Neurologic Clinics. Clinical Electromyography.

VIII; 326 p. Small stains and abrasions on the cover. Otherwise good and clean. - Einband berieben und leicht befleckt. Sonst gut und sauber. - This issue of Neurologic Clinics is devoted to clinical electromyography (EMG). Clinical EMG, also known as electrodiagnostic study, is the electrophysiological examination of peripheral nerve and muscle. It is a distinct discipline and plays a pivotal role in the evaluation and management of patients with neuromuscular disorders. Clinical EMG best serves as an extension of the neurologic examination. It is well suited to diagnose disorders of the peripheral nervous system, including the sensory nerves, the dorsal root ganglia, and the motor unit (anterior horn cells, motor nerves, neuromuscular junctions and muscles). Each study must be individualized, based on the manifestations and differential diagnosis, and modified as further information is gained. The focus of this issue is clinical. To accomplish this task, I have assembled a group of practicing academic electromyographers with expertise in the disciplines of clinical EMG and neuromuscular disorders. All contributions emphasize the practical aspects of the electrodiagnostic studies, as encountered daily in the EMG laboratory. I have divided the subjects into two sections: Basic Concepts and Findings in Neuromuscular Diseases. The first section starts with an introduction on the discipline of clinical EMG, in which I define the scope of the examination with emphasis on the EMG laboratory's referral process and reporting. This is followed by Asa Wilbourn's scholarly review of the basic abnormalities of nerve conduction studies seen in peripheral nerve lesions and their localization values. This interesting article provides many of the basics to the understanding and analysis of the electrodiagnostic study in general and the nerve conduction studies in particular. Next, Morris Fisher summarizes the physiology of the F-waves and H-reflexes and their utilities in diagnosing neuromuscular and spinal cord disorders. Finally, David Preston and Barbara Shapiro complete this section by covering, in detail, the fundamentals of needle EMG with emphasis on normal and abnormal findings. The second section of this issue is divided into several articles discussing the electrodiagnostic findings of the most common neuromuscular diseases referred to the EMG laboratory. In his comprehensive article on radiculopathies, Kerry Levin updates the classic EMG patterns seen with cervical and lumbosacral radiculopathies and emphasizes the recently published EMG- based myotomal charts. After setting the tone of the terminology and anatomy of the various elements of the brachial plexus, Mark Ferrante and Asa Wilbourn discuss, in detail, the value of the electrodiagnostic findings in the accurate and precise localization of brachial plexopathies. Next, two articles are devoted to mononeuropathies: David Herrmann and Eric Logigian discuss the approach and findings of upper limb mononeuropathies while I review the electrodiagnostic studies of those of the lower limb. The article on peripheral polyneuropathy, by Theodore Wein and James Albers, covers, first, the clinical approach to polyneuropathies in general, and then highlights the electrodiagnostic findings in the demyelinating and axonal polyneuropathies. David Chad's interesting article on motor neuron disease starts with a discussion of the clinical diagnosis and electrodiagnostic findings, with a healthy critique of the criteria (including the revised El Escorial criteria), and ends with a differential diagnosis of the mimickers of motor neuron disease. With Henry Kaminski, I outline the physiology of neuromuscular transmission as it pertains to the electrodiagnostic examination and highlight the findings of neuromuscular junction disorders with emphasis on myasthenia gravis, Lambert-Eaton myasthenic syndrome and botulism. Finally, David Lacomis summarizes the findings in the various myopathies presenting to the EMG laboratory and constructs practical tables summarizing their EMG patterns. Overall, I believe that this issue of Neurologic Clinics will prove to be an extremely useful reading to practicing neurologists and physiatrists, training fellows in clinical neurophysiology, neuromuscular diseases and clinical EMG, as well as residents in Neurology and in Physical Medicine and Rehabilitation. Finally, I want to thank all the authors for their generous contributions, and to the editors at W.B. Saunders for inviting me to be the guest editor of this issue. I am most grateful to my wife, Patricia, and my children, Linda and Michael, for their encouragement and support.