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PubMed2001

Stimulation electromyography as a method of intraoperative localization and identification of the facial nerve during parotidectomy: review of 15 consecutive parotid surgeries.

INTRODUCTION: It has been widely recognized that one of the major hazards during operation of the parotid gland, mainly in tumor resection, is the injury of the facial nerve. Facial nerve monitoring has achieved wide application in otologic and neurotologic procedures to help localization and protection of the facal nerve in the temporal bone. MATERIAL AND METHODS: The authors analyze localization and identification of 15 nerves in 15 patients who underwent parotid gland surgery in the Department of Ear Nose and Throat Diseases of the Medical University in Plovdiv from September 15, 2000 to December 15, 2000. Nerve integrity monitor Neurosign 100 and specially designed electromyographic electrodes were used. RESULTS: In all patients stimulation electromyography of the facial nerve was successfully used to locate, identify and evaluate the integrity of the facial nerve during and at the end of the operation. No postoperative facial nerve injury was detected clinically. In two patients with parotid gland cancer the inferior division of the facial nerve was found infiltrated by the cancer growth. CONCLUSION: The results indicate that identification of the facial nerve by electromyography is a safe, effective and simple method of electrophysiologic monitoring during parotid gland surgery. This method allows assessment of the nerve integrity at the end of the operation.

Electric Stimulation↗

PubMed1976

Electromyography before and after surgery for hip deformity in children with cerebral palsy. A comparison of clinical and electromyographic findings.

Twenty-three ambulatory children with spastic diplegic cerebral palsy were evaluated clinically and by electromyography before and after hip-muscle surgery. The stretch tests originally designed to distinguish specific muscle tightness and spasticity were found to be non-specific when tested by electromyography. Ambulatory electromyograms using needle electrodes and telemetry generally showed decreased activity in the released muscles and, on occasion, changes in activity in muscles not operated on. These unanticipated changes after release may explain some of the unpredictability of results of such procedures in cerebral palsy.

Adolescent↗

PubMed1976

Cystometry and sphincter electromyography.

Gas cystometry combined with electronically integrated sphincter electromyography provides a rapid and effective screening technique for evaluation of patients with disorders of micturition secondary to neurologic dysfunction. The most frequent cystometric patterns are (1) detrusor hyperreflexia secondary to interruption of the cortico-regulatory tracts and (2) detrusor areflexia secondary to impairment of the segmental innervation of the detrusor muscle. To observe these patterns it is necessary to perform detrusor reflex activation procedures, including change in posture, administration of bethanechol, and urethral and rectal distention. The two prinicpal sphincter disturbances observed with electronically integrated electromyography are detrusor sphincter dyssnergia and uninhibited sphincter relaxation. The delineation of combination of abnormal cystometric and sphincter responses provides for rational selection of pharmacologic and surgical therapy.

Electromyography↗

PubMed1992

Long-term electromyography as a possible diagnostic aid for detecting craniomandibular dysfunctions.

As there is a positive correlation between oral parafunctional habits and craniomandibular disorders, objective electromyographic findings on parafunctional jaw activities could be very interesting for the diagnosis and management of craniomandibular disorders. The described pocket-sized and battery-operated electromyographic measuring device fulfils the essential requirements for monitoring and recording parafunctional activity in a chosen time period. It is easy to handle and can therefore be operated by a trained patient. At the end of the registration the collected data are transferred to a computer for statistical or graphical analysis. With this device, long-term electromyography on patients in their usual environment is possible. Further studies on parafunctional behaviours applying long-term electromyography could increase the understanding of craniomandibular disorders.

Adult↗

PubMed1992

Nerve conduction and electromyography.

The advent of computer-based methodology in routine electromyography has much improved the analysis of motor unit (MU) decomposition, of interference pattern study, and of MU counting. Measuring minimum motor and sensory conduction velocities is becoming more accessible and is considered an essential procedure in assessing the condition of peripheral nerves. A series of studies has shown that nerve resistance and vulnerability can be modified by a steep temperature gradient, by ciguatera toxin, or by hyperventilation-induced changes in the electrical properties of the axonal membrane. The controversy as to the diagnostic procedures to use in cases of radiculopathy and carpal tunnel syndrome (CTS) shows no sign of abating. There is, however, general consensus that electrophysiologic procedures must play a key diagnostic role in these conditions. Lastly, several interesting articles have been published describing the use of electrophysiologic tests in motor neurone diseases. Moreover, some advances have been made in the diagnostic yield of single-fibre electromyography (SFEMG) with axonal microstimulation in myasthenia gravis and Eaton-Lambert myasthenic syndrome.

