Electromyoneurography – EMNG

Electromyoneurography is a method used for the functional assessment of the peripheral nervous system. During the examination, the function of nerves and muscles is evaluated.

The examination consists of two parts: electroneurography, which tests motor and sensory nerve conduction in the peripheral nerves of the arms and legs, and electromyography, which is used to analyse electrical activity in the muscles being examined.

Electrical stimulation of the nerves and muscles may cause mild discomfort, but it lasts only briefly (milliseconds) and cannot cause injury or damage to the skin, nerves, or muscles.

EMNG is used for a wide range of indications because it enables the assessment of spinal nerve roots, plexuses, peripheral nerves, neuromuscular junctions, and the muscles themselves.

Symptoms that may indicate the need for an EMNG examination include spontaneous numbness, weakness of the upper or lower limbs, burning pain in the arms or legs, muscle twitching, muscle weakness, loss of muscle mass, muscle cramps, abnormal muscle fatigue, and other similar symptoms.

The duration of an EMNG examination varies depending on the referring diagnosis and the neurological findings. It usually takes between 30 and 60 minutes.

Contraindications are rare. Anticoagulant therapy may be a contraindication or require special consideration when performing electromyography, but not electroneurography.

Examples of indications for an EMNG examination include:

• Carpal tunnel syndrome (compression of the median nerve), which can cause numbness in the first three fingers of the hand, burning sensations, pain, and, in advanced stages, weakness. EMNG is used to confirm the presence of the syndrome and determine the degree of median nerve compression, helping guide the decision between conservative and surgical treatment.
• Compressive neuropathy of the ulnar nerve at the elbow – a relatively common condition characterised by numbness and pain in the fourth and fifth fingers.
• Cervicobrachialgia or lumboischialgia – relatively common reasons for an EMNG examination. EMNG can determine whether one or more spinal nerve roots are affected and whether the condition is acute or chronic. The examination also helps guide decisions regarding further treatment (conservative or surgical).
• Assessment of the characteristics and severity of polyneuropathy, which can facilitate further investigation into its underlying cause.
• Diagnosis of immune-mediated polyneuropathies (acute polyradiculoneuropathy – Guillain-Barré syndrome (GBS), or chronic inflammatory demyelinating polyneuropathy – CIDP).
• Diagnosis and monitoring of neuromuscular junction disorders (myasthenia gravis).
• Various myopathies and myositis.
• Motor neuron diseases (ALS).

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