1Electroneuromyography (ENMG) of the lower extremities: price, purpose and application. How do ENMG?
- 1.1General information
- 1.2What is it assigned for?
- 1.3In which cases should be conducted?
- 1.4What does the ENMG of the lower extremities include?
- 1.5Another area of application
- 1.6What is the difference between emg and enmg?
- 1.7Electroneuromyography of the lower extremities: how do they do it?
- 1.8Types of examination
- 1.9Duration of the procedure
- 1.10The cost of electroneuromyography
2Enmg of the lower extremities: what is it, the price, how do the myography
- 2.1What is the essence of the methodology
- 2.2The aims and objectives of the method, the testimony
- 2.3Types and stages of the study
- 2.7Preparation for research
- 2.8Carrying out the Engm and the duration of the procedure
- 2.9Expand Results
- 2.10Contraindications to the diagnosis
- 2.11Cost of enmg
- 3.2Indications for the procedure
- 3.3Electroneuromyography of the upper and lower extremities
- 3.7Electroneuromyography in Moscow: addresses and prices
- 4What is it - ENMG of the upper and lower extremities
- 5.2Reasons for the study of ENMG
- 5.3Study of nerve conduction
- 5.4Study of evoked potentials
6Electroneuromyography of the lower and upper extremities, stimulation, needle
- 6.1What is the essence of
- 6.2Why Use
- 6.3Types of surveys
- 6.4For what is shown electroneuromyography
- 6.5Contraindications to the diagnosis
- 6.6How to prepare yourself
- 6.7How to conduct diagnostics
- 6.8About decoding
- 6.9About complications
- 6.10How much is
7Electromyography of lower extremities
- 7.1Types of electromyography
- 7.2Indication: spasm, cramps, numbness
- 7.3Contraindications for mental disorders
- 7.4Preparation for the procedure
- 7.5Conducting research
Electroneuromyography (ENMG) of the lower extremities: price, purpose and application. How do ENMG?
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.
What is it assigned for?
ENMG of the lower extremities is a well-proven method of functional diagnostics. Its main objectives are:
- the definition of the topic and the nature of the damage, as well as the prevalence of the process itself;
- determination of the degree of disturbances in work or damage to the neuromuscular system;
- determination of severity of pathological process.
In which cases should be conducted?
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:
- traumatic injuries of the radial, ulnar, median, femoral, large and peroneal nerve, as well as other nerves of the human peripheral system;
- with plexopathy (that is, lesions of the nerve plexuses of the anterior spinal branches, in which sensitive, trophic and motor disorders are observed);
- with polyneuropathy of different origin:
- - with post-diphtheria, postvaccinal polyneuropathy;
- - with lead, chlorophosic polyneuropathy (i.e., lesion of motor nerve fibers);
- - with dismetabolic polyneuropathy, which can occur due to the presence of somatic diseases, that is, diabetes, liver and kidney disease, as well as the digestive canal, etc .;
- - with diabetic polyneuropathy;
- - with polyneuropathy, which arose against the background of vasculitis or systemic diseases of connective tissue.
- neural amyotrophy (Charcot-Marie-Toot disease);
- tunneling neuropathy;
- osteochondrosis of the spine, which is accompanied by the presence of radicular syndrome;
- syringomyelia, that is, a chronic disease of the nervous system, which is accompanied by the appearance of voids in the spinal cord.
What does the ENMG of the lower extremities include?
The diagnostic method presented includes:
- hardware assessment of the performance of sensitive fibers of the peripheral system;
- neurological examination;
- hardware evaluation of the performance of motor fibers of the peripheral system;
- clarification of the degree of damage to muscle tissue and the extent of their involvement in the pathological process (carried out with the help of a needle electrode);
- analysis of all information received, as well as writing an opinion.
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.
Another area of application
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.
What is the difference between emg and enmg?
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.
Electroneuromyography of the lower extremities: how do they do it?
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.
Types of examination
Electroneuromyography of the lower extremities, the price of which depends directly on the chosen method of diagnosis, is divided into three different types:
- Needled ENMG. This procedure is based on the study of the functional activity of muscle tissue. It is carried out with the help of special needle electrodes, which are injected directly into the muscles.
- Surface ENMG. This method reveals the effectiveness of the passage of nerve impulses along nerve peripheral fibers. This is done with the help of surface electrodes, which are superimposed on certain parts of the body and skin areas. This method of investigation allows you to record the activity of muscle tissue with their arbitrary reduction.
