Role of EMG and Nerve Conduction Studies in the Management of Traumatic Peripheral Nerve Injuries

摘要

Background: Neurodiagnostic studies in the form of EMG and nerve conduction studies are frequently involved in the clinical evaluation of patients with traumatic peripheral nerve injuries and also to a major extent in the management of such patients. Objective: The aim of the present study is to verify the role of EMG and nerve conduction studies in the classification and management of patients with traumatic peripheral nerve injuries. Methods: The study was conducted on 101 adult patients with any causes of traumatic peripheral nerve injuries especially closed injuries. Any peripheral nerves of the upper and lower limbs suspected to be injured upon clinical examination were electrophysiologically examined. All patients were subjected to thorough history taking, clinical examination immediately and 4-5 months postinjury, Tinel’s sign, and EMG examination and nerve conduction studies one week and 2-3 months postinjury. Finally, the surgical decision of management was taken based on clinical, physical and electrophysiological examination. Results: First EMG and nerve conduction studies proved 19 cases (18.81%) with neurapraxia, 8 cases (8.91%) with mixed type injury and 72 (71.29%) cases with axonotmesis and 2 cases with neurotemesis (1.96%). EMG examination showed more percentage of early reinnervation than the Tinel’s sign evidenced by follow-up clinical improvement 4-5 months postinjury. Sensitivity of Tinel’s sign was 87.5% (77.59 % to 94.11%), while sensitivity of EMG and nerve conduction studies was 97.22%. Surgical decision for the type of management was taken in all cases according to the site of injury, classification of nerve injuries and reinnervation detection by EMG. Conclusion: This study concluded that neurodiagnostic studies in the form of EMG and nerve conduction studies play a major role in collaboration with clinical and physical evaluation of patients with traumatic peripheral injury and also to a major extent in the management of such patients. [Egypt J Neurol Psychiat Neurosurg.  2014; 51(4): 483-493]