions of the muscle tissue located far from the superimposed electrodes.
ENMG is also performed to stimulate the nerves of the upper extremities (fractures, stretching, pinched brachial and radial nerves).
There are no special features of preparation for ENMG, but the result can be partially affected by drinks with caffeine or energy. It is necessary to stop taking medication 3 days before the procedure.
The patient is warned about possible soreness or other unpleasant sensations during the operation of the device. It is also necessary for the patient to bring the results of tests, X-ray photographs or MRI to the doctor.
Before the ENMG, the patient is placed on a couch or occupies a semi-comfortable position. The electrode fixing points are smeared with alcohol.
Large sensors are applied to the muscles, and small ones to the tendons. For earthing, the electrode wicks are wetted with an isotonic solution.
To ensure conductivity, excess vegetation is removed, and the skin is lubricated with a special solution.
One of the sensors gives an impulse, the other records the signal and transfers it to the monitor.
To have a full understanding of the work of muscles and nerve endings, a comprehensive examination is conducted.
After the diagnostic manipulation, a small bruise or wound can remain due to the insertion of the electrode needle.
If during the procedure the patient experiences severe pain or has an allergic reaction to the gel, the examination is stopped until the symptoms are completely eliminated.
The duration of the ENMG procedure depends on the disease. Basically, it does not exceed an hour.
Data analysis should be done by a specialist. Usually the result is given on the same or the next day on the hands or sent to the patient's attending physician.
With the help of this procedure, it is possible to identify and localize inflammatory processes, as well as to see how treatment works for the restoration of nerve cells and the result of the therapy.
Basically the answer is represented by the following results:
Electroneuromyography of the lower extremities has general contraindications, which are discussed individually at the appointment of a neurologist:
Many state clinics conduct ENMG free of charge, for the procedure it is sufficient to have an MHI policy available.
In private medical centers, the price depends on the diagnosis and the region where the person lives.
With an accurate diagnosis, the prescribed treatment will be more effective, and the health of the damaged limb will recover faster.
A source: http://NogiNashi.ru/o-nogax/elektronejromiografiya-nizhnix-konechnostej.html
The diagnostic technique with the help of an electroneuromiograph allows you to assess the condition of muscles, as well as nerve endings, located in close proximity. This makes it possible to reveal their condition with high accuracy at the time of the study.
During the procedure, the peripheral nerve is stimulated by the electric pulse, after which the response of the muscle innervated by it is recorded by the apparatus. Electroneuromyography will allow:
In addition, it also reveals how much the speed of carrying out the impulses and the amplitude of their potential along the nerve end has been reduced.
There are two methods for conducting research using this device:
Diseases in which ENMG is necessary, have a fairly extensive list. Usually, the procedure is assigned in the following cases:
With the help of ENMG of the lower and upper extremities, the most accurate diagnosis of the following diseases is possible:
In such cases, the study allows you to accurately identify the damage, inflammation, as well as the place of squeezing nerves on the limbs.
In addition, you can determine whether the process of recovery of the nervous tissue is going on or if you need to take special medications.
In the study, the cutaneous electrodes are applied not simply at the site of the harassing muscle, but at points where the nerve fibers are closer to the skin.
A wide range of contraindications electroneuromyography has not.
But the needle type of the study is not recommended for patients with immune disorders, including HIV.
The procedure itself is not capable of affecting the patient, but the medical staff significantly increases the risk of infection.
Before the ENMG, special training is not required. But the results can affect some medicines (eg, anticholinergics or muscle relaxants).
The large fatty layer and the coagulation disorders are also dangerous. This is why, before starting the procedure, you will need mandatory counseling with the doctor.
Perhaps some drugs will need to be replaced, reduced weight or take some other measures.
In addition, it will be necessary to stop taking medications for a day, which can affect the transmission of nerve impulses. Immediately before the procedure, you must not eat for several hours.
At the beginning of the electroneuromyography, the patient is necessarily informed of all the sensations that can be expected.
The entire procedure is performed in the supine position, while the person should be completely relaxed.
As mentioned above, the needle type of procedure has fewer contraindications, but the cutaneous, although it provides a little less information, is less traumatic.
Cumulative electrodes are applied above the motor point of the muscle. Of these, the indifferent is adhered over the tendon, and the main one is above the abdomen of the muscle. Before applying, the skin must be rubbed with alcohol, and then a special gel is applied on it.
Between the two electrodes, which consist of a stimulating and regulating electrode, a special electrode is installed, acting as a grounding electrode. Before starting the test, the felt wicks are wetted in an isotonic solution (usually sodium chloride).
Thus the anode is fixed distally, and the cathode - above an impellent point.