- Stimulating ENMG. This procedure is similar to the surface procedure. However, it requires simultaneous stimulation of nerve fibers, which are at a remote distance from the recording electrodes.
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.
Duration of the procedure
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.
The cost of electroneuromyography
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:
- Stimulation standard electroneuromyography, including needle - about 3000-3500 Russian rubles.
- Extended electroneuromyography (1 degree of complexity), including needle - about 4000 Russian rubles.
- Electroneuromyography expanded 2nd degree of complexity, including needle - about 5000 Russian rubles.
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
Enmg of the lower extremities: what is it, the price, how do the myography
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.
What is the essence of the methodology
The procedure consists of two methods:
- EMG (neuromyography) - determines the electrical impulse of muscle tissue in motor activity and rest;
- ENG (electroneurography) - allows you to know the speed of the signal through the nerves.
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.
The aims and objectives of the method, the testimony
ENMG of the lower extremities allows:
- to assess the contractile ability of the muscle in response to stimulation: this is how diagnostics are carried out at the initial stages;
- signal quality and its passage through the neural pathway to assess the development of pathological symptoms;
- velocity of nerve impulses;
- The presence of axon pathology and the source of the problem, as well as the degree of its complexity.
The procedure has many indications for use:
- congenital or acquired disorders of the processes of nervous innervation (after trauma, diabetes, other diseases);
- concussion of the brain, bruises;
- tunnel syndrome;
- infringement of the median nerve;
- diseases of nerve fibers after a tumor, radiation therapy;
- neuritis of various etiologies;
- vibration disease;
- syringomyelia, pathology of the spinal cord;
- peptic ulcer of the skin;
- multiple sclerosis;
- deformation of bones and joints;
- Parkinson's disease;
- heightened sensitivity of the hands or feet to cold.
The procedure allows to reveal pathologies in the work of the nerves of the feet when:
- postinjection complications, improper sitting, trauma from falling;
- squeezing due to a hernia;
- stagnation of blood due to thrombosis;
- intensive physical exercises;
- squeezing of small pelvic vessels;
- clubfoot and shin pain;
- trauma from walking on high heels;
- pathologies after dislocations, sprains and fractures of the foot.
Types and stages of the study
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).
Preparation for research
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.
Carrying out the Engm and the duration of the procedure
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:
- The M-response is the complex muscle potential that arises when an electrical signal acts on them.
- F-wave - the reaction of muscle tissue to the stimulus. If the signal is violated, then this indicates problems of nerve endings in the spinal cord.
- H-reflex. Appears when the tibial nervous innervation is stimulated. He speaks about the absence of pathologies in this zone.
Contraindications to the diagnosis
Electroneuromyography of the lower extremities has general contraindications, which are discussed individually at the appointment of a neurologist:
- the presence of trophic ulcers on the legs;
- sufficiently severe damage to the skin;
- wearing a pacemaker and endoprosthesis;
- cardiovascular diseases, hypertension;
- pregnancy, lactation;
- fever, SARS;
- schizophrenia, epilepsy (the procedure can cause an exacerbation);
- bleeding disorder.
Cost of enmg
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.
- The standard procedure using surface and needle techniques is around , 00 rubles.
- Extended ENMG - 4000 - 4500 rubles.
- The procedure of the 2nd degree of complexity is 5-7 thousand. rubles.
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:
- Assess the ability of muscle fibers to contract under the influence of an irritating factor;
- Measure the number and speed of passing the impulses along the nerves;
- Identify the site of damage to the nervous tissue.
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:
- Needle. The electrode looks like a small needle and is inserted into the muscle. The method is most effective, although it can bring to the patient insignificant unpleasant sensations;
- Superficial. The technique does not bring painful sensations, since measurement of the indices is made by applying electrodes to the skin of the skin.
Indications for the procedure
Diseases in which ENMG is necessary, have a fairly extensive list. Usually, the procedure is assigned in the following cases:
Electroneuromyography of the upper and lower extremities
With the help of ENMG of the lower and upper extremities, the most accurate diagnosis of the following diseases is possible:
- Polyneuropathy of various forms;
- Compression or damage to nerve endings;
- Tunnel wrist syndrome;
- Peripheral neuropathy;
- Protrusion of the intervertebral disc.
