Functional Electromyography
Provocative Maneuvers in Electrodiagnosis
(Sprache: Englisch)
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...
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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 major contribution to the field of electrodiagnosis.
Klappentext zu „Functional Electromyography “
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
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field of electrodiagnosis.
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The book introduces the use of provocative maneuvers to widen the scope of application and sharpen the diagnostic acuity of electrodiagnostic studies including nerve conduction velocities (NCV) and electromyogram (EMG). Employing provocative maneuvers in somatosensory, ocular, and brainstem studies is suggested but not detailed. The author suggests the further use of provocative maneuvers in other electrodiagnostics such as somatosensory, visual, and brains stem evoked potential studies.
The electrodiagnostic studies described and suggested here are extensions of the physical examination conducted in many clinical specialties, ranging from internal medicine to neurosurgery to chiropractic and other types of body workers. These studies are central to the work of physiatrists, neurologists, orthopedic surgeons and specialists in pain management. The techniques extend the reach of EMG to conditions that were difficult to diagnose by any means before. In addition, the book provides direction to adapt its methods to cases beyond those it discusses.
The book presents three well-documented examples of functional EMG: the changes in electrophysiological parameters with provocative maneuvers help make diagnosis of piriformis syndrome that is otherwise considered a "diagnosis of exclusion" by many physicians, yet can be proven to occur frequently in respectably large sample populations.
Neurological thoracic outlet syndrome is another diagnosis that is even less accessible. Although its incidence and prevalence are less thoroughly documented, it is important both to identify the entity and to have a definitive means to rule it out, especially in referred or neurological upper extremity pain of non-cervical origin.
Third, the distinction between foraminal narrowing due to disc herniations and spinal stenosis is often difficult in the many cases in which both are present. The clinical question often revolves around which of the two conditions is the major pain generator. Studies in physical therapy, cadaveric and otherwise, find that extension is beneficial in treating disc herniation, yet it narrows the stenotic spine up to 63% further. Conversely, while flexion is beneficial for spinal stenosis, it can dangerously extend discal herniations. A safe. replicable and reversible maneuver can distinguish which of these two conditions is more likely to contribute the majority of the patient's symptoms.
The book then goes on to suggest a safe and scientific method for determining other functional maneuvers of value to the electromyographer and suggests means of validating one-time measures that may benefit the electromyographer in diverse clinical situations that are neither common nor predictable. Some of these are as obvious as comparison with the unaffected limb in a carpal tunnel syndrome that only shows up in the flexed wrist; others require the use of standard deviations derived for other purposes, and depend upon the discretion of the clinician as well as the particular case.
The electrodiagnostic studies described and suggested here are extensions of the physical examination conducted in many clinical specialties, ranging from internal medicine to neurosurgery to chiropractic and other types of body workers. These studies are central to the work of physiatrists, neurologists, orthopedic surgeons and specialists in pain management. The techniques extend the reach of EMG to conditions that were difficult to diagnose by any means before. In addition, the book provides direction to adapt its methods to cases beyond those it discusses.
The book presents three well-documented examples of functional EMG: the changes in electrophysiological parameters with provocative maneuvers help make diagnosis of piriformis syndrome that is otherwise considered a "diagnosis of exclusion" by many physicians, yet can be proven to occur frequently in respectably large sample populations.
Neurological thoracic outlet syndrome is another diagnosis that is even less accessible. Although its incidence and prevalence are less thoroughly documented, it is important both to identify the entity and to have a definitive means to rule it out, especially in referred or neurological upper extremity pain of non-cervical origin.
Third, the distinction between foraminal narrowing due to disc herniations and spinal stenosis is often difficult in the many cases in which both are present. The clinical question often revolves around which of the two conditions is the major pain generator. Studies in physical therapy, cadaveric and otherwise, find that extension is beneficial in treating disc herniation, yet it narrows the stenotic spine up to 63% further. Conversely, while flexion is beneficial for spinal stenosis, it can dangerously extend discal herniations. A safe. replicable and reversible maneuver can distinguish which of these two conditions is more likely to contribute the majority of the patient's symptoms.
The book then goes on to suggest a safe and scientific method for determining other functional maneuvers of value to the electromyographer and suggests means of validating one-time measures that may benefit the electromyographer in diverse clinical situations that are neither common nor predictable. Some of these are as obvious as comparison with the unaffected limb in a carpal tunnel syndrome that only shows up in the flexed wrist; others require the use of standard deviations derived for other purposes, and depend upon the discretion of the clinician as well as the particular case.
Inhaltsverzeichnis zu „Functional Electromyography “
Chapter 1: Electricity in Medicine - Philosophy meets Physiology.- Chapter 2: Electrodiagnosis and the Physical Examination - Casting a fine net widely.- Chapter 3: Functional electrodiagnosis - Provocative Maneuvers define Diagnoses of Exclusion, and refine Dual Diagnoses.- Chapter 4: Neurological Thoracic Outlet Syndrome - Approaching a pathognomonic electrophysiologic sign.- Chapter 5: Treating Neurological Thoracic Outlet Syndrome Identified Functional Electrodiagnostically - Analysis of the Data.- Chapter 6: Piriformis Syndrome - Electrophysiology corrects Anatomical Assumption.- Chapter 7: Treating Piriformis Syndrome Identified Functional Electrodiagnostically - Analysis of the Data.- Chapter 8: Radiculopathy vs. spinal stenosis - Evocative Electrodiagnosis Identifies the Main Pain Generator.- Chapter 9: Basing Treatment on the Evoked Delay in Spinal Stenosis - Analysis of the Data.- Chapter 10: Extending the Methods of Functional Electrodiagnosis - Application to Common and Uncommon Conditions.
Bibliographische Angaben
- Autoren: Loren M. Fishman , Allen N Wilkins
- 2011, XVI, 171 Seiten, Maße: 16,6 x 24,4 cm, Gebunden, Englisch
- Verlag: Springer, Berlin
- ISBN-10: 1607610191
- ISBN-13: 9781607610199
Sprache:
Englisch
Pressezitat
From the book reviews:"This is an excellent monograph concerning EMGs of the upper and lower extremities for electrodiagnosis and treatment planning. It covers all aspects of diagnosis, surgery, and physical therapy. ... This is a great text on EMG. I highly recommend it to physiologists, surgeons, students, and fellows of EMGs." (Joseph J. Grenier, Amazon.com, July, 2014)
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