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     and Electrodiagnostic Medicine (AANEM)

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Electrodiagnostic Medicine Consultation

AAEM Resource Guide for Referring Physicians

© June 1996
American Association of Electrodiagnostic Medicine
421 First Avenue S.W., Suite 300E
Rochester, MN 55902
Tel: 507/288-0100Fax: 507/288-1225
E-mail: aaem@aaem.net
Homepage: http://www.aanem.org

The electrodiagnostic medicine consultation evaluates nerve and muscle function and is a direct extension of the clinical neuromuscular examination. The electrodiagnostic medicine consultation provides helpful information in the evaluation of the motor and sensory neurons, the nerve roots, the brachial and lumbar plexi, the peripheral nerves, the neuromuscular junction, and the muscles. Etiologies of clinical problems of weakness, atrophy, fatigability, pain, numbness, and parasthesias can be investigated by these methods.

Some of the common problems in which the electrodiagnostic medicine consultation can be especially helpful include carpal tunnel syndrome, ulnar palsy Footdrop, polyneuropathy, and radiculopathy in the cervical and lumbar regions. Weakness can be evaluated to identify specific etiologies such as motor neuron disease, neuropathy, myopathy, and myasthenia gravis.

In the nerve conduction portion of the examination, small electrical stimuli are used to activate peripheral nerves. In the electromyographic (EMG) portion of the examination, narrow?gauge sterile needle electrodes are used to investigate nerve and muscle integrity. The patient may experience mild discomfort during the procedure but most patients tolerate the procedure very well.

Techniques such as evoked potentials can be used to test the function and integrity of central nervous system pathways conveying visual, auditory, and somatosensory information. There are also special electrodiagnostic techniques for evaluating autonomic dysfunction and movement disorders. Electrodiagnostic studies can also be useful in monitoring the integrity of the central and peripheral nervous system during surgery.

An electrodiagnostic medicine consultant undergoes special training in electrodiagnostic medicine procedures. The knowledge and expertise gained from such specialized medical training maximizes the ability of the consultant to consider appropriate differential diagnoses in planning and performing the electrodiagnostic examination. The expertise enables the consultant to assist colleagues in establishing diagnoses and lesion severity, determining prognoses, and assisting in proper management.

Nerve conduction studies and evoked potentials should be performed by a physician or a trained technologist under the direct supervision of a physician. The needle EMG examination should be performed by a physician with special training in this area.

The American Association of Electrodiagnostic Medicine (AAEM) is an organization of physicians, primarily specialists in neurology or physical medicine and rehabilitation, who have an interest in electrodiagnostic medicine. The purpose of the association is to continually raise the standards of electrodiagnostic medicine practice and patient care through education. This is accomplished through an annual meeting with educational courses, workshops, and scientific presentations in addition to programs in research and quality assurance. The official publication of the association is Muscle & Nerve. Unique educational publications and videotapes are available through the association's Executive Office. A patient information brochure is also available. Inquiries concerning the AAEM and its programs and services should be directed to the Executive Director.