Referral Guidelines - EMG NCV Testing in TN, MS, and AR - Bingham Nerve & Muscle

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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

Generalized Weakness

Diagnoses

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

Symptoms

Neck pain

Diagnoses

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

Symptoms

Thoracic

Diagnoses

Thoracic radiculopathy

Symptoms

Back pain

Diagnoses

Lumbosacral radiculopathy
Lumbosacral plexopathy

Symptoms

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

Diagnoses

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)

Symptoms

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

Diagnoses

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)

Symptoms

Distal paresthesias

Diagnoses

Carpal tunnel syndrome
Peripheral neuropathy

Symptoms

Cramps

Diagnoses

Peripheral neuropathy
Motor neuron disease (early)
Myopathy

Symptoms

Distal weakness

Diagnoses

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

Symptoms

Proximal weakness

Diagnoses

Myopathy

Plexopathy