Referral Guidelines

These guidelines are designed to help providers determine when a referral for an electrodiagnostic medicine consultation may be useful for a patient. During the consultation, the provider evaluates nerve and muscle function, and this is a direct extension of the clinical history and neuromuscular examination. This list is not exhaustive but serves as a reference for frequently encountered problems.


Symptoms


Diagnoses


Generalized Weakness

Neuropathies
Myopathies
Motor system disease (i.e., amyotrophic lateral sclerosis)
Neuromuscular junction disorder (i.e., myasthenia gravis)


Neck pain


Cervical radiculopathy
Brachial plexopathy
Focal neuropathy (i.e., spinal accessory nerve)


Thoracic


Thoracic radiculopathy


Back pain


Lumbosacral radiculopathy
Lumbosacral plexopathy


Shoulder and arm pain, numbness,
altered sensation (i.e., pins and
needles), weakness, cramps,
fasciculations, muscle atrophy
or hypertrophy (focal or diffuse)


Cervical radiculopathy
Brachial plexopathy
Polyneuropathy
Focal neuropathy (i.e., carpal tunnel syndrome, ulnar nerve injury at the elbow, suprascapular nerve injury at the shoulder)
Myopathy
Motor system disease (i.e., amyotrophic lateral sclerosis)


Hip and leg pain, numbness, altered sensation
(i.e., pins and needles), weakness, cramps,
fasciculations, muscle atrophy
or hypertrophy


Lumbosacral radiculopathy
Lumbosacral plexopathy
Polyneuropathy
Focal neuropathy (i.e., tarsal tunnel syndrome, femoral [focal or diffuse] mononeuropathy)
Myopathy
Motor system disease (i.e., amyotrophic lateral sclerosis)


Distal paresthesias


Carpal tunnel syndrome
Peripheral neuropathy


Cramps


Peripheral neuropathy
Motor neuron disease (early)
Myopathy


Distal weakness


Polyneuropathy
Focal mononeuropathy (i.e., carpal tunnel syndrome, ulnar neuropathy)
Myopathy (i.e., inclusion body myositis, distal myopathy)


Proximal weakness


Myopathy

Plexopathy


These guidelines are designed to help providers determine when a referral for an electrodiagnostic medicine consultation may be useful for a patient. During the consultation, the provider evaluates nerve and muscle function, and this is a direct extension of the clinical history and neuromuscular examination. This list is not exhaustive but serves as a reference for frequently encountered problems.

Symptoms And Diagnosis

Generalized Weakness:

  • Neuropathies
  • Myopathies
  • Motor system disease (i.e., amyotrophic lateral sclerosis)
  • Neuromuscular junction disorder (i.e., myasthenia gravis)

 

Symptom and Diagnosis

Neck pain:

  • Cervical radiculopathy
  • Brachial plexopathy
  • Focal neuropathy (i.e., spinal accessory nerve)

 

Symptom and Diagnosis

Thoracic:

  • Thoracic radiculopathy

Symptom and Diagnosis

Back pain:

  • Lumbosacral radiculopathy
  • Lumbosacral plexopathy

Symptom and Diagnosis

Shoulder and arm pain, numbness,
altered sensation (i.e., pins and
needles), weakness, cramps,
fasciculations, muscle atrophy
or hypertrophy (focal or diffuse):

  • Cervical radiculopathy
  • Brachial plexopathy
  • Polyneuropathy
    Focal neuropathy (i.e., carpal tunnel syndrome, ulnar nerve injury at the elbow, suprascapular nerve injury at the shoulder)
  • Myopathy
  • Motor system disease (i.e., amyotrophic lateral sclerosis)

Symptom and Diagnosis

Hip and leg pain, numbness, altered sensation
(i.e., pins and needles), weakness, cramps,
fasciculations, muscle atrophy
or hypertrophy:

  • Lumbosacral radiculopathy
  • Lumbosacral plexopathy
  • Polyneuropathy
  • Focal neuropathy (i.e., tarsal tunnel syndrome, femoral [focal or diffuse] mononeuropathy)
  • Myopathy
  • Motor system disease (i.e., amyotrophic lateral sclerosis)

Symptom and Diagnosis

Distal paresthesias:

  • Carpal tunnel syndrome
  • Peripheral neuropathy

Symptom and Diagnosis

Cramps:

  • Peripheral neuropathy
  • Motor neuron disease (early)
  • Myopathy

Symptom and Diagnosis

Distal weakness:

  • Polyneuropathy
  • Focal mononeuropathy (i.e., carpal tunnel syndrome, ulnar neuropathy)
  • Myopathy (i.e., inclusion body myositis, distal myopathy)

Symptom and Diagnosis

Proximal weakness:

  • Myopathy
  • Plexopathy