Amazing series! I'm getting ctr on Monday because my ncv was finally abnormal after having symptoms for a decade. (Also have a connective tissue disorder)
Really good question! It's a bit 'East side-West side'. I don't know of any UK Neurophysiologists who do APB EMG as part of routine Carpal Tunnel testing. I think this happens more in the USA. I'm not going to tell you that it's pointless, because there are occasions where it can be useful. Philosophically - I'd suggest that with any NCS or EMG test that we perform - there has to be a point that you are trying to demonstrate - whether proof of diagnosis or exclusion within the differential. EMG is most sensitive for motor axonal loss rather than demyelination. Sure, we can see blocking patterns but that's really at later stages of denervation. The vast majority of CTS related information is included in the NCS segment - both for diagnosis, stratification and prognosis. You might want to explore further with EMG in it's most end stage or perhaps if suspecting additional or other entities. But if so, it won't just be the APB. To experienced eyes, NCS/EMG reports can speak volumes about the quality of thought that went into them, by the selection of tests performed. Referring colleagues want to see that the right amount of tests were done - not too few and not too many. One day I'll give a talk on this - but the best description of my personal philosophy is the application of the 'dairy farming analogy' described by the late author, Sir Terry Pratchett, whereby you want to get the 'maximum amount of milk for the minimum amount of moo'. Wishing you all the best and a Happy New Year, Simon
Amazing series! I'm getting ctr on Monday because my ncv was finally abnormal after having symptoms for a decade. (Also have a connective tissue disorder)
Very useful
Very helpful.Thanks so much Dr.Simon.I am a neurology resident in my 4th practicing year and I learn a lot from your Videos. Keep up 👍
Excellent video
Excellent tutorial. Very helpful!
Hi Dr Simon I'm Ella I fell of The Monkey Bars And Broke My Arm You Gave Me A Nerve Test
FunTastic - Your definitely a star and good luck with everything! Bw Simon
Thank you. Great video
No need to check the emg of APB or it will always be altered (because of the NCV abnormalities we encounter in the exam)?
Really good question! It's a bit 'East side-West side'. I don't know of any UK Neurophysiologists who do APB EMG as part of routine Carpal Tunnel testing. I think this happens more in the USA. I'm not going to tell you that it's pointless, because there are occasions where it can be useful. Philosophically - I'd suggest that with any NCS or EMG test that we perform - there has to be a point that you are trying to demonstrate - whether proof of diagnosis or exclusion within the differential. EMG is most sensitive for motor axonal loss rather than demyelination. Sure, we can see blocking patterns but that's really at later stages of denervation. The vast majority of CTS related information is included in the NCS segment - both for diagnosis, stratification and prognosis. You might want to explore further with EMG in it's most end stage or perhaps if suspecting additional or other entities. But if so, it won't just be the APB. To experienced eyes, NCS/EMG reports can speak volumes about the quality of thought that went into them, by the selection of tests performed. Referring colleagues want to see that the right amount of tests were done - not too few and not too many. One day I'll give a talk on this - but the best description of my personal philosophy is the application of the 'dairy farming analogy' described by the late author, Sir Terry Pratchett, whereby you want to get the 'maximum amount of milk for the minimum amount of moo'. Wishing you all the best and a Happy New Year, Simon
@@DrSimonFreilich Thank you for the great response :D Very very helpful
Thanks very much
great series , i really enjoyed it , so thankful for your efforts doctor .
Danke