- Видео 7
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Leiden Clinical Neurophysiology
Добавлен 2 сен 2010
In this channel I aim to share videos on practical aspects of clinical neurophysiology and neuromuscular diseases, in particular myasthenia gravis. I am a neurologist/clinical neurophysiologist at Leiden University Medical Center. I hope to continue to add new content on a semiregular basis.
Needle EMG: fasciculations
In this video, I am going to talk about fasciculations: what they look like clinically, their clinical significance, pathophysiology and what they look when they occur during a needle EMG examination.
Просмотров: 5 860
Видео
Needle EMG: normal vs myopathic MUPs
Просмотров 2,8 тыс.9 месяцев назад
In this video, I'll describe what the EMG looks like in patients with a myopathy, such as OPMD, CEPO or inclusion body myositis. The video is intended for neurologists, clinical neurophysiologists or people training to become one. IF you are unfamiliar with the basic principles of EMG, please watch the primer first.
Needle EMG: spontaneous muscle fiber activity
Просмотров 1,2 тыс.11 месяцев назад
In this video I will give some examples of spontaneous muscle fiber activity as it can be seen on needle EMG. Please watch my primer on needle EMG first for an overview of the basic principles of electromyography.
Needle EMG: early reinnervation
Просмотров 1,1 тыс.11 месяцев назад
This video contains an example of small, polyphasic motor unit potentials that can be seen as the first sign of reinnervation.
Needle EMG: normal vs neuropathic MUPs
Просмотров 1,7 тыс.11 месяцев назад
This a short video explaining the difference betwen normal and neuropathic motor unit potentials using actual EMG recordings from real patients.
Needle EMG: primer
Просмотров 5 тыс.Год назад
In this video, I will explain the underlying neuroanatomy en neurophysiology needed to interpret the needle EMG. This video is intended for neurology trainees and therefore requires some knowledge of basic neuroanatomy and physiology. After watching this video, you will be able to explain the processes going on in the muscle that result in the EMG signal as we see it on the screen, in healthy s...
Repetitive stimulation of the anconeal muscle
Просмотров 2,8 тыс.Год назад
This video is in Dutch, but I have added an English translation in the captions. The video contains a demonstration of repetitive nerve stimulation, recorded from the anconeal muscle. Repetitive nerve stimulation is a technique to diagnose diseases of the neuromuscular junction, of which myasthenia gravis is the most common. The anconeal muscle is not commonly investigated, but I find it a part...
Large, long, some polyphasic MUPs, reduced recruitment. Old neuropathic injury.
Great explanation. Thank you
Great explanation. Thank you
Thanks!
I am a recent graduate specialising in clinical neurophysiology - I was wondering if you also perform EEG and Evoked Potential monitoring as well? Or even Intra-operative nerve monitoring? - Your videos are very nicely refined and comprehensive!
Hello sir. Thanks for sharing. I had an EMG done roughly 3 weeks ago to investigate muscle twitching in my right arm. ( not sure if that was recommended ). The emg was uncomfortable. I jumped at one point during the exam during the NVC part. The examiner apologised. It was over my ulnar nerve. I was told my EMG was normal. Apart from a mild ulnar neuropathy ( velocity 40) I was unaware nor did I have symptoms of neuropathy prior to the exam ever . Now 3 weeks later and i am still having excruciating burning in my palm 5th and 4th digit and shocky feelings in my arm after the EMG, all of which is new to me. Is this normal? Can the emg cause nerve damage ? If so how can I find out? I was told by a colleague that during the needle portion no needles was placed near my ulnar or elbow region. Can the volts during NVC cause nerve damage or irritation that lasts this long ? Are EMG standardised so that the examiner cannot exceed unsafe voltage? And is any of this temporary from your experience? Thank you kindly for any input you may have.
Normally they are huge when compared to other potentials... Just look at the settings in the EMG Window in the video...
Really Nice explanation..kindly add more live vedio about EMG.
Please 🙏 more practical videos and more examples. and can du talk about EMG bei children
Thank you so much, this video was very helpful!
Very helpful video. Could you please use a better microphone? It is hard to understand, espacially for demonstration to students in large rooms.
Thank you! This was recorded with a very basic setup, but I will pay more attention to the audio quality in future recordings.
I feel audio is not so clear, content is good 😊
What the difference between benign and malignant fasciculations?
I suppse one is connected with a underlaying cause I assume?
Thanks
Thanks
Thanks, but what about post-exercise RNS with this muscle?
Hi, I usually don't do post-exercise RNS, but it is a matter of taste. It could lead to a slight increase in diagnostic yield, but I prefer to use my time to investigate multiple muscles, which also increases diagnostic yield.
@@leidenclinicalneurophysiology which other muscles do you prefer ? Other than clinically affected muscles.
@@gamaltaher9714 We usually go for abductor digiti minimi, anconeus, nasalis and trapezius. I recently learned that the deltoid also has a relatively high sensitivity for MG.
@@leidenclinicalneurophysiology Thanks, what is your protocol to confirm that the decrement is due to MG and not due to chronic neurogenic conditions as MND
Regular rate.
Thanks
Hello which machine do u use
These traces were recorded on a synergy machine, but there are many excellent brands
NERVE CONDUCTION STUDY and EMG
@@leidenclinicalneurophysiology Thanks for all your help. I am used to Caldwell and recently started using Natus with synergy which is a downgrade for me. Can you make a video or go over the settings that you are using including the voltage per division and duration per division for both spontaneous and volitional activities. Thanks and much appreciated
thanks for your demostration.
fibrillation potentials are regular firing
Hi Simone, although individual fibrillation potentials can indeed fire at a semiregular rate, their abundance, the fact that they are usually intermingled with positive sharp waves and fact that they can be elicited by needle movements all result in a rather irregular sounding signal, which is very different from the sound caused by the regular firing of MUPs at a rate of 5 to 30 Hz.
@@leidenclinicalneurophysiology I'm still confused after your answer Is it regular or irregular
Deeply impressed by the usefulness and practical value and quality of videos with real professional content! Great job! Perfect! Highly appreciate, thank you a lot! Sir, you are born for a teacher and university professor. 👍
Thank you very much! I am glad that people find these videos useful. I realise my recordings are all a bit amateurish, but there is not much educational content available for clinical neurophysiologists, so I hope I can help fill this void.
Great video! Very precise and correct, so much practical and much useful for neurophysiologists. Thank you, colleague! 😊👍
Fibrillation and polyphasic waves consistent with neuropathic patterns
Large, long, polyphasic MUAPS with reduced recruitment suggestive of neuropathic pattern. Your content is concise & informative. Keep up the good work 🌹
Great. 🎉🎉🎉
Amazing video with clear explanation thank you !!
Thank you for sharing these videos with real exemples thats very helpful
It is a neurogenic pattern some of th MUP are higher than 2mv , and less recruitment, Thank you for this interesting video very helpful, if you can give us more video training 😅that will be fantastic
You are absolutely correct! Unfortunately I don't have a prize to hand out... I plan to be back with more recordtijd soon!
🤭 kennelijk heb ik altijd de klemtoon verkeerd gelegd. Ik dacht m. ancóneus was..
Eerlijk gezegd heb ik geen idee Claire! Ik heb een tijdje geleden aan de neuroanatoom van het LUMC gevraagd wat de juiste uitspraak was, maar hij wist het ook niet. Ik doe dus maar wat :)
Thank you , great job