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:
Electroneuromyography in Moscow: addresses and prices
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.
- Clinic of restorative neurology. Located on the street. Marshal Vasilevsky, d. 13, near the metro (art. Shchukinskaya). The cost will be set depending on the type of illness, but usually it does not exceed 5000 rubles.
- Real-Clinic conduct research of varying degrees of complexity. Cost - up to 5 thousand. rubles. At the same time, it is possible to pay for the procedure on credit. The clinic is located at Moskovsky Prospekt, 121A, pr. Engels, 22, Kolomyazhsky Ave, 28, and also in St. Petersburg.
- Physio-honey is located in Bibirevo, 17 and offers similar services, but at a price that will be somewhat cheaper. So, different types of electroneuromyography will cost from 1200 to 6000 for the most complex operation.
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
What is it - ENMG of the upper and lower extremities
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.
- The essence of the method
- Indications and contraindications
- Conducting research
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:
- the level of reduced muscle response to the signal;
- number of functioning motor units;
- the speed of the pulse;
- place of nerve damage.
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:
- 1. Electromyography - checking the electrical activity of muscles in a state of contraction or rest.
- 2. Electro-neurology - allows you to assess how fast the pulse passes through the nerves.
Modern methods of electroneutrography include both methods.
Electrical neuromyography of the hands and feet can be prescribed to persons who exhibit the following symptoms:
- fast fatigue when walking, which previously was not;
- swelling of the lower extremities;
- heightened sensitivity of the feet to low temperatures;
- tingling sensations and sensory disorders in the limbs;
- involuntary jerking in the limbs;
- pain during exercise;
- painful sensations when lifting hands;
- ulcers on the skin.
Indications for this method of research are pathological conditions and diseases:
- various types of neuropathies and neuritis (including diabetic, alcoholic and others);
- intervertebral hernia;
- cervical and lumbar osteochondrosis;
- recent injuries of the back, neck, head;
- inflammatory and toxic lesions of the nervous system (poliomyelitis);
- myasthenia gravis and other muscle pathologies;
- multiple sclerosis;
- Parkinson's disease;
- a microstroke;
Before conducting a study, the specialist should be warned about the presence of such conditions as:
- problems with blood coagulability;
- presence of a pacemaker and heart problems.
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:
- Invasive method. It is an easy way, not bringing pain and discomfort. The patient should lie down on the couch and relax. Bipolar and unipolar electrodes are connected to the apparatus and applied to the skin. Further, the machine captures the impulses that occur with arbitrary contractions of the muscles of the arms and legs. The invasive method is less sensitive, as it examines only the muscles located next to the skin. Because of its painlessness, it is used for children and people with low pain syndrome. Since invasive electroneuromyography has no contraindications, it is resorted to in case if for any reason it is not possible to conduct the study by a local method.
- Local method. It is also called acicular, since a special electrode, resembling a thin needle, is inserted into the muscle of the patient. The area of the future puncture is disinfected and treated with a special soap. After that the expert makes a puncture. During the procedure, the patient feels minor pain. The electrodes are connected to a device that fixes electrical impulses. The results are displayed on the monitor and tape in the form of a graph similar to a cardiogram. At first the patient is without movement, then the procedure is performed with spontaneous-slow muscle contraction and in tone. Diagnosis lasts 30-60 minutes, depending on the number of muscles being checked.
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:
- Electromyography (EMG);
- Study of nerve conduction (NCS);
- Investigation of evoked potentials (EPS).
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.
Reasons for the study of ENMG
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:
- muscle disorders;
- myasthenic nerve disorders outside the spinal cord (peripheral nerves);
- muscular dystrophy and polymyositis affecting the connection between nerves and muscles;
- carpal tunnel syndrome or peripheral neuropathies affecting motor neurons in the brain and spinal cord;
- amyotrophic lateral sclerosis or poliomyelitis affecting the nerve roots;
- a hernia of the intervertebral disc.
Study of nerve conduction
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:
- Assessment of nerve damage after injury;
- assessment of the presence of nerve damage caused by diabetes and other conditions;
- checking the presence of pathologies that affect the nervous system;
- detection of affected nerves, leading, for example, to carpal tunnel syndrome.
Study of evoked potentials
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:
- Visually induced reaction (VER). The test allows you to diagnose problems with nerves that affect your eyesight. Electrodes are placed along the scalp. The patient is asked for some time to look at the flashes located on the screen in a staggered order, while electrical signals in the brain are recorded on the carrier and subsequently interpreted doctor.