Animals↗

PubMed2003

Food-borne botulism cases in Van region in eastern Turkey: importance of electromyography in the diagnosis.

OBJECTIVES: Food-borne botulism is an acute form of poisoning that results from ingestion of a toxin produced by Clostridium botulinum. Botulism toxin causes its major effect by blocking neuromuscular transmission in autonomic and motor nerve terminals. METHODS: In this study, we present the features of eleven cases of food-borne botulism admitted to our hospital in 2001. All of the cases were caused by home-prepared foods; green beans. In these cases, the main symptoms and signs were generalized muscular weakness, dry mouth, dysphagia, disponea and diplopia. Electrophysiological studies were performed on four patients. RESULTS: Motor conduction studies showed that compound muscle action potentials were decreased with normal latencies and conduction velocities. The needle electromyography showed signs of denervation potentials like fibrillation and positive waves in four patients. Repetitive nerve stimulation with high frequency (20 Hz) induced an increment close to 100% in the amplitudes in 2 of 4 patients. CONCLUSION: Although toxin could not be detected in the patients, the electromyographic findings supported our diagnosis. We concluded that electromyography has an important role in diagnosis of botulism, especially in the condition that serologic tests are negative or cannot be performed.

Action Potentials↗

PubMed2003

Intranasal electromyography in evaluation of the nasal valve.

OBJECTIVES: The present study was performed to investigate the best way of using surface electromyography (sEMG) in evaluation of muscle involvement in nasal valve function. The function of the nasal muscles in nasal valve movements has not been investigated sufficiently and in the present study we tried to improve the way of testing these muscles introducing the intranasal placement of surface EMG electrodes. METHODS: Skin surface electromyography (EMG) and intranasal electrode EMG investigation of nasal muscles was performed in two groups (n = 30 for each Group) of healthy subjects: (1) subjects with extremely effective coordination of nasal muscles and (2) those with extremely poor coordination of nasal muscles. Functions of the nasal muscles were assessed by EMG in response to breathing and voluntary nasal movements. RESULTS: In both Groups, during normal breathing all the tested muscles were not active. During forced nasal inspiration in Group 1 the transverse nasalis, anomalous nasi, alar nasalis and dilator naris anterior were active. In Group 2 during forced nasal inspiration these muscles remained inactive. During rhythmic widening of the nostril, the tested nasal muscles were active in subjects of Group 1 and significantly less active in Group 2 (p = 0.0024). In both Groups the amplitude of muscle activity, recorded from intranasal electrodes was significantly higher that the amplitude recorded from the skin electrodes (p < 0.05). During the tests with two intranasal electrodes, the insignificant difference was detected in amplitude between left and right nostrils in majority of subjects (Group 1 p = 0.15; Group 2 p = 0.1). CONCLUSION: We conclude that in human population the ability to operate nasal muscles is varying from person to person, i.e. the nasal muscles can be either inactive ("relatively rudimentary") or active. This fact should be taken into account before any surgical intervention is planned. The subjects with active nasal muscles can control the function of their nasal valve. The intranasal surface EMG is a more direct and precise EMG method for nasal valve evaluation in comparison to skin surface EMG testing.

Adolescent↗

PubMed1992

[The use of kinesiography and electromyography in assessing the outcome of a fracture of the mandibular condyles].

The purpose of this work is to consider the sensibility, reliability, and utility of the computerized electromyography and kinesiography in the diagnosis and study of the functional results in patients affected of single or bilateral previous fractures of the condyles. The Authors analyse three clinical parameters and compare them with thirteen parameters gathered from the computerized data and the kinesiogram and electromyogram analysis of a selected sample of thirteen patients with previous fractures of the condyles. This comparison has shown the greatest reliability and sensibility (a larger quantity of instrumental data as regards the clinical checkup and absence of false negative diagnosis) of these techniques with regard to ordinary clinical checkup. Furthermore the features of objectivity, non invasion and easy repetition, indicate that computerized electromyography and kinesiography play an important role in the diagnosis and study of the functional results of fractures of the condyles and in the follow-up examination.

