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- EMG or Electro-Myo-Graphy is a test where a
electrical needle is placed in a muscle to record its electrical
activity. It is used to differentiate other causes of muscle
weakness, such as myopathy (inflammation of muscle), axonal
neuropathies (Dysfunction in the center of the nerve) and
disorders of neuromuscular transmission (dysfunction at the
place where a nerve connects to a muscle) seen in Myasthenia.
Its Not a diagnostic Test meaning the EMG cannot tell you what
is the diagnosis. For complete details we will send you to a
in detail EMG page to learn more.
NCV is a Nerve-conduction-Velocity is the second part
of the Electrophysiological Test. In NCV a nerve is shocked by a
electrical current and the time this current takes to
reach a second point is measured. If the speed of this measured
electrical conduction is slow, then the nerve conduction studies
show demyelination or CIDP. If the speed is slightly slow then a
axonal neuropathy is considered which may be due to vitamin
deficiency. Axonal or Demyelinating both forms respond to
anti-inflammatory treatment. Its Not a diagnostic Test
Meaning the test cannot give you a diagnosis. The test can
just tell you weather the nerves conduct electricity at slow of
fast speeds and in most cases of cidp this test will be normal
as most cidp is due to small fiber
neuropathy and the small fiber speeds cannot be checked by
NCV.
Some of the NCV findings
include:
(see this link for EMG findings in CIDP)
(a) a slowing in the nerve conduction velocities ;
(b) the presence of conduction block (meaning no
or little electrical current is transmitted in the nerve). Is
seen in Mutli Focal Motor Neuropathy.
(c) prolonged distal latencies in at least two nerves; (means
that it takes a long time for the current to get past the ends
of the nerve)
(In some case EMG/NCV can be normal). EMG does not tell what
is the cause of your disease, it can only locate the site of the
damage.
- CSF Examination: Cerebro Spinal Fuid is the fluid
that bathes your brain and spinal cord. Cytoalbuminologic
dissociation (means elevated CSF protein >45 in the absence of a
high cell count <10) is characteristic of CIDP & GBS. CSF
pleocytosis (excess of white cells) is rare except in
HIV-associated CIDP.
want to
learn about the brain and spinal cord
Not all the patients will have lab abnormalities. In many the
EMG/NCV findings will not show that they have CIDP yet they will
still have the disease.
Is EMG/NCV Insensitive in the Diagnosis of CIDP?
The clinical profile of chronic inflammatory demyelinating
polyneuropathy (CIDP) is variable. The current EMG
criteria for CIDP is not sensitive. EMG IS
INSENSTIVE & non diagnostic test.
In a study electrophysiologic abnormalities were those of
simple
axonopathy in 7 patients; the other patient had almost normal
electrophysiologic results. The, examination of nerve
biopsies in all 8 patients revealed loss of myelinated
fibers; and various degrees of onion bulbs. These
histology findings were identical to those of the 36
other CIDP patients.
The authors conclude that many patients with
unrecognized CIDP are erroneously classified by electrodiagnosis
as having chronic axonal neuropathy and that nerve biopsy should
be considered to further investigate a chronic idiopathic
neuropathy.
Click to view different size nerve fibers.
| : Neurology. 2002 Dec 24;59(12 Suppl 6):S2-6. |
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Diagnosis of CIDP.
Latov N.
Peripheral Neuropathy Center, Weill Medical College of Cornell
University, New York, NY 10022, USA.
...patients with neuropathy of unknown etiology are
more likely to have CIDP than idiopathic axonal neuropathy, and
warrant a trial of therapy . A favorable response to therapy,
consisting of stabilization or improvement of the neuropathy, would
confirm the diagnosis
Some things have been said, yet so much more cannot be written
about. See this message from God.
A study called Mr FIT was done and it showed people who took oral
hypoglycemic drugs for ten years went on to also develop heart
disease. Allopathic drugs may trigger other diseases.
Dr. Imran Khan cidpusa.org
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