Neurophysiological Assessment of Abnormalities of the Neuromuscular Junction in Children

Electrodiagnostic Assessment of Neuromuscular Junction Disorders

Please verify edits, "These techniques", or specify. This article reviews advanced electrodiagnostic techniques used to assess for neuromuscular junction disorders, including repetitive nerve stimulation, conventional or concentric-needle single-fiber electromyography (SFEMG), and stimulated SFEMG. These techniques have high sensitivity but limited specificity. Novel methods currently under investigation are discussed, including vestibular ocular myogenic potential and oculography analysis.

Utility and practice of electrodiagnostic testing in the pediatric population: An AANEM consensus statement

Nerve conduction studies and needle electromyography, collectively known as electrodiagnostic (EDX) studies, have been available for pediatric patients for decades, but the accessibility of this diagnostic modality and the approach to testing vary significantly depending on the physician and institution. The maturation of molecular diagnostic approaches and other diagnostic technologies such as neuromuscular ultrasound indicate that an analysis of current needs and practices for EDX studies in the pediatric population is warranted. The American Association of Neuromuscular & Electrodiagnostic Medicine convened a consensus panel to perform literature searches, share collective experiences, and develop a consensus statement. The panel found that electrodiagnostic studies continue to have high utility for the diagnosis of numerous childhood neuromuscular disorders, and that standardized approaches along with the use of high-quality reference values are important to maximize the diagnostic yield of these tests in infants, children, and adolescents.

Differentiating Congenital Myopathy from Congenital Muscular Dystrophy

The congenital muscular dystrophies and congenital myopathies are a heterogenous group of diseases with a wide variety of presentations and outcomes. With the growing understanding of genetic involvement, and developing therapies, having a genetically confirmed diagnosis with phenotype correlation is essential. To achieve this, a structured approach is warranted to each child to ensure that mimickers are excluded. By structuring the evaluation appropriately, the clinician can help expedite the evaluation of these infants in a cost-effective manner. Understanding the pitfalls of each step of testing will allow the clinician to better understand variants in presentation and avoid cognitive errors in the process.

Clinical Neurophysiology in the Treatment of Disease

Clinical neurophysiology has a long-standing history and value in the diagnosis of neurologic diseases. Because of their unique ability to assess physiology and function of the nervous system, electroencephalography (EEG), evoked potentials, electromyography (EMG), and polysomnography have long been used in the diagnostic evaluation of epilepsies, demyelinating disorders, neuromuscular disorders, sleep disorders, and other diseases affecting the central and peripheral nervous systems. The role of these tests and clinical neurophysiology in general has usually ended upon diagnosis. New applications of these trusted techniques are changing old perceptions. Continuous EEG monitoring has found new value in not only diagnosis but also in treatment of nonconvulsive seizures and status epilepticus. Visual evoked potentials have been shown to be a biomarker for assessment of demyelination and remyelination associated with treatment of multiple sclerosis. Various EMG techniques can be used to independently assess improvement or otherwise of many neuromuscular diseases. The use of these techniques in the treatment of various neurologic disorders is the next frontier for clinical neurophysiology.