NCS UPPER LIMB and electro diagnostic studies.pptx

About different aspects of NCS Upper Limb

1. NCS UPPER LIMB Maj Maimuna Rashid

2. Approach to NCS/EMG

3. Protocol Electrodiagnostics is an extension of clinical exam History Exam DDx Formulate a study based on DDx Perform NCS EMG

4. Cardinal rules Extension of clinical exam Technical factors Reexamine the patient Contextual / clinical relevance Donot overcall a diagnosis

5. Technical factors Temperature Age Height Pro vs distal seg Cathode positioning Supramaximal stim Co-stimulation Motor electrode placement Distance btw record and ref electrode Limb position and distance measurement Sweep speed and sensitivity

6. Procedure Active electrode Reference electrode Ground electrode Belly-tendon montage

7. Components of NCS Motor NCS CMAP DML/PML MCV Sensory NCS SNAP SL SNCV F wave RNS

8. CMAP Sensitivity 2-5mv/div Sweep 20ms Stimulation 20-50mA

9. CMAP

10. Motor NCS

11. Motor NCS

12. Latency Orthrodomic Antidromic

13. Latency

14. Sensory conduction study Sensitivity 10-20uv/div Sweep 20ms Stimulation 5-25mA

15. Median

16. Median

17. Ulnar

18. Ulnar

19. Mixed

20. Radial

21. L&M ABC

22. Late responses F wave

23. Late responses a wave

24. ?

25. EMG Spontaneous activity Voluntary activity

26. Spontaneous activity

27. Spontaneous Activity

28. CRDS

29. Myotonia

30. Tremor vs Myokymia

31. Spectrum

32. Voluntary Activity

33. Voluntary Activity

34. MUAP