Neurol Clin N Am 20 (2002) 605 617 Index Note: Page numbers of article titles are in boldface type. A ALS. See Amyotrophic lateral sclerosis (ALS) Amyotrophic lateral sclerosis (ALS) active denervation changes in, 541 approach to patient with, 527 555 chronic denervation changes in, 541 547 described, 527 diagnosis of, 528 531 differential diagnosis of, 530, 547 551 electrodiagnostic approach to overview of, 551 552 electrophysiologic diagnostic criteria in, 538 541 electrophysiologic evaluation in, 531 547 fasciculation potentials in, 547 incidence of, 527 motor conduction studies in, 533 535 motor unit number estimate in, 535 536 needle electrode examination in, 536 538 nerve conduction studies in, 531 532 repetitive nerve stimulation in, 535 sensory conduction studies in, 532 533 survival rates with, 527 Amyotrophy monomelic benign, 548 549 Arm/forearm median neuropathy in approach to patient with, 460 462 Axillary neuropathies approach to patient with, 454 455 B Benign monomelic amyotrophy, 548 549 Botulism electrodiagnostic approach to findings in, 580 581 0733-8619/02/$ - see front matter Ó 2002, Elsevier Science (USA). All rights reserved. PII: S 0 7 3 3-8 6 1 9 ( 0 2 ) 0 0 0 0 5-1
606 Index / Neurol Clin N Am 20 (2002) 605 617 Brachial plexopathy pathophysiologic subtypes of electrodiagnostic manifestations of, 429 434 approach to patient with, 423 450 Brachial plexus anatomy of, 424 428 electrodiagnostic assessment of, 435 436 approach to, 446 450 elements of assessment of, 436 445 axillary nerve, 442 C5 APR, 438 C6 APR, 438 439 C7 APR, 439 C8 APR, 439 440 lateral cord, 442 lower trunk, 442 medial cord, 442 median nerve, 443 middle trunk, 441 musculocutaneous nerve, 442 443 posterior cord, 442 radial nerve, 443 T1 APR, 440 ulnar nerve, 443 upper trunk, 441 assessment of MABC nerve, 443 445 lesions of classification of, 428 429 Bulbospinal neuronopathy, 550 C Central nervous system (CNS) disorders evaluation of needle EMG in, 394 395 CNS. See Central nervous system (CNS) Complex repetitive discharges spontaneous activity on needle EMG generated from muscle fibers and, 373 374 Congenital myasthenic syndromes electrodiagnostic approach to findings in, 581 583 Cramp discharges spontaneous activity on needle EMG generated from nerve/motors neurons and, 378 379
Index / Neurol Clin N Am 20 (2002) 605 617 607 D Distal superficial peroneal mononeuropathy approach to patient with, 492 E Elbow ulnar neuropathy at approach to patient with, 469 473 weakness about approach to patient with, 455 456 Electromyography (EMG) for radiculopathy approach to patient with, 397 421. See also Radiculopathy(ies) in myopathies, 596 601 laboratory report in, 297 302 needle. See Needle electromyography (EMG) overview of, 291 303 procedures for, 294 296 referral process for, 293 294 scope of, 292 293 single-fiber in neuromuscular junction disorder, 566 569 terminology associated with, 291 292 EMG. See Electromyography (EMG) Endplate spikes in spontaneous activity on needle EMG generated near neuromuscular junction, 369 Extremity(ies) lower. See Lower extremities upper. See Upper extremities F F response, 345 353. See also F waves analysis of, 341 349 clinical application of, 350 353 physiology of, 341 349 technique of, 349 350 F waves. See also F response vs. H reflexes, 345 Fasciculation potentials spontaneous activity on needle EMG generated from nerve/motors neurons and, 376 Femoral mononeuropathy approach to patient with, 493 496
