Neuropathy EMG Changes explained

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  • เผยแพร่เมื่อ 13 มิ.ย. 2016
  • This video will explain the EMG findings in neurogenic problems with denervation and re-innervation changes explained. If you found this useful, please support this channel by clicking Subscribe and giving me a thumbs up!
  • วิทยาศาสตร์และเทคโนโลยี

ความคิดเห็น • 60

  • @DrSimonFreilich
    @DrSimonFreilich  7 ปีที่แล้ว +10

    Thanks Syeda. In a nutshell in Myopathy one gets small polyphasic units recruiting rapidly to a full interference pattern with minimal effort and Neurogenic changes are enlarged and often polyphasic units with reduced interference patterns.

  • @DrSimonFreilich
    @DrSimonFreilich  7 ปีที่แล้ว

    Thanks Len and wishing you better soon!

  • @rezrogers8837
    @rezrogers8837 ปีที่แล้ว +1

    Such a brilliant video, has helped massively for my neurophys exam, thank you!

  • @jyotsnagumashta351
    @jyotsnagumashta351 2 ปีที่แล้ว

    Thanks Dr Simon. You explain so well

  • @mancaldonkisot1752
    @mancaldonkisot1752 3 ปีที่แล้ว

    Perfect explanation, appreciate.

  • @lengottfried8814
    @lengottfried8814 7 ปีที่แล้ว +1

    Thanks, this gives me a high degree of confidence that the NCS/EMG study that I am scheduled for will actually yield some valuable information to enable my physician to do an accurate diagnosis.

  • @vg473
    @vg473 7 ปีที่แล้ว

    very helpful, thank you!

  • @DrSimonFreilich
    @DrSimonFreilich  7 ปีที่แล้ว +2

    Much appreciated!

  • @hrhuntergaming5263
    @hrhuntergaming5263 7 ปีที่แล้ว

    thank you very much your reply is explain me the difference.

  • @mohsinishfaq2554
    @mohsinishfaq2554 7 ปีที่แล้ว

    thank you sir, do u have any lecture series on ncs emg? I really need that

  • @johnalvarado1995
    @johnalvarado1995 7 ปีที่แล้ว +1

    Is it necessary to test both arms to get an accurate reading

  • @user-gf5ll1et3s
    @user-gf5ll1et3s 3 ปีที่แล้ว

    Thank you for usefull video!

  • @ichikireiLV
    @ichikireiLV 5 ปีที่แล้ว +3

    Excellent explanation! Thank you!

    • @lucianoreginald9276
      @lucianoreginald9276 2 ปีที่แล้ว

      You all probably dont give a damn but does anybody know a method to log back into an instagram account??
      I stupidly forgot the login password. I would love any tips you can give me

    • @ignaciomitchell7176
      @ignaciomitchell7176 2 ปีที่แล้ว

      @Luciano Reginald instablaster :)

  • @jfresh2054
    @jfresh2054 2 ปีที่แล้ว

    I have muscle twitching going on 7 months now. Whole body. Would this test be any good for me?

  • @jamaicanempress2334
    @jamaicanempress2334 4 ปีที่แล้ว

    I'm a medical biller learning to bill those code...trust me it's harder than u explained

  • @stephaniemorley3697
    @stephaniemorley3697 2 ปีที่แล้ว

    I suffer with lots of twitching will the emg pick it up and diagnose me what it cud be

  • @hrhuntergaming5263
    @hrhuntergaming5263 7 ปีที่แล้ว +2

    sir please if you don't mind please explain me what are the basic difference of findings of EMG between myopathy and neuropathy. THANK YOU

  • @Kohliflie
    @Kohliflie 5 ปีที่แล้ว

    very interesting, thank you !

  • @DrSimonFreilich
    @DrSimonFreilich  7 ปีที่แล้ว

    Thanks Mohsin, not yet! Bw Simon

  • @karanjotgill886
    @karanjotgill886 5 ปีที่แล้ว

    Do the muscles in ALS twitch on rest and stop when they are active or they twitch regardless of the state of muscle (rest/motion) ?

    • @DrSimonFreilich
      @DrSimonFreilich  5 ปีที่แล้ว

      They'll twitch at any time. Bw Simon

  • @amerimnos
    @amerimnos 2 ปีที่แล้ว

    Hi there. My EMG after a year of cervical radiculopathy showed chronic denervation (mild-moderate) in brachioradialis and moderate chronic partial denervation in triceps and to a lesser extent in deltoid. What is the difference between denervation and partial denervation? Also, do larger motor units cause slower contractions and therefore slower movements? I.e. is there a functional difference between a normal muscle and a reinnervated one? Thank you!

