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Incidental complex repetitive discharges on needle electromyography.

Harsh V Gupta1, Michael P Skolka2, Ruple S Laughlin2

  • 1Department of Neurology, Mayo Clinic, Jacksonville, Florida.

Muscle & Nerve
|November 23, 2022
PubMed
Summary

Complex repetitive discharges (CRDs) are abnormal EMG findings that can appear incidentally in normal studies. These findings are most common in the L5 and C6 nerve root areas, suggesting potential clinical significance.

Keywords:
CRDEMGcomplex repetitive dischargeincidentalradiculopathy

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Area of Science:

  • Neurology
  • Electromyography (EMG)
  • Nerve conduction studies

Background:

  • Complex repetitive discharges (CRDs) are spontaneous electromyography (EMG) waveforms.
  • CRDs are typically associated with chronic neurogenic or myopathic conditions.
  • However, CRDs can also be incidentally identified in normal electrodiagnostic studies.

Purpose of the Study:

  • To describe the distribution and potential significance of incidentally identified CRDs.
  • To analyze patients with CRDs found during otherwise normal electrodiagnostic assessments.

Main Methods:

  • Retrospective chart review of patients with incidentally documented CRDs.
  • Analysis of clinical symptoms, referral reasons, electrodiagnostic reports, and imaging studies.
  • Descriptive statistical analysis of patient data.

Main Results:

  • Ninety-four patients with 107 CRDs were studied; 86% were female, mean age 62.
  • CRDs were most frequent in tensor fasciae latae, biceps brachii, and gluteus maximus muscles.
  • Of 58 patients with imaging, 79% had abnormalities in CRD-associated myotomes (L5, C6), with 61% referred for radicular or limb pain.

Conclusions:

  • Complex repetitive discharges can be incidentally found in normal electrodiagnostic studies.
  • These incidental CRDs are most commonly observed in the L5 and C6 myotomes.
  • The underlying mechanism of CRDs without other electrodiagnostic abnormalities remains unclear.