Diagnosis, Computer-Assisted↗

PubMedDate not supplied

Electromyography study of the hamstring muscles while exercising on a bicycle and the Roman table.

During the past few years electromyography has been used a lot in developing research in the science of sports; it has made a great contribution to what is called muscle biomechanics. The Biceps Femoris (long head), Semitendinosus and Semimembranosus bi-articulated muscles make up the muscle group called Hamstring; they act in articulated movements of the hip (extensors) and in articulated movement of the knee (flexors). In this sense, the Hamstring have been the object of many investigations, precisely because they are bi-articulated. All the Hamstring pass through the knee's articulation producing flexing as well as leg rotation and their effectiveness as hip extensors depends on the positioning of the knee's articulation, Hamill, Knutzen (1999). The knee's flexor muscles (Biceps Femoris - long head, Semimembranosus and Semitendinosus) were studied using electromyography with surface electrodes in 10 male subjects between 19 and 25 years old. They included five who used a stationary bicycle and five doing activities on the roman table. Knee flexing on the roman table (concentric and eccentric action) was performed in the ventral decubitus position. Surface electrodes with electro-conductive gel were used to register the action potentials; they we fixed on the skin covering the areas of interest to this study in each ventral muscle. For each type of experiment, a laboratory with all the apparatus needed for the study was created. Results, expressed in RMS, demonstrate that on the bicycle the Biceps Femoris (long head) showed an RMS of 31.81 (+/- 10.15), the Semimembranosus 65.15 (+/- 18.76) and the Semitendinosus 44.33 (+/- 44.33 (+/- 22.34). In flexing the knee the values were 188.54 (+/- 46.10) for the Biceps Femoris (long head) muscle, 480.00 (+/- 130.13) for the Semimembranosus and 303.50 (+/- 63.31) for the Semitendinosus. The verified data demonstrated greater values for the bicycle activities. The Semimembranosus muscle showed greater values in RMS for all activities studied, followed by the Semitendinosus and Biceps Femoris (long head).

Action Potentials↗

PubMed2004

[An adulthood progressive case of congenital nemaline myopathy showing rimmed vacuoles in muscle biopsy and diffuse neurogenic changes on electromyography].

A 29-year-old woman with benign congenital nemaline myopathy is reported. She did not walk until the age of one year and seven months. Although she acquired the ability to run, she ran very slowly. She first noticed the progression of weakness of the limbs at age 21, and it worsened gradually. On admission, she showed moderate weakness in the face, neck, and four limbs. Serum creatine kinase was elevated to 218 U/l. Needle electromyography showed giant and polyphasic motor unit potentials with a reduced reference pattern in the four limbs diffusely. In muscle biopsy, about 10% of fibers had many small vacuoles, and half of them were rimmed. Modified Gomori trichrome stain revealed nemaline rods in about 20% of both type I and type II fibers. Fibers with large diameter and atrophic ones showed increased acid phosphatase activity. Type I fibers were small, and type II fibers numbered only 2%. We diagnosed her illness as a congenital nemaline myopathy that began in infancy and progressed in adulthood. The increased autophagic activity probably caused the progression of muscle weakness. Moreover, the presence of both nemaline rods and rimmed vacuoles may have contributed to the development of diffuse neurogenic changes seen in electromyography.

Acid Phosphatase↗

PubMed2004

[Electromyography study on complete bilateral cleft lip after reparation.].

PURPOSE: This study was undertaken to evaluate the motion effect of complete bilateral cleft lips objectively using electromyography. METHODS: 45 patients of complete bilateral cleft lips after operations several years which included 20 patients repaired using orbicularis oris muscle restoring functional method and 25 patients using straight line suture method were examined with electromyography (EMG) in prolabium, right and left lateral lips respectively. The most potential in every area of each patient at the maximal lip contraction position was measured and the values of two different method groups were subject to statistical analysis. RESULTS: The prolabium and lateral lips of both groups had no electric activity at posture position. At maximal contraction position, the mean potential of prolabium of orbicularis oris muscle restoring method group had no difference with the lateral lips. But the mean potential of prolabium of straight line suture method group was lower than that of the lateral lips significantly,also,it was lower than the potential of prolabium in the muscle functional reparation group. CONCLUSIONS: The reparation method of restoring orbicularis oris muscle to complete bilateral cleft lips was better than the straight line suture method in the motion effect. These findings suggest the superiority and necessity of functional muscle reparation for complete bilateral cleft lips.

