Functional Electromyography

Provocative Maneuvers in Electrodiagnosis

By: Loren M. Fishman, Allen N Wilkins

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eText | 4 November 2010

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Functional Electromyography: Provocative Maneuvers in Electrodiagnosis integrates electrophysiology further into the physical examination than ever before. It introduces the use of electrodiagnostic studies to quantify the neurological changes brought about by three provocative maneuvers commonly used in contemporary medicine. This widens the scope of electromyography while sharpening physicians' diagnostic acuity. The book presents nerve conduction velocity (NCV) and H-reflex techniques to identify common conditions that are difficult to diagnose by any other means, often using the needle exam (EMG), MRI or musculoskeletal ultrasound to verify their clinical utility. Functional electromyography successfully diagnoses some cases of thoracic outlet syndrome, nearly all cases of piriformis syndrome, and offers a method for determining whether spinal stenosis or radiculopathy is the main pain generator when both are present in a single patient, even at the same level. This is particularly valuable because the standard conservative and surgical treatments for these two conditions are opposite, in spite of the identical symptom-set they produce. The book carefully describes each technique and persuasively documents their validity in statistical series and individual case presentations. It further guides the attentive electromyographer to adapt these methods to cases beyond those presented in its pages, suggesting a safe and scientific approach to other functional maneuvers of value to the electromyographer, and methods for validating one-time measures that may aid the electromyographer in clinical situations that are neither common nor easily analyzed. Hand drawn illustrations are included alongside text developed by experts in the field. An invaluable resource for physiatrists, neurologists, orthopedic surgeons, specialists in pain management and other providers, Functional Electromyography: Provocative Maneuvers in Electrodiagnosis represents a majorcontribution to the field of electrodiagnosis.