Session outline
Electrodiagnosis is of utmost importance in the assessment of radiculopathy in physical and rehabilitation medicine (PRM) and involves the use of various neurophysiological techniques to identify and localize the nerve root involvement accurately.
Structured electromyography (EMG), sensory and motor nerve conduction studies, including F-waves and H-reflexes, somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP) contribute significantly to the diagnosis of cervical, thoracic and lumbosacral radiculopathy, as well as polyradiculopathy (such as Guillain Barré syndrome). A detailed and structured methodology is necessary in diagnosing most common radiculopathies of C5, C6, C7, C8, T1, L4, L5 and S1 nerve roots. But also other radiculopathies are more common than previously thought. C2 sensory latency can contribute in documenting objectively to the diagnosis and treatment of Arnold’s headache. Dermatomal SSEPs and MEPs can be helpful in the diagnosis of thoracic and other less frequent radiculopathies.
Paraspinal mapping EMG can be very useful in diagnosing cervical and lumbar spinal stenosis. This technique shows an excellent specificity for spinal nerve disorders and can detect non-anatomical causes of nerve pain.
Surface EMG based biomarkers can detect early back extensor muscle functional loss, especially in an aging population. Loss of back extensor muscles, that are critically involved in gait and balance, will be substantially faster than muscles of the extremities. Therefore, this technique can identify early back muscle decline in a middle-aged population and can provide opportunities for intervention to successfully prevent or delay risk factors of falls, disability and dependency in later years.
Learning outcomes
When following this workshop participants will learn which diagnostic test to perform in order to diagnose most common cervical and lumbosacral radiculopathies, as well as polyradiculopathy and less frequent radiculopathies.
New techniques will be shown. C2 sensory latency will enable attendees to diagnose Arnold’s headache. Recent research on cervical paraspinal EMG mapping will be presented, as well as lumbar paraspinal mapping as a new quantitative approach in diagnosing radiculopathy and spinal stenosis. Finally, surface EMG based biomarkers will be explained to detect early back extensor muscle functional loss, especially in an aging population to prevent or delay risk factors of falls, disability and dependency in later years.
Target audience
- Medical practitioners
- Students
- Trainees
