EMG Preparation/General Info
What are the 3 main symptoms people experience that require EMG?
Numbness, tingling and/or pain in limbs
What's the difference between CTS and Ulnar Neuropathy?
CTS - symptoms localize in the hands (in the thumb, pointer and middle fingers), and are worse at night
Ulnar - symptoms localize between the elbow and the hand (in the pinky finger and ring finger); characterized by hand weakness as well
When there is a space to double book, can you book any type of appointment?
**NEW RULE: Simple EMGs should be staggered next to another simple EMG.
How would you book the following: "Bilateral hand/arm weakness"? EMG or GNC?
EMG Moderate
What type of appointment should follow a complex EMG?
EMG Simple, Lunch, or End of Day
Do you give a polyneuropathy/peripheral neuropathy a hot pad?
YES! They typically test one arm and one leg.
Glove stocking numbness is characteristic of which EMG condition?
Polyneuropathy/Peripheral neuropathy
What complexity and duration of appointment would the following complaint fall into: "Brachial/Lumbar Plexopathy"?
30 Mins, EMG Complex
How would you book the following complaint: "Numbness in hands, feet, and chin"? EMG or GNC?
GNC
**If ever the symptoms are not in the limbs it is likely to be a GNC. However, there are some exceptions to this, so task the referral coordinator if you are unsure.**
This is not correct. This should be an EMG Complex.
**NOTE: We have run into a lot of these types of errors on the waitlist. If you are ever unsure, ASK. Don't just book something assuming it was triaged correctly.
How would you book a 4 limb study?
As a complex with a simple EMG or a break following it.
Foot drop is characteristic of which EMG-related condition?
Peroneal neuropathy
How would you book an Lumbosacral Radiculopathy?
What if it was bilateral?
EMG moderate
EMG complex if bilateral
How would you book the following complaint: "numbness in R leg and R arm"? EMG or GNC?
GNC
**If symptoms are on opposite sides, book EMG
**sometimes there are exceptions to this, such as onset of symptoms after a trauma injury. If ever unsure, task the referral coordinator.**
How many moderate EMG appointments can be booked back to back, before you should book a simple EMG?
2-3
Name two EMG conditions (moderate or complex only) that we give hot packs to.
Polyneuropathy/peripheral neuropathy
Cervical Radiculopathy
Brachial Plexopathy
What's the difference between a radiculopathy and a plexopathy?
Plexopathies are typically characterized by a trauma injury to the neck/shoulder/back area
Droopy eye (Ptosis) and muscle aches/weakness are characteristic of which EMG condition?
How is this booked (complexity and duration)?
Myasthenia Gravis
Complex EMG, 60 Mins
** if only ptosis, it could be GNC or EMG - Ask the referral coordinator**
How would you book the following complaint: "Fasisculations to L bicep"? EMG or GNC?
EMG Moderate
What are the maximum number of complex EMG appointments you should book in a single day for any doctor?
2 (including urgent complex EMGs, unless specifically told to do so)
What is the only medication patients cannot take before having an EMG done?
How long before their appointment must they stop taking this med?
Mestinon
24 hours
**Patients coming in for MG testing are typically the ones who are on Mestinon**
MULTIPLE CHOICE: Which of the following conditions would require us to expedite an EMG referral?
A) Pregnancy
B) Sudden onset symptoms (i.e. foot drop)
C) Vasculitis
D) Incontinence
E) A, B and C
F) B, C and D
G) All of the above
G
How would you triage the following list of complaints: "Numbness, tingling, abnormal/lack of sensation, difficulty to control movement, inability to move part of the body"? EMG? GNC? Complexity? Duration?
EMG - Mononeuritis
Complex
60 mins
How would you book the following complaint: Burning/Numbness/Tingling in limbs after Covid-19 vaccine? EMG or GNC?
EMG Moderate
**If symptoms are in limbs and other parts of the body, AND are after vaccine, task referral lead.**
On the GNC waitlist you see "numbness" "tingling" "paresthesia", but the body region is unspecified. What should you do with this?