- Auditory Reaction (BAER). The test allows to diagnose problems of auditory nerves and can indicate the presence of a brainstem tumor and multiple sclerosis. Electrodes are placed on the scalp and ear lobes. Hearing stimuli, such as sounds and pressures, affect the ear, and at this time, electrical signals are recorded.
- Somatosensory evoked potentials (SSER). The test allows you to detect problems with the spinal cord, as well as determine the cause of numbness and weakness in the limbs. During the examination, the electrodes are attached to the wrist, back of the knee or other places. A weak electrical stimulus is transmitted through electrodes attached to the scalp and determining the amount of time needed for the current to flow through the nerve to the brain.
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/
Electroneuromyography of the lower and upper extremities, stimulation, needle
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:
- electromyographic examination, which is a hardware way of examining how biologically and electrically active are muscle fibers, the charges of the unit creating the motion are also determined in a quiet state, and when it is decreasing. It is well known that different muscles consist of a certain number of myofibers, ranging from 7-8 to 2000, depending on the type of muscle fiber. When synchronizing the contractions of myofibers, there are all conditions for the appearance of the charge of the unit creating the motion, it indicates the sum of the charges in the myofilaments. The graphical representation of charges can vary, depending on the pathology of the peripheral NA. Based on these data, we can conclude on the functioning of the central nervous system and the PNS. Amplitude oscillatory motion of the charge in the muscles is a few millivolts, and they last no more than 24-25 milliseconds. Electromyographic apparatus is captured, fixed on a photographic film in the form of a curved line;
- electroneurographic examination, allowing you to find out at what speed an electrical impulse is carried out along nerve fibers.Peripheral and CNS are closely interrelated with muscles. The signal is transmitted from the nerve fibers to the brain and spinal cord, and the reverse process is also performed. When such a survey is carried out, the peripheral nerve is stimulated, the extent to which it is active in all areas where stimulation occurs is measured.
What is the essence of
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.
Types of surveys
When conducting electroneuromyography of the upper and lower extremities, there are 3 methods:
- during surface electromyography, impulse transmission is carried out by means of electrodes attached to the skin of the hands and feet. With this non-invasive method, stimulation is not performed. Such electroneuromyography is simple, often used in medical examinations;
- needle electroneuromyography is an invasive method in which needle electrodes are injected into muscle tissue, it is determined how active it is;
- The stimulatory type differs from the superficial type in that the nerve fibers are stimulated. Electrodes of cutaneous, acicular type are used.
For what is shown electroneuromyography
Electroneuromyographic examination of the lower and upper extremities is indicated for various neurological pathologies, including:
- radiculitis, characterized by radicular infringement of nerves of the spinal cord. They occur in the cervical, thoracic, lumbar spine;
- tunnel carpal tunnel syndrome, in which the median nerve is infringed by the carpal bones with the tendons;
- neuropathy diagnoses that occurred before the birth of a person or functional disorders of the nervous tissue due to injuries, infections, diabetes;
- a condition that is not amenable to cure, in which it is affected by the dorsal with oblong brain in the form of amyotrophic lateral sclerosis;
- plexopathy manifestations, in which the nerve plexus is affected by trauma, malignant neoplasm, radiation exposure, which can make a person paralyzed.
Also, electroneuromyography is not superfluous for symptomatology in the form of:
- tingling sensations or swelling of the legs;
- soreness with sluggish movements of fingers;
- lethargy of the lower limbs, as if the legs were very tired;
- skin ulcers;
- high cold sensitivity of the legs and hands;
- asymmetry of motion;
- bone and joint deformities.
Contraindications to the diagnosis
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.
How to prepare yourself
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.
How to conduct diagnostics
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.
How much is
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
Electromyography of lower extremities
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.
Types of electromyography
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.
Indication: spasm, cramps, numbness
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:
- spinal cord injuries;
- presence of tunnel syndromes;
- with neuritis;
- injuries of peripheral nerves;
- polyneuropathy of various origin;
- a microstroke;
- multiple sclerosis;
- brain concussion;
- neuropathy of the femoral nerve;
- Parkinson's syndrome;
- residual manifestations of poliomyelitis;
- myasthenia gravis.
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 mental disorders
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.
Preparation for the procedure
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