When conducting ENMG, there may be a slight tingling and pain, but soon after the procedure they pass completely.
The following video shows the progress of electroneuromyography with a real patient:
In Moscow, research using an electroneuromyograph can be carried out in both private and public clinics. So, at the following addresses, you can get this service.
Medical state clinics offer patients to undergo electroneuromyography for free, but only under the condition of the MHI policy and the appropriate direction from the doctor for this procedure. In other cases it will be necessary to pay up to 4000 rubles.
To pass ENMG, you need to contact the polyclinics № 180, 31, 7, 12.
A source: http://www.neuroplus.ru/diagnostika/elektroneyromiografiya.html
ENMG is a complex study necessary to check the condition of the peripheral nervous system and muscles of the upper and lower extremities.
The method is based on an assessment of the level of their electrical activity. Electroneuromyography is used to diagnose neuromuscular, skeletal-muscular diseases and diseases of the nervous system.
The study helps to identify pathological changes in the early stages.
Muscles work on this principle: an impulse appears in the brain regions responsible for movements. Further, the brain transmits the signal through neurons, neural pathways, plexuses to the muscles. Special synapses transform the electronic form into a mechanical one, and the muscle is contracted.
In the presence of pathologies, this process is disrupted. The person feels fast fatigue, difficulty of movements, involuntary contraction of muscles.
During the procedure, a special device starts the impulse and checks the response of the body. This allows you to determine the following:
If there is damage to the nerve fibers, then the speed of the pulse along them slows down (the muscle contracts later and with less force than in a healthy person). If the disturbances occur in the muscles themselves, only the force of their contraction changes, the speed remains normal.
ENMG is carried out by two methods:
Modern methods of electroneutrography include both methods.
Electrical neuromyography of the hands and feet can be prescribed to persons who exhibit the following symptoms:
Indications for this method of research are pathological conditions and diseases:
Before conducting a study, the specialist should be warned about the presence of such conditions as:
If the cardiovascular system of the patient has undergone surgical treatment, then electrical impact on the left side of the body should be avoided. The results may be distorted in patients with excess fat in the study area.
ENMG is prohibited for people with epileptic seizures, mental disorders, severe hypertension and the presence of deep injuries and trophic ulcers on the skin.
The direction to the passage of ENMG can be written by such specialists as neurologist, neurosurgeon, endocrinologist, orthopedist and rheumatologist. A special preparation before the diagnosis is not required.
If the patient used drugs that reduce muscle tone and inhibit the carrying out of impulses, then for a day you need to stop taking them. Also, 4 hours before the procedure, you can not eat.
Depending on the disease, the study is conducted in two ways:
The local method allows you to explore different parts of the muscle, compared to the invasive one, which is able to test only one.
Electroneuromyography can help to identify the pathology of the peripheral nervous system at the initial stage. This makes it easier to treat the disease and avoid complications.
A source: http://spina-health.ru/enmg-chto-eto-takoe/
In the Israeli Center for Neurosurgery, Neuromed at the private clinic "Herzliya Medical Center" apply the most modern methods of diagnosing neurological disorders and diseases, including examination ENMG.
Electroneuromyography (ENMG) is a procedure aimed at quantifying the nerve impulse through neuromuscular fibers and determining the response to various types of stimulation.
The test provides the physician with objective data, allowing to make a medical decision regarding further actions.
ENMG examination in a clinical setting may include:
In the surgical aspect, electroneuromyography (ENMG) is called intraoperative monitoring.
Electromyography (EMG) is a study aimed at assessing the state of muscles and nerve cells that control them and are called motor neurons.
Motor neurons are conductors of electrical impulses that cause muscle contraction. EMG converts received signals into sounds, graphic images or numeric indices, deciphered by a doctor.
During the study, small electrodes are used to trap and transmit electrical impulses.
The conductivity of the nerves is examined by means of electrodes attached to the skin and measuring the speed and intensity of pulses transmitted between two or more regions. Needle-type electrodes are inserted into muscle tissue and record the electrical activity that forms in them.
According to the test results, the doctor can determine muscle or nervous dysfunction, as well as problems with the transmission of nerve signals to the muscles.
The attending physician prescribes the conduct of ENMG of the upper extremities or ENMH of the lower limbs, if the patient has symptoms that indicate the presence of nerve or muscle pathologies. Such signs include weakness in muscles, numbness, tingling, pain and muscle spasms, severe pain in the extremities.
EMG allows to confirm or exclude a number of pathologies, such as:
The study of nerve conduction gives doctors information on how well and how quickly the nerves in the patient's body transmit electrical impulses.
