Potential risks of iatrogenic complications of nerve conduction studies (NCS) and electromyography (EMG)

Gechev, Antonin; Kane, Nick; Koltzenburg, M; Rao, Dasappaiah Ganesh; Star, R. van der

doi:10.1016/j.cnp.2016.09.003

Cited by 37 publications

(24 citation statements)

References 33 publications

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“…The role of these tests in diaphragmatic paralysis is limited due to the many technical challenges of performing these tests, and complexity in their interpretation. They can assist in differentiating neuropathic and myopathic dysfunction [ 59 , 60 ].…”

Section: Investigationmentioning

confidence: 99%

Diaphragmatic Palsy

Kokatnur

Rudrappa

2018

Diseases

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The diaphragm is the primary muscle of respiration, and its weakness can lead to respiratory failure. Diaphragmatic palsy can be caused by various causes. Injury to the phrenic nerve during thoracic surgeries is the most common cause for diaphragmatic palsy. Depending on the cause, the symptoms of diaphragmatic palsies vary from completely asymptomatic to disabling dyspnea requiring mechanical ventilation. On pulmonary function tests, there will be a decrease in the maximum respiratory muscle power. Spirometry shows reduced lung functions and a significant drop of lung function in supine position is typical of diaphragmatic palsy. Diaphragmatic movements with respiration can be directly visualized by fluoroscopic examination. Currently, this test is being replaced by bedside thoracic ultrasound examination, looking at the diaphragmic excursion with deep breathing or sniffing. This test is found to be equally efficient, and without risks of ionizing radiation of fluoroscope. Treatment of diaphragmatic palsy depends on the cause. Surgical approach of repair of diaphragm or nonsurgical approach of noninvasive ventilation has been tried with good success. Overall prognosis of diaphragmatic palsy is good, except when it is related to neuromuscular degeneration conditions.

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Section: Investigationmentioning

confidence: 99%

Diaphragmatic Palsy

Kokatnur

Rudrappa

2018

Diseases

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“…Although an electrodiagnostic study is considered the most important diagnostic test for cubital tunnel syndrome, it has some critical disadvantages. It is time-consuming, causes pain and injury to patients due to needle insertion and electrical stimulation, provides limited information regarding lesion localization and structural abnormalities, and carries a strong possibility of falsenegative results [5]. Thus, complementary imaging studies such as magnetic resonance or ultrasound imaging are required for the diagnosis of various neuropathies.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the ulnar nerve with shear-wave elastography: a potential sonographic method for the diagnosis of ulnar neuropathy

Kim

Lee

2021

Ultrasonography

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This study was designed to verify whether shear-wave elastography (SWE) can be used to differentiate ulnar neuropathy at the cubital tunnel from asymptomatic ulnar nerve or medial epicondylitis. An additional aim was to determine a cutoff value to identify patients with ulnar neuropathy. Methods: This study included 10 patients with ulnar neuropathy at the cubital tunnel as confirmed with electromyography (three women and seven men; mean age, 51.9 years), 10 patients with medial epicondylitis (nine women and one man; mean age, 56.1 years), and 37 patients with asymptomatic ulnar nerve and lateral epicondylitis (21 women and 16 men; mean age, 54.0 years). Each patient underwent SWE of the ulnar nerve at the cubital tunnel, distal upper arm, and proximal forearm. Results: Patients with ulnar neuropathy at the cubital tunnel exhibited significantly greater mean ulnar nerve stiffness at the cubital tunnel (66.8 kPa) than controls with medial epicondylitis (21.2 kPa, P=0.015) or lateral epicondylitis (33.9 kPa, P=0.040). No significant differences were observed between patients and controls with regard to ulnar nerve stiffness at the distal upper arm or the proximal forearm. A stiffness of 31 kPa provided 100% specificity, 80.0% sensitivity, 100% positive predictive value, and 83.3% negative predictive value for the differentiation between ulnar neuropathy and medial epicondylitis. Conclusion: Cubital tunnel syndrome is associated with a stiffer ulnar nerve than lateral or medial epicondylitis. SWE seems to be a new, reliable, and simple quantitative diagnostic technique to aid in the precise diagnosis of ulnar neuropathy at the cubital tunnel.

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“…As with any other invasive technique there remains a risk of bleeding, however slight. Previous studies have shown an incidence for bleeding events between 0% and 11%, with a much lower risk for a necessary surgical intervention ( Baba et al, 2005 , Boon et al, 2012 , Butler and Dewan, 1984 , Farrell et al, 2003 , Gechev et al, 2016 , Gertken et al, 2013 , Rosioreanu et al, 2005 , Vaienti et al, 2005 ). In general, the risk of a significant bleed has to be weighed against the risks inherent in postponing or cancelling the EMG.…”

Section: Introductionmentioning

confidence: 95%

Needle EMG induced muscle bleeding complication after guideline approved discontinuation of anticoagulation

Bartl

Krahn

Riggert

et al. 2021

Clinical Neurophysiology Practice

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Potential risks of iatrogenic complications of nerve conduction studies (NCS) and electromyography (EMG)

Abstract: HighlightsRisks associated with NCS and EMG investigations.Review of the published level of complications.Pragmatic recommendations.

Cited by 37 publications

References 33 publications

Diaphragmatic Palsy

Diaphragmatic Palsy

Evaluation of the ulnar nerve with shear-wave elastography: a potential sonographic method for the diagnosis of ulnar neuropathy

Needle EMG induced muscle bleeding complication after guideline approved discontinuation of anticoagulation

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