    • @DrSimonFreilich
      @DrSimonFreilich  2 ปีที่แล้ว

      Hi, too complex for a one liner but residual strength very much depends on baseline and age. Bw Simon

  • @jennashinn8322
    @jennashinn8322 4 ปีที่แล้ว

    This is new to me so I don’t really understand and am not sure that it’s related to this video directly, but can I ask you about normal emg results but delayed reactions and if this could only be due to being cold or if there are other causes?

    • @DrSimonFreilich
      @DrSimonFreilich  4 ปีที่แล้ว

      Hi Jenna, I'm not sure what you mean but would direct you to the person who did your tests in the first place, as it seems that it might be more complex than a brief TH-cam answer. Bw Simon

  • @johncoughlan7408
    @johncoughlan7408 7 ปีที่แล้ว

    Dear Dr.how do you test the Tounge with EMG?do you put a needle under the chin?

    • @DrSimonFreilich
      @DrSimonFreilich  7 ปีที่แล้ว

      Hi again John, there are 2 approaches to doing this, either under the chin or directly into the side of the tongue. It looks weird but is actually very well tolerated (which never ceases to surprise me). I personally prefer the under chin method. Inferring (rightly or wrongly) from your line of questions, it seems that you may be due to have an EMG? If so, good luck with it and very best wishes.

  • @rosadeen6756
    @rosadeen6756 4 ปีที่แล้ว

    Why when I got an EMG I didn't feel anything not even the pokes or electricity, is that normal, painful neck, shoulder, back and chest with painful radiation burning on my skin on elbow and progressive loos of arm strength. Thank you.

    • @DrSimonFreilich
      @DrSimonFreilich  4 ปีที่แล้ว

      1.The needles are very thin 2. The tips are super sharp and if you take a look at the videos I made on single fiber emg you can see just how small and sharp they are 3. Unlike blood taking needles they aren't hollow so they dont cure your skin 4. A good EMGer (not a proper word but hey...) can perform distraction techniques much like a skilled magician (doesn't work on everyone and not something your formally taught) 5. I get asked this all the time and quite honestly, if it didn't hurt, don't complain ;) Bw Simon

  • @Dom699
    @Dom699 2 ปีที่แล้ว

    Hello, i have a question.
    I had a biopsy test done and my results were 4,6 mf p mm skin in the lower right leg. They said this would be classified as normal but its not far away from an sfn diagnosys.
    My emg showed high amplitude potencials in 3 limbs. Up to 1633 uv.
    I read that a sfn wouldnt rise the amplitude in an emg.
    Originally i went to the neurologist because of fasciculations and im very concerned about a possible motor neuron desease.
    So could the reason for the higher amplitude in emg mean that i have a beginning sfn and dont have an mnd?

    • @DrSimonFreilich
      @DrSimonFreilich  2 ปีที่แล้ว

      1. That's not high. 2. EMG isn't about size per se anyway. Bw Simon

    • @Dom699
      @Dom699 2 ปีที่แล้ว

      @@DrSimonFreilich thanks a lot.
      What about emg results of almost 4mv in the lower legs and fasciculations but without any other noticeble signs?

  • @Maraaaap
    @Maraaaap 3 ปีที่แล้ว +1

    Random question? When I had the needle inserted into my leg, but I was unable to push down when they asked , my leg went weak is that normal?

    • @DrSimonFreilich
      @DrSimonFreilich  3 ปีที่แล้ว +1

      Quite common actually, because it's often uncomfortable to contract the muscle with a pin inside it. Bw Simon

  • @kallahemanth
    @kallahemanth 6 ปีที่แล้ว

    Sir is there any fellowship/observership course to get trained under you?

    • @DrSimonFreilich
      @DrSimonFreilich  6 ปีที่แล้ว

      Thanks, it's great to be asked, but unfortunately it's not possible at this time. Bw Simon

  • @to564bnyt
    @to564bnyt 4 ปีที่แล้ว

    I have had a recent EMG. The result showed denervation in my deltoid, tricep, bicep and brachialis. The problem is going on over 2 years. Is it scientifically possible for reinnervation at this stage? I have athropy in the above muscles. No direct injury. Repeated MRI of both cervical spine and brachial plexus have shown nothing.
    I'm not asking for a medical diagnosis just an educated opinion on reinnervation

    • @DrSimonFreilich
      @DrSimonFreilich  4 ปีที่แล้ว +1

      Hi, not sure of the specifics but unlikely to at this stage. Bw Simon

    • @to564bnyt
      @to564bnyt 4 ปีที่แล้ว +1

      @@DrSimonFreilich thank you for your reply .
      If a thoracic outlet syndrome was present and operated on successfully and a compression was released could the chance of reinnervation be increased or has the window for reinnervation been missed. Medically and hypothetically

  • @sudharanjith6784
    @sudharanjith6784 3 ปีที่แล้ว

    how do you differentiate chronic denervation from reinnervation in EMG findings?

