Standards for quantification of EMG and neurography

Area of Science:

• Neuroscience
• Clinical Electrophysiology

Background:

• The 1999 ICCN Standards for EMG and Neurography required updating to reflect current expert consensus.
• Advances in neurophysiological methods necessitate a revised guide for practitioners.

Purpose of the Study:

• To provide an updated and extended consensus document on electromyography (EMG) and neurography methods.
• To consolidate current knowledge on various neurophysiological testing techniques for clinical application.

Main Methods:

• A panel of international experts contributed and reviewed sections on their areas of expertise.
• A consensus-building process involving circulation of submissions for edits and comments was employed.
• The document synthesizes information on conventional EMG, Macro EMG, surface EMG, electrical impedance myography, and neurography.

Main Results:

• The document covers conventional EMG, Macro EMG, surface EMG applications, and electrical impedance myography.
• Neurography methods discussed include motor/sensory neurography, F wave, H-reflex, short segment recordings, CMAP scan, and motor unit number estimation.
• Additional sections address repetitive nerve stimulation and pediatric electrodiagnostic testing, including methodologies, pitfalls, and reference values.

Conclusions:

• This consensus document serves as a comprehensive update on established and emerging EMG and neurography techniques.
• It offers essential guidance on methodologies, potential challenges, and the interpretation of results in clinical neurophysiology.
• The updated standards aim to improve the consistency and accuracy of electrodiagnostic testing in clinical practice.