608 Index / Neurol Clin N Am 20 (2002) 605 617 Fibrillation potentials spontaneous activity on needle EMG generated from muscle fibers and, 369 371 Finger drop approach to patient with, 457 460 Foot pain/numbness of approach to patient with, 488 493 distal superficial peroneal mononeuropathy, 492 493 tarsal tunnel syndrome, 488 489 anterior, 490 492 weakness of approach to patient with, 479 488 peroneal mononeuropathy, 480 486 sciatic mononeuropathy, 486 488 Forearm/wrist/hand pain and weakness/numbness in approach to patient with, 461 475 G Genitofemoral mononeuropathy approach to patient with, 499 500 Gluteal mononeuropathy approach to patient with, 497 Groin numbness of approach to patient with, 497 500 H H reflex(es), 339 360 clinical uses of, 343 345 normal findings in, 343 physiology of, 339 342 recording technique in, 342 343 vs. F waves, 345 Hand(s) weakness/numbness in approach to patient with, 473 475 I Iliohypogastric mononeuropathy approach to patient with, 499 500 Ilioinguinal mononeuropathy approach to patient with, 499 500 Inclusion body myositis, 550 551
Index / Neurol Clin N Am 20 (2002) 605 617 609 L Lambert-Eaton myasthenic syndrome electrodiagnostic approach to findings in, 577 580 Lateral femoral cutaneous mononeuropathy approach to patient with, 497 498 Leg(s) weakness of approach to patient with, 493 497 femoral mononeuropathy, 493 496 gluteal mononeuropathy, 497 obturator mononeuropathy, 496 497 Long thoracic neuropathies approach to patient with, 452 Lower extremities mononeuropathy of approach to patient with, 479 501. See also specific site, e.g., Foot foot pain/numbness, 488 493 foot weakness, 480 488 groin and thigh numbness, 497 500 introduction to, 479 proximal leg weakness, 493 497 M Median neuropathy at wrist approach to patient with, 463 468 in arm/forearm approach to patient with, 461 462 Meralgia paresthetica approach to patient with, 497 498 Mononeuropathy(ies) distal superficial peroneal approach to patient with, 492 493 femoral approach to patient with, 493 496 genitofemoral approach to patient with, 499 iliohypogastric approach to patient with, 499 500 ilioinguinal approach to patient with, 499 500 lateral femoral cutaneous approach to patient with, 497 498
610 Index / Neurol Clin N Am 20 (2002) 605 617 Mononeuropathy(ies) (continued ) obturator approach to patient with, 497 498 peroneal. See Peroneal mononeuropathy sciatic approach to patient with, 486 488 of lower extremities approach to patient with, 479 501. See also specific type and Lower extremities, mononeuropathy of,, approach to patient with of upper extremities approach to patient with, 451 478. See also specific type and Upper extremities, mononeuropathy of, Motor conduction studies in ALS, 533 535 Motor neuron disease. See also specific disease, e.g., Amyotrophic lateral sclerosis (ALS) approach to patient with, 527 555 Motor unit action potentials (MUAPs) in myopathies, 594 595 voluntary needle EMG examination of, 380 395. See also Needle electromyography (EMG), in voluntary MUAP evaluation Motor unit number estimate in ALS, 535 536 Multifocal motor neuropathy with conduction block, 549 Musculocutaneous neuropathies approach to patient with, 455 456 Myasthenia gravis electrodiagnostic approach to findings in, 569 576 Myasthenic syndrome congenital electrodiagnostic approach to findings in, 581 583 Myokymic discharges spontaneous activity on needle EMG generated from nerve/motors neurons and, 378 Myopathy(ies) approach to patient with, 587 603 differential diagnosis of, 587 590 electrodiagnostic studies in, 593 596
