Electromyography in Pediatric Population
Elif Kocasoy Orhan1, Leyla Baysal Kiraç1, Pınar Yalinay DİKmen2
1Department of Neurology, Istanbul University Faculty of Medicine, İstanbul, Turkey.
Insights
Pediatric electrodiagnostic evaluations reveal common diagnoses like plexopathy in infants and myopathy in older children. These studies are crucial for diagnosing neuromuscular diseases, with brachial plexopathy often treatable through better obstetrical care.
Area of Science:
- Pediatric Neurology
- Clinical Electrophysiology
Background:
- Electrodiagnostic evaluation is vital for diagnosing pediatric neuromuscular diseases.
- Disease prevalence differs significantly across pediatric age groups.
Purpose of the Study:
- To retrospectively analyze electrophysiological examinations in children aged 0-15 years.
- To identify common neuromuscular disorders in different pediatric age strata.
Main Methods:
- Reviewed 5563 pediatric electrodiagnostic records (January 2004 - June 2013).
- Classified patients by diagnosis: plexopathy, polyneuropathy, myopathy, mononeuropathy, etc.
- Analyzed diagnostic yields across age groups (0-5, 6-10, 11-15 years).
Main Results:
- Electromyography (EMG) constituted 14% of all lab examinations.
- Common diagnoses varied by age: plexopathy (infants), myopathy and polyneuropathy (older children).
- Normal results were observed in 55% of cases.
Conclusions:
- Brachial plexopathy is frequent in infants, preventable with optimal obstetrical management.
- Nerve conduction studies and EMG are essential for diagnosing demyelinating neuropathy and myopathy in children over 6.
- Electrophysiology aids in differentiating pediatric neuromuscular conditions.
Introduction:
Electrodiagnostic evaluation provides an important extension to the neurological examination for the evaluation of pediatric neuromuscular disease. Many pediatric neuromuscular diseases are analogous to those seen in the adult. However, the relative frequency of these illnesses varies greatly when different age populations are compared. The purpose of the present study is to provide a retrospective analysis of children referred to our electromyography (EMG) laboratory for electrophysiological examinations.
Methods:
We retrospectively reviewed electrodiagnostic records of patients aged between 0-15 years, from January 2004 to June 2013. Patients were classified as having plexopathy, nerve root lesions, polyneuropathy, myopathy, mononeuropathy, anterior horn cell disease, neuromuscular transmission disorder, facial nerve palsy, and other rare disorders.
Results:
We reviewed totally 5563 pediatric records, which was on the average 578 studies per year. It was about 14% of the all EMG examinations performed in our laboratory. When we looked at all the procedures, 3271 of the records included needle EMGs, 170 of them were single fiber EMGs, 100 of them were repetitive nerve stimulations, and 52 of them were evoked potentials. The results were normal in 55% of the cases. As a result of electrophysiological examinations, the common diagnoses were: plexopathy (28.6%), polyneuropathy (7.4%), and myopathy (6.6%) in patients aged 0-5 years (41.2% of all records); myopathy (9.4%), PNP (8.5%), mononeuropathy (6.4%), and plexopathy (5.9%) in 6-10 years (28.2% of all records); PNP (11.3%), myopathy (6.6%), and mononeuropathy (5.6%) in 11-15 years (30.6% of all records).
Conclusion:
Infants and toddlers mostly suffered from brachial plexopathy which can be prevented by proper obstetrical management. Nerve conduction studies and EMG yielded diagnostic importance for demyelinating neuropathy and myopathy in patients older than 6 years of age.
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