Electromyography (EMG) measures the muscle's response, or electrical activity, in response to nerve stimulation of the muscle. The test is used to help diagnose neuromuscular abnormalities. During the test, one or more small needles (also called electrodes) are inserted through the skin into a muscle.The electrical activity picked up by the electrodes is then displayed on an oscilloscope (a monitor that displays electrical activity as waveforms). A sound amplifier is used so that the activity can be heard. EMG measures the electrical activity of muscles during relaxation, small contractions and vigorous contractions.Muscle tissue does not normally generate electrical signals during rest. When an electrode is inserted, a brief period of activity may be seen on the oscilloscope, but after that no signal should be present.
After the electrodes are inserted, you may be asked to contract a muscle, for example, by lifting or bending your leg. The action potential (shape and size of the wave) it produces on the oscilloscope provides information about the muscle's ability to respond when the nerve is stimulated.As the muscle is contracted with greater force, more and more muscle fibers are activated, producing an action potential.A related procedure that can be performed is a nerve conduction study (NCS). NCS is a measure of the size and speed of conduction of an electrical impulse through a nerve.NCS can determine nerve damage and destruction, and is often performed at the same time as EMG. Both procedures help determine the presence, location and extent of nerve and muscle damage.
About the procedure (EMG)
Before the procedure:
Your doctor will explain the procedure to you and give you the opportunity to ask any questions you may have about the procedure.
Generally, there is no need to fast before the test. In some cases, cigarettes and caffeinated drinks, such as coffee, tea, and cola, may be limited to two or three hours before the test.
Tell your doctor about all medications (prescription and over-the-counter) and herbal supplements you are taking.
Tell your doctor if you have a pacemaker.
Wear clothing that allows access to the area to be checked or that can be easily removed.
Stop using lotions or oils on your skin a few days before your procedure, or at least stop using them on the day of the test.
Depending on your medical condition, your doctor may ask for other specific preparations.
During the procedure:
An EMG procedure can be done on an outpatient basis or as part of your hospital stay. Procedures may vary depending on your condition and your doctor's practices.The EMG is performed by a neurologist (a doctor who specializes in disorders of the brain and nerves), although parts of the test can also be performed by a technologist.An EMG is usually done immediately after a nerve conduction study (a test that measures the flow of current through the nerve before it reaches the muscle, rather than the muscle's response).
Generally, an EMG procedure follows this process:
You will be asked to remove any clothing, jewelry, hairpins, glasses, hearing aids or other metal objects that may interfere with the procedure. If you are asked to wear a dress, you will be given a dress to wear.
You will be asked to sit or lie down for the test.
A neurologist will locate the muscles to study.
The skin will be cleaned with an antiseptic solution. Next, a fine sterile needle will be inserted into the muscle. An earth electrode will be placed under your arm or leg.
The test may require five or more needles. You may feel a slight pain when the electrodes are inserted, but this is usually painless.
You should tell your examiner if the test is painful as it may affect the results.
You will be asked to relax and then perform a light or full force muscle contraction.
The electrical activity of your working muscles will be measured and displayed on an oscilloscope.
An audio amplifier can also be used to evaluate the presence and sound of electrical potential. If the recorder is connected to an audio amplifier, you might hear a sound like tin falling on the ceiling as your muscles contract.
After the procedure:
Some muscle soreness may continue for a day or two after the procedure. Notify your doctor if there is pain, tenderness, swelling, or collection of pus at the injection site. Your doctor may give you additional or optional instructions after the procedure depending on your specific situation.
If you have symptoms of muscle disease, nerve damage, or injury, an EMG test will help your provider make an accurate diagnosis. It also helps your provider create a treatment plan. Before having an EMG test, be sure to tell your provider if you are taking blood-thinning medications. These medicines may increase your risk of bleeding after the test.
Summary
EMG testing is a minimally invasive procedure used by health professionals to diagnose and monitor muscle dysfunction. EMG testing can be performed by neurologists and trained technicians.
During the procedure, a neurologist will insert thin, needle-shaped electrodes into the muscles. These electrodes record the electrical activity of resting and contracting muscles.
After the NCV test, neurologists perform an EMG test, which measures how fast electrical impulses travel through the motor nerves.
Both EMG and NCV tests provide useful information that helps doctors determine the location and extent of muscle and nerve damage.
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