2. Basic Principles of Electrodiagnostic Medicine S.Mansoor Rayegani, M.D Professor Of Physical Medicine And Rehabilitation. Shahid Beheshti Medical University PM&R research center

3. Definition EMG, EMG/NCV, EMG/NCS, Electrodiagnosis, Electrodiagnostic medicine consultation. A specific branch of medicine practiced by a physician using history, physical examination, lab study, imaging and performing special electrodiagnostic tests including NCS, EMG and/or EP for diagnosis and treatment of PNS and CNS disorders.

4. C.N.S Cortex cerebellum Midbrain Brainstem Medulla Spinal cord

5. PNS Motor neuron Root Plexus Nerve NMJ Muscle

6. Specific Diagnostic Tools NCS: latency, NCV, amplitude -Motor/Sensory/F, H responses, RST - EMG (Needle EMG) -Spontaneous activities; Fibr., PSW -MUAP EP: VEP, ABR, SEP, MEP

7. Disease diagnosed by EDX CNS demyelinating disorders, MS Myelopathy Motor Neuron Disease Radiculopathy Plexopathy PNP (Axonal, Demyelinating) Entrapment syndromes (CTS…) NMJ dis. Myopathy (dystrophic, inflammatory, myotonic)

8. Electrodiagnostic medicine steps Hx, P/E, Lab., Imaging DDx NCS EMG (muscle needling) Impression & judgment Suggestions

9. Components of report Demographic data Clinical information Body of report Findings and description Impression(EDX, Clinical??) Comment/recommendation/suggestion.

10. Hints… Highly Practitioner Dependent, It Is Not a TEST But a Consultation.. Physiologic and Not Anatomic Evaluation More Specific to Sensitive Time Dependent Process Somewhat painful!