Index / Neurol Clin N Am 20 (2002) 605 617 611 EMG patterns in, 596 601 laboratory testing in, 590 593 quantitative studies in, 595 596 signs and symptoms of, 587 590 Myositis inclusion body, 550 551 Myotonic discharges spontaneous activity on needle EMG generated from muscle fibers and, 374 376 N Needle electrode examination in ALS, 536 538 Needle electromyography (EMG) abnormal patterns of, 361 396 demanding nature of, 361 equipment in, 362 363 examination using, 362 364 fundamentals of, 361 396 in neuromuscular junction disorder, 565 in myopathies, 594 in voluntary MUAP evaluation, 380 395 abnormal findings acute myopathic, 392 acute neuropathic axonal loss, 389 390 chronic myopathic, 392 chronic neuropathic axonal loss, 390 391 CNS disorders, 394 395 myopathic end stage, 392 neuromuscular junction disorders, 393 394 neuropathic demyelinating lesions, 391 patterns of, 388 395 reinnervation following severe denervation, 393 firing pattern, 386 388 morphologic aspects, 382 385 normal findings, 382 388 physiologic aspects, 381 382 stability in, 385 386 insertional activity on, 364 needle electrode in, 362 363 normal patterns of, 361 396 procedure for, 363 364 scope of, 292 spontaneous activity on, 364 380 analysis of, 365 369 firing characteristics in, 368 369 generated from muscle fibers, 369 376
612 Index / Neurol Clin N Am 20 (2002) 605 617 Needle electromyography (EMG) (continued ) complex repetitive discharges, 373 374 fibrillation potentials, 369 371 myotonoic discharges, 374 376 positive sharp waves, 371 373 generated from nerve/motor neurons, 376 380 cramp discharges, 378 379 doublets, 17, 376 fasciculation potentials, 376 multiplets, 17, 376 myokymic discharges, 378 neuromyotonic discharges, 379 380 triplets, 17, 376 generated near neuromuscular junction, 369 endplate spikes in, 369 morphology of, 365 368 role of, 364 365 stability of, 368 Nerve conduction studies (NCS), 305 337 amplitude in, 310 area in, 313 combined patterns in, 323 324 components assessed in, 310 313 conduction block pattern in, 316 320 conduction failure pattern in, 315 316 conduction velocity in, 312 313 differential slowing in, 320 321 duration of, 311 focal nerve lesion pathophysiology of, 313 324 focal slowing in, 322 323 in ALS, 531 534 in neuromuscular junction disorder, 565 in myopathies, 593 595 in radiculopathy, 399 405 interpretation of, 324 325 latency of, 311 312 localization by, 326 336 anatomy factor in, 331 332 duration factor in, 335 in focal nerve injuries, 325 326 nerve fascicle factor in, 333 335 nerve fiber localization, 336 pathway localization, 336 point localization, 327 segment localization, 327 330 severity factor in, 332 333 scope of, 292 standard vs. nonstandard, 313
Index / Neurol Clin N Am 20 (2002) 605 617 613 technical aspects of, 309 310 types of, 305 313 Nerve/motor neurons spontaneous activity on needle EMG generated from, 376 380 Neuromuscular blocking defined, 567 Neuromuscular jitter defined, 567 Neuromuscular junction described, 557 558 diseases of, 549 550 spontaneous activity on needle EMG generated near, 369 Neuromuscular junction disorders electrodiagnostic approach to, 557 586. See also specific approaches, e.g., Repetitive nerve stimulation, in neuromuscular junction disorder findings in, 569 583 needle EMG in, 393 394, 565 nerve conduction studies in, 565 repetitive nerve stimulation in, 558 565 rapid, 562 565 slow, 560 562 single fiber EMG in, 566 569 strategy in, 583 585 Neuromyotonic discharges spontaneous activity on needle EMG generated from nerve/motors neurons and, 379 380 Neuron(s) nerve/motor spontaneous activity on needle EMG generated from, 376 380 Neuronopathy bulbospinal, 548 Neuropathy(ies) axillary approach to patient with, 455 456 median at wrist approach to patient with, 462 468 in arm/forearm approach to patient with, 460 462 musculocutaneous approach to patient with, 455 456 radial approach to patient with, 457 461