The test can be used to test various types of problems with the peripheral nervous system, which includes all the nerves in the body, except those that are in the brain and inside the spinal cord (they make up the central nervous system).
This study is conducted for various reasons, including:
The study of evoked potentials involves measuring electrical activity in the brain in response to stimulation of vision, hearing, or touch.
The stimuli that enter the brain through each of these senses cause the smallest electrical signals that pass through spinal cord to specific areas of the brain along the nerves, are captured by electrodes and transferred to a storage medium.
The study includes three main tests that allow you to evaluate the response to visual, auditory, electrical stimuli:
Examination of ENMG and all procedures included in this concept can be used to assess hearing and vision, especially in infants and children, as well as for diagnosis of diseases of the optic nerve, detection of tumors and other problems affecting the head and spinal brain. Also, the ENMG procedure of the limbs can be performed to assess brain function during coma, or for other reasons.
A source: http://www.neuro-center.ru/elektroneiromiografiya/
Due to the electroneuromyography, which is a whole complex of examinations, it is possible to get an overall picture of how the myofiber fibers and the peripheral NA are functional.
In this study, two diagnostic methods are combined:
The relationship between the peripheral and central HC is due to electric pulses transmitted along the nerve fibers from the brain to the spinal cord. Everything that a person feels is represented in the form of information data obtained with the help of receptors and transmitted to the brain.
When a person has a pathological condition, the movement of the electric impulse is violated, along with the information is perceived incorrectly.
For example, a person feels as if something is numb, tingles, or small ants creep in the problem area. Often, a condition is revealed when a person does not feel pain, does not hear well, there are problems with vision, smell.
If the path of impulse movement from the spinal cord or from the brain to the muscle fibers is damaged or broken, the patient then is immobile or his movements are inadequate. In this case, the person is completely or partially paralyzed, his muscles are weak.
For example, when the brain is examined, stimulation is obtained by nerve fibers responsible for hearing, vision, and the CNS response is analyzed.
The use of electroneuromyography (ENMG) helps inform the neurological pathology of the legs, arms, joint and muscular lesions most informatively.
Electroneuromyography of the upper and lower extremities reveals an early phase of pathology, so that the disease is cured faster.
No other survey will give a complete information picture of the functionality of axons, like electroneuromyography. This method determines the area of lesion of the nervous tissue, the severity of the pathology.
Another correctly conducted electroneuromyography determines the effectiveness of therapeutic measures.
When conducting electroneuromyography of the upper and lower extremities, there are 3 methods:
Electroneuromyographic examination of the lower and upper extremities is indicated for various neurological pathologies, including:
Also, electroneuromyography is not superfluous for symptomatology in the form of:
Contraindications to the diagnosis are the patient's epileptic seizures, mental disorders, hypertension.
Before diagnosis, the doctor must know whether the patient has heart disease, infectious diseases, is there a pacemaker device, is the patient not afraid of blood.
As a rule, the doctor determines the contraindications individually.
Electron neuromyography of special preparatory measures does not require.
But the patient is obliged to remember that the determination of the result is influenced by medicinal products that affect CNS, should also be excluded before the diagnostic procedure of drinking sweet cola, strong tea, coffee beverages.
Drugs are stopped taking a couple of days, and drinks that raise the general tone ─ for 3-4 hours before the start of diagnostic procedures. Only if these conditions are met, electroneuromyography will show reliable information.
Electroneuromyography lasts from half an hour to an hour. Here there is a dependence on the type of survey, how extensive it is.
The patient must either sit or sit. At a superficial kind of inspection morbidity is absent. It appears a little during the needle and stimulation type of examination.
The doctor determines the location of the location where the electrodes are attached. They are wiped with a solution that has a disinfectant effect, spread with a specific gel. When the electroneuromyography is completed, the patient may feel some muscle weakness.
The results obtained, when electroneuromyography is already performed, are deciphered only by an experienced specialist.
From these data, the doctor sees the reaction of nerve fibers from the signals acting on them.
Then the data is compared with the normal parameters, all possible deviations are detected, the doctor determines the final diagnosis on the basis of which the therapeutic measures are performed.
These diagnostic measures are absolutely safe. A small temporary discomfort delivers only a bruise of a small diameter in the area where the needle was inserted. Compliance with sterile conditions completely minimizes infectious complications.
The price of the survey directly depends on the type of research, the degree of complexity. Extended electroneuromyography is more expensive than the standard one. The cost, as a rule, conditional, in different medical institutions it is different.
