This book was developed to assist physical therapy students and clinicians in learning the techniques, interpretation and use of electroneuromyography evaluation in the differential diagnosis of patients with neuromuscular disorders. It provides the physiological basis and techniques of this diagnostic test through the use of nerve conduction studies and needle electromyography. Readers will learn the application of these techniques to the upper and lower extremities, plus the interpretation of results/reports through case studies. Differential diagnosis of abnormalities that are distributed throughout the neuromuscular system will be presented. Knowledge of basic anatomy related to peripheral nerve and root distributions is being assumed. Table of Contents CHAPTER ONE1 Introduction to Electrophysiological Evaluation - Peripheral Nerve and Muscle1 CHAPTER TWO17 Instrumentation used in Electroneuromyography Examinations17 CHAPTER THREE23 Upper Extremity Motor Nerve Conduction Studies & Sensory Nerve Action Potential's (SNAP's)23 Motor Nerve Conduction Studies - Overview23 Sensory Nerve Conduction Studies42 CHAPTER FOUR53 Lower Extremity Motor Nerve Conduction Studies & Sensory Nerve Action Potential's53 Motor Nerve Conduction Studies54 Sensory Nerve Conduction Studies61 CHAPTER FIVE66 Advanced Techniques of Nerve Studies - Late Responses66 Somatosensory Evoked Potentials (SSEP's)66 Brainstem Auditory Evoked Potentials (BAER's)69 Visually Evoked Potentials (VEP's)69 H- Reflex70 F- Wave Testing72 Repetitive Nerve Stimulation - Myasthenia Gravis73 CHAPTER SIX78 Diagnostic Electromyography78 CHAPTER SEVEN92 Problem Solving in Electroneuromyography and Case Studies92 Case Study # 1: Carpal Tunnel Syndrome95 Case Study # 2: Age 5 - Duchenne MD (DMD)96 Case Study # 3: Suspected L5 Root Compression97 Case Study # 4: Suspected Peripheral Polyneuropathy99 Case Study #5: EMG Report #1100 Case Study #6: EMG Report #2102 Case Study #7: EMG Report #3103 Case Study #8: Gun Shot Wound to the Cauda Equina, L1 - L2.105 Case #9: Anterior Glenohumeral Joint Dislocation107 Case #10: Mid Humeral Fracture107 Case #11: Multiple Sclerosis107 Case #12: Isolated Scapula Winging107 Case #13: Idiopathic Bell's Palsy107 Appendix A111 Anatomical Correlates and Associated Impairments111 Appendix B113 Common Causes of Peripheral Neuropathies113 Appendix C114 Upper Extremity - Root and Peripheral Nerve Innervations114 Lower Extremity - Root and Peripheral Nerve Innervations115 References116
About the Author: Gary Krasilovsky, PT, PhD, SST is Executive Officer, Graduate Center DPT Program and Associate Professor & Director, Hunter College/Graduate Center DPT Program of the City University of New York. He has been a physical therapy clinician, educator, and researcher for almost forty years. He earned a BS degree in Special Education from the University of Missouri, and a Certificate in Physical Therapy, MA and PhD in Physical Therapy from New York University. His career in physical therapy included ten years at the Rusk Institute of Rehabilitation Medicine of NYU, where he worked as a clinician, researcher, and received advanced training and mentoring in the electrodiagnostic department. He also was senior physical therapist in the Jerry Lewis Muscular Dystrophy clinic based at Rusk Institute and was Chief of Physical Therapy at Norwalk hospital. He began his full time teaching career at Hunter College in 1987 and became acting program director two years later. He has continued to serve as program director since 1992 and teaches clinical neurology, adult neurological rehabilitation, electroneuromyography and therapeutic exercise. He has published in various peer-reviewed journals and textbooks on various areas related to physical therapy, with an emphasis on neurology based topics. Dr. Krasilovsky is also certified as a Schroth Scoliosis Therapist.