Electrodiagnostic Services
Dr. Niles M Roberts, MD
Electrodiagnostic Procedures
Electrodiagnostic procedures are a set of electrical methods that generate data about the function and physiology of nerves, which enables the diagnosis of nerve injury or disease. The accompanying picture shows the EMG machine that I use to perform these procedures.
I perform this procedure for my own patients when needed, and offer it as a consultation service for other doctors.
As a Physical Medicine & Rehabilitation (PM&R) physician, I have completed a comprehensive course of training over the three years of residency. In addition, I completed a two-year Neurosciences Fellowship at the Zablocki VA Medical Center in Milwaukee WI from 2007 to 2009, where I not only performed these procedures on a nearly full time basis, but also performed and published research involving such, and instructed or supervised residents performing them.
Carpal Tunnel Syndrome
The most common nerve injury is carpal tunnel syndrome, but nearly any nerve injury in the hand, arm, leg, foot, or any nerve root in the low back or cervical spine (‘neck’) can be evaluated. Injuries or impingement of nerve roots in the neck or low back are common, and these conditions are known as cervical or lumbar radiculopathies.
Nerve Conduction Studies (NCS)
One category of electrodiagnostic procedures is Nerve Conduction Studies, or NCS for short. This procedure is used to diagnose nerve injury in the extremities, and involves the placement of ‘passive’ or receiving electrodes which are taped to the skin. A passive electrode will pick up voltage any signals produced by underlying muscle or sensory nerve. Then another electrode, known as the ‘stimulating electrode’ is placed elsewhere, on skin overlying the nerve to be stimulated. The stimulating electrode delivers a small spike of electrical current that subjectively feels like a discharge of static electricity. I’m able to adjust these stimuli or ‘shocks’ to lay below the pain threshold 90% of the time, and in the instances where that is not possible, I’ll notify the patient before the fact. I have performed over 4000 (estimated) of these procedures since 2004, with virtually 100% percent of my patients tolerating the procedure to completion.
Electromyography (EMG)
The other category of procedures is Electromyography, or EMG for short, which is used chiefly to diagnose injury to nerve roots, but also to augment NCS evaluation of nerves in the extremities. These procedures involve the insertion of a needle electrode through the skin into muscle. The needle electrode does not ‘shock’ or deliver a stimulus; rather, it picks up voltage signals generated by the muscle tissue. These signals are both displayed on a computer screen as a moving waveform, and also transformed into sound. The waveforms and sounds convey information as to the health and function of the nerve that innervates the muscle under study. The human interpretation (by me) of these signals enables the diagnosis of the nerves or nerve roots in question.
The needle electrodes are teflon-coated, are finer than hypodermic needles, so they hurt less than hypodermic needles. Nevertheless, the procedure is not as comfortable as NCS’s. But my patient’s are generally able to tolerate the procedure to completion.
How to get started
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1) Intake Form - PDF
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