Cleft Lip↗

PubMed1992

Electrical microstimulation with single-fiber electromyography: a useful method to study the physiology of the motor unit.

This article reviews the essential technical principles and findings with electrical microstimulation as used in conjunction with single-fiber electromyography (SFEMG). It highlights the details in the microphysiology of the motor unit that can be conveniently studied with these methods, particularly the neuromuscular transmission at the individual motor endplates, muscle fiber recovery functions, and a variety of late responses. The differences, advantages, and disadvantages of the stimulation method of jitter measurement, compared to the original method, in the voluntarily activated muscle are described. Special attention is given to the pitfalls of the technique. Indications for clinical use of stimulation SFEMG in the electromyography laboratory are suggested.

Axons↗

PubMed2004

[Estimation of intramuscular load of the upper limb in static postures and repetitive work by surface electromyography].

OBJECTIVE: To evaluate the intramuscular loads of the upper limb during static postures and repetitive work by surface electromyography. METHODS: Twenty-six male college student volunteers were recruited for the experiment. The surface electromyography (SEMG) singal were recorded from the brachioradialis, biceps brachii, deltoid and trapezius of right arm during static postures including forward elevating, abducting, extending and a repetitive performance at different height of the bench, and root mean square (RMS) values were educed from the singal. RESULTS: The SEMG amplitudes from forward elevating and abducting were in direct proportion to the angle of the elevating and abducting (r > 0.9, P < 0.01). The maximal voluntary electrical activation (MVE) of the deltoid were 6.4%, 10.1%, 12.6%, 16.2% and 20.8% while the arm elevated forward at an angle of 0 degrees , 45 degrees , 90 degrees , 135 degrees and 180 degrees respectively. The repetitive work showed that the height of the bench and the duration had more effects on deltoid and trapezius than the other muscles. The MVE% of the deltoid were 13.0%, 14.4% and 15.6% while the bench was 74, 79 and 84 cm in height respectively (P < 0.01). CONCLUSION: SEMG which is suitable for determining and reflecting the muscle strain during static postures and repetitive work may be a reasonable indicator for the assessment of manual workload and the ergonomic design.

Arm↗

PubMedDate not supplied

[Single fibre electromyography in 18 patients with amyotrophic lateral sclerosis].

INTRODUCTION: Single fibre electromyography (SFEMG) is a method that complements conventional electromyography and studies the activity of individual muscle fibres and of the neuromuscular junction. AIMS. We attempt to demonstrate the presence of reinnervation disorders by studying Jitter, fibre density (FD) and the presence of neurogenic blocks in patients with amyotrophic lateral sclerosis (ALS). PATIENTS AND METHODS: SFEMG was carried out on 18 patients diagnosed with ALS. All the patients were submitted to a voluntary SFEMG in the extensor digitorum communis muscle of the fingers on the most affected side. RESULTS: The SFEMG in the extensor digitorum communis muscle of the fingers showed alterations in 13 out of the 18 patients studied (72%). FD was the most reliable parameter for translation of the motor neuron instability and increased in all cases. This was followed by the mean and the maximum individual (62%) Jitter and, lastly, the percentage of blocks (38%). CONCLUSIONS: In ALS, the parameters studied with SFEMG were modified in 72% of the cases studied. There is an overall correlation between the length of time the patient has had the disease and the modifications in the SFEMG (21.5 versus 13.7 months). The degree of clinical involvement is higher (6.5/13) in those who present an altered SFEMG compared to those who present a normal SFEMG (5.3/13).

Adult↗

PubMed2005

Changes of single fiber electromyography in patients with inflammatory myopathies.

