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Paediatric electromyography in the modern world: a personal view
1Department of Clinical Neurophysiology, Great Ormond Street Hospital for Children NHS Trust, London, UK. pittm@gosh.nhs.uk
Insights
Paediatric electromyography (EMG) is a crucial diagnostic tool for childhood neuromuscular diseases, despite inconsistent use. This study highlights its value in diagnosing various nerve and muscle disorders, proving it
Area of Science:
- Neurology
- Clinical Electrophysiology
Background:
- Paediatric electromyography (EMG) is essential for diagnosing neuromuscular diseases in children.
- Its utilization varies globally, with some perceiving it as painful, although it is generally well-tolerated compared to other common pediatric investigations.
- Advancements in clinical genetics have raised questions about EMG's future, yet the increasing discovery of genetic abnormalities necessitates precise phenotypic delineation, a role EMG fulfills.
Purpose of the Study:
- To underscore the diagnostic value and evolving applications of paediatric electromyography (EMG).
- To address perceptions of pain associated with EMG and compare its tolerability with other paediatric procedures.
- To highlight EMG's specific strengths and emerging roles in diagnosing complex paediatric neuromuscular conditions.
Main Methods:
- Review of current clinical applications and diagnostic strengths of paediatric EMG.
- Comparison of EMG tolerability with other routine paediatric investigations.
- Identification of areas for future development and application in paediatric neuromuscular diagnostics.
Main Results:
- EMG demonstrates particular efficacy in diagnosing neuropathies, motor neuronopathies, and neuromuscular transmission disorders like myasthenia gravis.
- It serves as a valuable supplementary tool for investigating myopathies.
- EMG is a well-tolerated procedure in children, comparable to or better than many routine investigations.
Conclusions:
- Paediatric EMG remains an invaluable diagnostic tool for a range of neuromuscular disorders, including neuropathies, motor neuronopathies, and myasthenia.
- Despite advances in genetics, EMG's role in precise phenotypic delineation is increasingly important.
- Emerging applications include diagnosing myasthenia, identifying causes of dysphagia, predicting prognosis in neonatal brachial palsy, and investigating channelopathies, affirming its utility in diverse healthcare settings.
Abstract:
Paediatric electromyography (EMG) is an invaluable diagnostic test for the investigation of neuromuscular disease, but its use is inconsistent between and within different countries. One perception is that the procedure is painful; however, in comparison with common investigations performed routinely in children, EMG is better tolerated. While some developments, such as those within clinical genetics, would appear to mark its demise, paradoxically the more genetic abnormalities that are discovered in conditions such as hereditary neuropathy, the more precise a delineation of the phenotype is required. EMG has particular strengths in the diagnosis of neuropathies, motor neuronopathy and neuromuscular transmission disorders such as myasthenia. Also, it can supplement the investigation of myopathies. Areas of development include the diagnosis of myasthenia, delineation of bulbar palsy as a cause of dysphagia, more accurate and earlier prediction of prognosis in neonatal brachial palsy and investigation of channelopathies. It is a valuable diagnostic tool in developed countries and those with limited resources.