614 Index / Neurol Clin N Am 20 (2002) 605 617 Neuropathy(ies) (continued ) spondylotic, 547 548 suprascaular approach to patient with, 453 454 thoracic long approach to patient with, 452 ulnar at elbow approach to patient with, 467 470 O Obturator mononeuropathy approach to patient with, 496 497 P Pain in peripheral polyneuropathy, 508 510 Peripheral polyneuropathy causes of, 504 characterization of, 504 evaluation of, 503 504 patterns of, 505 prevalence of, 503 anatomic considerations in, 506 508 approach to patient with, 503 526 introduction to, 503 505 autonomic nervous system dysfunction in, 515 516 clinical history of, 506 523 electrodiagnostic studies in, 518 525 facial nerve involvement in, 516 517 family history in, 517 518 localization considerations in, 506 508 neurocutaneous manifestations in, 517 pain in, 506 509 pathologic considerations in, 506 508 proximal and distal sensorimotor neuropathies in, 514 515 symptoms of motor, 512 513 sensory, 513 514 time course of, 510 512 Peroneal mononeuropathy approach to patient with, 479 487 axon loss in, 482, 485 486 conduction block across fibular neck in, 482 electrodiagnostic patterns in, 484
Index / Neurol Clin N Am 20 (2002) 605 617 615 electrodiagnostic studies in, 481 484 mixed loss in, 485 486 distal superficial approach to patient with, 492 493 Plexopathy brachial. See Brachial plexopathy Polyneuropathy(ies) peripheral. See Peripheral polyneuropathy Polyradiculopathy(ies), 416 419 compressive, 417 418 diabetic, 418 419 Posterior cutaneous nerve of thigh (PFCN) numbness of approach to patient with, 498 499 R Radial neuropathies approach to patient with, 457 461 Radiculopathy(ies) acute defined, 407 409 cervical, 411 412 chronic defined, 410 extraspinal, 414 415 lubosacral, 412 414 severity of defined, 410 anatomy of, 398 399 approach to patient with, 397 421 needle electrode examination in, 405 414 nerve conduction studies in, 399 405 pathophysiology of, 398 399 Repetitive nerve stimulation in ALS, 535 in neuromuscular junction disorder, 558 565 basic concepts of, 558 559 rapid, 562 565 slow, 560 562 technical aspects of, 559 561 S Sciatic mononeuropathy approach to patient with, 486 488
616 Index / Neurol Clin N Am 20 (2002) 605 617 Sensory conduction studies in ALS, 532 533 Sharp waves positive spontaneous activity on needle EMG generated from muscle fibers and, 371 373 Shoulder(s) weak or painful approach to patient with, 452 456 axillary neuropathies, 454 455 long thoracic neuropathies, 452 suprascapular neuropathies, 453 454 Single-fiber EMG (SFEMG) in neuromuscular junction disorder, 566 569 stimulation, 569 technical aspects of, 566 voluntary, 566 569 Somatosensory evoked responses in radiculopathy, 403 404 Spondylotic neuropathy, 547 548 Suprascapular neuropathies approach to patient with, 453 454 T Tarsal tunnel syndrome anterior approach to patient with, 490 492 approach to patient with, 488 490 Thigh(s) numbness of approach to patient with, 497 500 Thoracic neuropathies long approach to patient with, 452 U Ulnar neuropathy at elbow approach to patient with, 469 473 Upper extremities mononeuropathy of approach to patient with, 451 478. See also specific site, e.g., Shoulder(s)
Index / Neurol Clin N Am 20 (2002) 605 617 617 forearm/wrist/hand pain and weakness/numbness, 461 473 general principles of, 452 introduction to, 451 weak or painful shoulder, 452 455 weakness about the elbow, 455 456 wrist or finger drop, 457 461 W Wrist median neuropathy at approach to patient with, 463 469 Wrist drop approach to patient with, 457 461