OBJECTIVE: To assess the significance of single fiber electromyography (SFEMG) in diagnosis of inflammatory myopathies and the correlation with other assistant examination findings. METHODS: SFEMG were recorded from the extensor digitorum communis of 34 patients with polymyositis or dermatomyositis and compared with the findings of routine electromyography (EMG), serum creatine kinase (CK) determination, and muscle biopsy. RESULTS: SFEMG recordings in 34 patients were all abnormal. The prominent feature was markedly increased fiber density (FD) with normally or mildly increased jitter. FD ranged from 1.0 to 6.0 (2.34 +/- 0.43). Jitter ranged from 5 to 78 micros (41.6 +/- 10.3 micros). The potential pairs with jitter values greater than 55 micros ranged from 0% to 55% (7.7% +/- 11.8%). Block was detected at one recording site in only one patient. Routine EMG demonstrated myogenic lesions in only 24 patients (70.6%). FD was a little higher in the normal-EMG subgroup or the neurogenic-EMG subgroup than myogenic-EMG subgroup but without statistical significance. Elevated CK levels were found in 75% patients (24/32). FD in the normal CK subgroup was significantly higher than that in the elevated CK subgroup (2.62 +/- 0.40 vs. 2.28 +/- 0.40, P < 0.05). Muscle pathologies were consistent with the diagnosis of myositis in 75% (15/20). CONCLUSION: SFEMG is of great value in the diagnosis and disease process understanding of inflammatory myopathies for the clinically suspected patients with normal routine EMG, CK levels, and muscle biopsies.

Adolescent↗

PubMed2005

[Electromyography at the beginning of the 21st century].

This review article is concerned with the role of electromyography (EMG) in the clinical diagnostic work. After a summary on the developmental history of electromyography, the most important EMG methods are presented. The modern quantitative EMG methods are sensitive and accurate thus providing important information in the evaluation of various neurological diseases, particularly in the diagnosis of neuromuscular disorders. The EMG examinations are useful tool for the clinician only if the applied methods are carefully chosen and properly performed and the rules of interpretation are strictly followed.

Electromyography↗

PubMed2006

[Evaluation of work load and related factors during asymmetric lifting with surface electromyography].

OBJECTIVE: To evaluate the work load and related factors for asymmetric lifting tasks using surface electromyography (EMG). METHODS: Thirteen male volunteers lifted loads of 6 and 13 kg at two speeds, in varying angles of trunk rotation, from floor to knuckle height, performing 16 lifting tasks. During lifting, surface electromyography signals from the erector spinae, bilaterally at level of T10 and L3, was continually recorded. The work load and related factors for asymmetric lifting tasks were evaluated by comparing the average amplitude of EMG signals. RESULTS: The EMG average amplitude when lifting the load of 13 kg (43.30% MVE) was significantly greater than that when lifting the load of 6 kg (37.70% MVE) (P < 0.01). The EMG average amplitude when lifting at the higher speed (41.80% MVE) was significantly greater than that at the lower speed (39.19% MVE) (P < 0.05). The EMG average amplitude was increased with the increase of the trunk rotation angle without significant difference (P > 0.05). At T10, the EMG average amplitude was greater on the right side than that on the left side (50.31% MVE and 25.88% MVE respectively) while at L3, it was on the contrary (45.60% MVE on the left and 40.22% MVE on the right respectively) (P < 0.01). Multiple stepwise regression analysis showed that the load of lifting was the factor contributing most to the EMG average amplitude followed by the lifting speed. CONCLUSION: The risk factors related to work load for asymmetric lifting tasks are mainly the load and the speed of lifting. The EMG activity between the right and left side of erector spinae is different during such lifting.

Adult↗

PubMed1978

Diagnostic value of quantitative electromyography. Its scope and limitations.

On the evidence of 951 cases of the 10,500 investigated with the aid of quantitative electromyography the author shows the value of the method for diagnosing muscle activity. Statistical analysis was applied to check the diagnostic value of EMG parameters separately and jointly in the identification of the pathology and its classification as either neurogenic or myogenic. Also surveyed are the sources of the discrepancies between the electromyographic and the histopathological results in very early and very advanced cases. Examples are given that show electromyographic findings as nosologically non-specific and the method as inferior to the morphological in this respect. On the other hand the method is stressed as one that permits it to (a) tell a malignant and rapid process from a slow one, (b) obtain evidence of repair and (c) prove generalization of processes considered to be local or the progressive character of processes considered to be non-progressive. The author also refers to the added scope given to electromyography by such developments as automatic recording, SFEMG, and determination of motor unit territory with the aid of multielectrodes.

Electrodes↗