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Kritična analiza napotitev na elektrodiagnostično preiskavo perifernega živčevja = Critical analysis of referrals to electrodiagnostic examination of the peripheral nervous systemPodnar, SimonBackground. Clinical neurophysiologists observe a large number of examinees referred to a electromyographic (EMG) laboratory without clinical symptoms or signs of the peripheral nervous system ... lesion. Such referrals do not improve management of patients, but only unnecessarily burden examinees and laboratorypersonnel. The aim of the present study was to check appropriatenessof referrals to electrodiagnostic examination, look for reasonsfor problems and suggest possible improvements. Methods. From the database of the Institute of Clinical Neurophysiology in Ljubljana all examinees evaluated by the author in a "general" EMG laboratory in the first 4months of 2002 were included. From data about examinees, referral doctors, referral diagnoses, clinical symptoms and signs and electrophysiological findings, predictive values for neurological referral diagnoses and electrodiagnostic abnormalities were calculated using descriptive and multivariate statistical analyses. Results. Three hundred examinees (42% men) were included. Neurological diagnosis was provided in 55% of referrals. Electrodiagnostic abnormalities were found in 45% of examinees (carpal tunnel syndrome 50% radiculopathy 25%, other mononeuropathies 15%, polineuropathy 9%). In 9% of examinees only clinical, and in 47% neither clinical nor electrodiagnostic abnormalities were demonstrated. Using a multivariate analysis positive effect of referral with neurological diagnosis, of paraesthesiae and findings of weakness and sensory loss, and negative effect of pain and referral diagnosis cervicobrachialgia or lumboischialgia on pathological electrodiagnostic findings were found. Isolated pain and paraesthesiae (with carpal tunnel syndrome excluded) were particularly poor predictors of abnormal electrodiagnostic findings (9% and 16%, respectively). With exception of 20 patients with carpal tunnel syndrome, none with normal clinical neurological examination had abnormal electrodiagnostic findings.Vir: Zdravniški vestnik : glasilo Slovenskega zdravniškega društva = Slovenian medical journal = journal of Slovenian Medical Association. - ISSN 1318-0347 (Letn. 72, št. 4, 2003, str. 205-212)Vrsta gradiva - članek, sestavni delLeto - 2003Jezik - slovenskiCOBISS.SI-ID - 16259289
Avtor
Podnar, Simon
Teme
Electromyography |
Utilization |
Contraindications |
Methods |
Peripheral Nervous System Diseases |
Diagnosis |
Neurologic Examination |
Radiculitis |
Brachial Plexus |
Neuritis |
Low Back Pain |
Carpal Tunnel Syndrome |
Polyneuritis |
Elektromiografija |
Periferno živčevje, bolezni |
Brahialni pletež |
Križ, bolečina |
Nevritis |
Nevrološka preiskava |
Zapestni prehod, sindrom
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vir: Zdravniški vestnik : glasilo Slovenskega zdravniškega društva = Slovenian medical journal = journal of Slovenian Medical Association. - ISSN 1318-0347 (Letn. 72, št. 4, 2003, str. 205-212)
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