    • @DrSimonFreilich
      @DrSimonFreilich  3 ปีที่แล้ว

      Hi Sudha, important question but it's too complex for a one liner answer... bw Simon

  • @cucumber63
    @cucumber63 4 ปีที่แล้ว +1

    What amplitude are we talking about in the neurogenic changes?

    • @DrSimonFreilich
      @DrSimonFreilich  4 ปีที่แล้ว

      A good question and it depends on lots of factors e.g which muscle, time since onset, severity, as well as the type of needle used and machine filters (I could go on..). Usually above 3mV tends to be considered enlarged but it's not just about the amplitude.. morphology, width, pattern of recruitment and insertional activity all contribute to this evaluation. Bw Simon

  • @johncoughlan7408
    @johncoughlan7408 7 ปีที่แล้ว +1

    Dear Sir,is it easy to diagnose ALS with EMG

    • @DrSimonFreilich
      @DrSimonFreilich  7 ปีที่แล้ว +3

      Dear John,
      The answer to this depends entirely upon where the disease stage is at and what type of ALS a patient may have. For example, the upper motor neuron predominant form (PLS) which is characterised by spasticity, can be quite challenging as denervation in the muscles is often quite sparse and so difficult to pick up with the EMG. Conversely, lower motor neuron predominant MND can have very florid changes which are easy to detect but can be difficult to distinguish from other neuro-muscular conditions.
      Hope this makes sense, and best wishes
      Simon

  • @Phaizal555
    @Phaizal555 8 หลายเดือนก่อน

    You are amazing, Dr. freilich. I’ve been watching your videos for the last few months and they’ve helped so much in clarifying concepts and guide further reading. Thank you so much for being amazing.

  • @stefan9858
    @stefan9858 5 ปีที่แล้ว

    Hello doctor, i have a question about my abnormal EMG test results. I have right leg and right arm weakness but i can move normally. I’m 25 years old and i have numbness, tingling and twitching all over my body, especially in my legs and feet.
    My EMG says ( i will try to translate it from my language to english): We register normal motor and sensory speed of conduction of the nerves of lower extremities with reduced amplitude potentials n tibialis left. The needle test of lower leg muscles on both sides shows there is no signs of acute denervation. However, we register high amplitude potentials of prolonged duration with moderate reduction in muscles of lower extremities but with no significant asimmetry. (What does this mean??)
    Left and Right TIB Anterior shows +1 on amplitude, reduction and pol. akc. Neu.
    Also the same for Left and Right Gastrocn (med).
    What does this mean? Doctor didn’t explain anything.

    • @DrSimonFreilich
      @DrSimonFreilich  5 ปีที่แล้ว

      Hi, I'm really sorry but I can't answer personal questions. You will need to ask them directly. Wishing you all the best though, Simon

    • @iykegideon8199
      @iykegideon8199 4 ปีที่แล้ว

      I have the same issue with you how are you now

    • @iykegideon8199
      @iykegideon8199 3 ปีที่แล้ว

      How are you now

    • @izachu904
      @izachu904 5 หลายเดือนก่อน

      @@iykegideon8199 i can relate to that. not one side but only ne foot small symptoms

  • @csb.2513
    @csb.2513 4 ปีที่แล้ว

    is +2 Fibrillation able to heal

    • @DrSimonFreilich
      @DrSimonFreilich  4 ปีที่แล้ว

      Yes. Bw Simon

    • @csb.2513
      @csb.2513 4 ปีที่แล้ว

      @@DrSimonFreilich even if it's been 2 years ? But seeing improvement in last 2 months ?

    • @izachu904
      @izachu904 5 หลายเดือนก่อน

      how are you now brother@@csb.2513

  • @user-ot1xr1tg4g
    @user-ot1xr1tg4g ปีที่แล้ว

    👋

  • @agnieszkaczesnik2308
    @agnieszkaczesnik2308 ปีที่แล้ว

    Gr

  • @gaylecheung3087
    @gaylecheung3087 3 ปีที่แล้ว

    Turn up the volume and hardly hear you