A source: http://NashiNervy.ru/o-nervnoj-sisteme/chto-takoe-elektronejromiografiya-konechnostej.html
EMG of the lower and upper limbs consists of several stages, including the study of the degree of muscular excitability, the study of the neural muscular system, the study of the state of neurons in general, as well as a general analysis of the sensitivity of the nervous fibers. Electromyography of the lower extremities is a study that helps to identify the causes of muscle weakness legs, violation of the sensitivity of the lower limbs, the causes of walking disorders, the source of pain syndrome.
During the procedure, the stimulation of the peripheral nerve with an electrical impulse is performed, then the apparatus registers the response of the muscle that is innervated by this nerve.
Electromyography of the lower and upper extremities allows to diagnose and determine the stage of impaired peripheral nerve function, realizes the identification of tunnel syndromes, and also determines the nature of the pathological process - local or generalized.
It should be distinguished electromyography (EMG) and electroneuromyography (ENMG). EMG registers only electrical activity that appears as a result of muscle contractions.
EMNG, in turn, evaluates the conductivity of nerve fibers.
Nevertheless, electromyography is never carried out in an isolated manner and also assumes an estimate of the rate of advance of the pulse along nerve fibers. Therefore, these two concepts can be equated.
There are the following types of diagnosis, depending on how the electrodes are attached to the muscles:
Surface electromyography. Such a study is done by a non-invasive method, since electrodes for studying muscle potentials are fixed on the surface of the skin.
This method people tolerate well, while you can explore several muscle groups at the same time.
However, the surface method has a low sensitivity, therefore it is used only if there is no possibility to apply needle electromyography. Often this type of examination is assigned to children.
Needle electromyography. It is carried out with a thin needle electrode, which penetrates the muscle.
This study of an invasive nature is prescribed strictly according to strict indications.
The needle method allows to reveal the hiding negative changes in muscles with suspected neuronal damage.
Electromyography of the lower and upper extremities is prescribed in case of manifestation of muscle weakness. The patient has muscle spasms and cramps, numbness, decreased limb sensitivity, twitching, or neurological symptoms in osteochondrosis.
The study is also prescribed in the presence of certain diseases:
Neuritis is an inflammatory disease of the peripheral nerve, manifested by a pain syndrome throughout the nerve, a violation of sensitivity and muscle weakness in the innervated area.
When neuritis diagnosis is carried out by a neurologist in the process of inspection and performing special functional tests.
Treatment with neuritis should include antibiotics, antiviral and vascular drugs, physiotherapy, massage, exercise therapy, anti-inflammatory and decongestants.
It is also worthwhile to separate neuropathy of the femoral nerve. Very often neuropathy of the femoral nerve is confused with vertebrogenic pathology.
Neuropathy of the femoral nerve - defeat of the nerve of the hip, which occurs for various reasons and leads to a violation of the passage of nerve impulses along it.
Clinical manifestations may depend on the nature of the lesion and represent a pain syndrome in the region of the thigh and lower leg, difficulty in walking. The pathology of the femoral nerve is quite common and has long been known, however, this disease remains poorly understood.
Neuropathy of the femoral nerve is caused by compression due to muscle spasm or hemorrhage in the lumbar muscle, which occurs during overload or damage. Diagnosis of the pathology of the femoral nerve is usually carried out using electromyography, rarely x-ray.
Contraindications for this study include mental disorders, severe forms of hypertension, epilepsy, attacks of angina pectoris, the use of a pacemaker patient. The procedure is undesirable to pass if the patient on the lower and upper extremities have unhealed ulcers, deep burns, purulent wounds.
No special preparatory measures are required before the diagnosis.
Nevertheless, the day before the study of the lower and upper extremities, you should stop taking muscle-tapering drugs (muscle relaxants).
Also, do not take acetylcholine blockers and drugs that directly affect the passage of nerve impulses.
For a couple of hours before the procedure, doctors are not advised to eat. The doctor should carefully analyze the patient's medical history, as needle electromyography requires that he does not have a clotting disorder.
The patient should sit on the couch, lie on his back and completely relax.
When carrying out the needle technique, a special concentric electrode is inserted into the muscle of the upper or lower extremities by means of a needle.
The procedure will bring a little pain, but holding it will give the doctor quite a vast layer of information.
When performing a surface view of electromyography, a sensor electrode is applied to a specific area of the skin.
Its carrying out gives less information, but this procedure does not cause painful sensations (only a slight tingling).
The condition of the peripheral nerves is analyzed and displayed as data on the neuroimiograph monitor - such a special analyzer device. In particular, the speed of the passage of the pulse, the amplitude of the muscle potential,
Deciphering the graphic data is only the specialist-neurologist.The procedure for the time takes, as a rule, not more than an hour, and the patient is given the conclusion on the same day.
A source: http://drpozvonkov.ru/diagnostika/mielografiya/emg-nizhnih-konechnostey.html
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