2 For this reason, test results must be analyzed in the course of the test results cannot be documented and retrieved at a later date, as is the case with routine laboratory tests. In addition, most EMG machines cannot permanently copy the sounds emitted during testing and the oscilloscope tracings are too difficult and expensive to copy. The muscles studied will vary based on new information gained during the course of the testing. Interpretation must occur during the performance of the needle EMG for several reasons. Testing is painful and expensive and should be limited to the minimum muscles necessary. Accurate placement of the needles is required to avoid significant veins or arteries, lung puncture or nerve damage. They may include common muscles of the arms and legs but may also include muscles in the throat, near the eyes, the tongue and the pelvic region. The patient’s problem dictates which muscles are studied. Needle EMG is an invasive procedure needle electrodes are inserted into muscles at varying depths as muscle fibers are fired. The skill of the examiner is paramount in conducting and interpreting needle EMG testing. It requires the insertion of a needle electrode through the skin and into the muscle.1 The muscle’s electrical characteristics at rest and in action are shown through wave-forms on an oscilloscope and through characteristic sounds. Needle EMG is an invasive diagnostic procedure used to evaluate the physiology of the peripheral nervous system and muscles-to rule out, diagnose, describe, and follow diseases. This policy statement addresses needle EMG and who can perform it safely and where it should be performed. Needle electromyography (EMG) is one of several tests that comprise electrodiagnostic studies and it is usually performed in conjunction with nerve conduction velocity tests. The studies are designed based on the individual patient’s history, physical and differential diagnosis and are adjusted during the course of the study as new information is received. The board may make formal policy only through administrative rules, declaratory orders or contested case decisions.Įlectrodiagnostic studies are done in individuals with a sensory or motor disturbance to assist in the diagnosis of neuromuscular diseases or conditions.
This policy statement is not a legally binding opinion of the board, but is only intended to provide guidance to the public. Approved by the Iowa Board on February 10, 2005
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