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Electrodiagnostic tests are physiological tests that measure the time it takes electrical impulses to travel from one site to another, such as EEC, EMG, EP, and NCV. These tests are important in that they determine nervous system dysfunction and diagnose ailments that are not anatomical in nature.
The Somatosensory Evoked Potential (SSEP), the Dermatomal Evoked Potential (DEP), the Nerve Conduction Velocity (NCV) and Musculoskeletal/Spinal Ultrasound tests are the most relevant to the management of cases involving neuroskeletal or soft tissue injuries and disease.
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Are used to test the large sensory fibre tract in the peripheral nervous system (nerve root) through the central nervous system to the cortex.
These tests essentially assist the doctor in differentiating peripheral lesions from proximal lesions as well as localization of the lesions.
It is useful in evaluating and documenting suspected plexus stretch injuries, thoracic outlet or carpal tunnel syndromes.
Other applications include spinal cord injuries or diseases, neuro-muscular disease and demyelinating disease.
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Are used to test that area supplied with nerve fibers by
a single spinal nerve root.
The DEP has proven to be appropriate in documenting injuries and substantiating continued treatment in those cases with negative and/or minimal disc bulges on MRI and CT Scans, wherein the patient still reports significant radicular pain.
A DEP can be valuable when the EMG is negative since
it shows sensory dysfunction rather than motor loss.
Other applications include nerve root entrapment,
neuroforaminal stenosis, nerve root stretch injury and
plexus irritations.
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Checks the pathways from the ear to the brain.
Used to help uncover the causes of hearing, balance and other problems.
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Checks pathways from the eyes to the brain.
Used to detect lesions in the retina, optic nerve and tract, visual cortex.
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Studies show the condition of the motor portion of the peripheral nerve along with the distal sensory information.
NCV tests are usually performed in conjunction with the EMG or EP.
It is a good study to use when history and physical exam suggest a polyneuropahty, a motor radiculopathy and/or entrapment symptoms.
NCV’s are extremely valuable in the diagnosis of peripheral nerve lesions, entrapment syndromes and several types of neuropathies.
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Can document soft-tissue injuries such as muscular contusion, ruptures, spasm, rhabdomyolisis or crushing injury, fibrous scars, cystic hematomas, muscular hernias, and myositis ossificans or muscular hemorrhage.
A spinal ultrasound scan can identify signs of inflammation in the facets, nerve roots, tendons, ligaments as well as muscles.
Studies show that ultrasound of the nerves, tendons and muscle groups produce consistent echogenic patterns.
Spinal/musculoskeletal ultrasound can provide a low-cost alternative to MRI for orthopedic-related imaging, particularly for practices dealing with personal and worker’s compensation injuries.
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