Electromyography EMG Lab
AANEM Accredited EDX Lab (5/18/2015)
Re-Accredited 5/18/2020
CNS’ West EDX Lab is Nevada’s first physician-owned outpatient EDX Labs to achieve exemplary status rating by American Academy of Neuromuscular & Electrodiagnostic Medicine.
CNS’ Electromyography EMG Lab is directed by Triple-Board Certified neurologist, Leo Germin, M.D., FAANEM. Dr. Germin is an AANEM Fellow. Dr. Germin is board certified by the American Board of Electrodiagnostic Medicine. Dr. Germin is board certified by the American Board of Psychiatry and Neurology in both Neurology and Vascular Neurology.
What to Expect During Nerve Conduction Study and EMG Test
What is electromyography (EMG)?
According to the International Electrotechnical Commission, electromyography is a:
technique for investigating the electrical activity of skeletal muscles, based on the recording and interpretation of the electromyogram
Your doctor may have referred you to CNS’s West EDX Lab to evaluate your muscles and nerves. This testing is also referred to as EMG and Nerve Conduction Studies. The EDX Lab also performs other neurodiagnostic procedures.
According to AANEM,
EDX medicine includes a variety of EDX studies, including Nerve Conduction Studies, Electromyography, Neuromuscular junction testing, and other specialized studies.
Some other specialized studies may include Evoked Potentials Studies, including somatosensory evoked potentials (SEP), visual evoked potentials testing (VEP), auditory evoked potentials testing also called brainstem auditory evoked potentials testing (BAER).
What Do “Electrodiagnostic” and “Neuromuscular” Mean?
(Excerpts taken from American Association of Neuromuscular & Electrodiagnostic Medicine, © 2019)
Neuromuscular medicine is the practice of medicine that involves the care of patients with disorders of the peripheral nervous system (PNS) and its connections with the central nervous system. The PNS includes the motor and sensory neurons, peripheral nerves, neuromuscular junctions, and muscles. The care of patients with neuromuscular symptoms includes physical examination, clinical investigation, diagnosis, management, and counseling for patients and their families. Neuromuscular medicine requires training and knowledge beyond that expected of a general neurologist or physical medicine and rehabilitation physician.
Electrodiagnostic medicine is medical subspecialty. Specially trained physicians use information from a patient’s history and physical exam, along with test results that analyze electrical impulses between muscles and nerves, to diagnose, evaluate, and treat neuromuscular, musculoskeletal, and nervous system disorders. Electrodiagnostic medicine is a part of neuromuscular medicine.
Who performs the needle electromyogram (EMG) and nerve conduction study (NCS)?
The AANEM’s policy is that an appropriately trained doctor should do all needle EMG testing. A trained technologist under a doctor’s supervision can perform nerve conduction studies.
What kind of medical training do doctors who perform EMGs have?
Doctors who perform EMGs go to 4 years of medical school then have 3 or 4 more years of training in a residency program. Most work as neurologists or physical medicine and rehabilitation doctors. Medical training helps the doctor decide which tests to perform based on your symptoms. It teaches doctors what can go wrong with the human body and how to tell the difference between these problems.
Why am I being sent to the EMG Lab for tests?
You are being sent to the EMG lab because you have numbness, tingling, pain, weakness, or muscle cramping. Some of the tests that the EMG doctor may use to diagnose your symptoms are nerve conduction studies, needle EMGs, and evoked potentials. The EMG doctor will examine you to decide which tests to do.
Some other specialized studies may include Evoked Potentials Studies, including somatosensory evoked potentials (SEP), visual evoked potentials testing (VEP), auditory evoked potentials testing also called brainstem auditory evoked potentials testing (BAER).
What does an NCS show?
Nerve conduction studies show how well the body’s electrical signals are traveling to a nerve. This is done by applying small electrical shocks to the nerve and recording how the nerve works. These shocks cause a quick, mild, tingling feeling. The doctor may test several nerves.
What happens during a needle EMG?
For this test, a small, thin needle is inserted into several muscles to see if there are any problems. It is used once for each patient and is thrown away after the test. There may be a small amount of pain during this part of the examination. The doctor tests only the muscles necessary to decide what is wrong. During the EMG test the doctor will be able to hear and see how your muscles and nerves are working by the electrical signals made by your muscles. The doctor then uses his medical knowledge to figure out what could be causing your problem.
What is an Evoked Potential?
Evoked potentials are painless tests that check the nerve pathways through the spinal cord or from the eyes and ears. The signals for these tests can come from small electrical shocks, light pulses, or clicks of sound in the ears. The nerve responses are recorded over the scalp and other areas of skin.
How long will these tests take?
The tests usually take 20 to 90 minutes. You can do any of your normal activities, like eating, driving, and exercising, before the tests. There are no lasting side effects. You also can do your normal activities after the tests.
How should I prepare for the tests?
Tell the EMG doctor if you are taking aspirin, blood thinners (like Coumadin®), have a pacemaker, or have hemophilia. Take a bath or shower to remove oil from your skin. Do not use body lotion on the day of the test. If you have myasthenia gravis, ask your EMG doctor if you should take any medications before the test.
When will I know the test results?
After the exam, check with the doctor who sent you to the lab for the next step in your care.
What other tests may be recommended?
Depending on your symptoms, your physician may recommend neuromuscular ultrasound, biopsies, or genetic testing.
What is a muscle biopsy?
A needle muscle biopsy is a short procedure to remove a small piece of muscle tissue using a hollow needle. Once in the laboratory, the muscle cells are checked for various proteins, which may be responsible for neuromuscular disorders.
What is NM ultrasound?
Neuromuscular ultrasound is an emerging diagnostic field which focuses on traumatic and bad changes in your tendons and joints. Recent advances allow doctors to see these with ultrasound to help diagnose neuromuscular disorders.
