Expanded State-of-the-Art EMG Testing Offered at East Clinic

State-of-the-art electromyography (EMG) testing is now offered with expanded availability at the UW Health East Clinic, conveniently located on the far east side of Madison, right off I-94.


EMG is a valuable part of a complete neurological exam that can help diagnose cervical and lumbar radiculopathies, entrapment neuropathies (such as carpal tunnel syndrome), amyotrophic lateral sclerosis (ALS), anterior horn cell disease, spinal muscular atrophy, muscular dystrophy, myasthenia gravis, myopathies and other neuropathies.


A new EMG machine was delivered to the East Clinic in November 2009 in order to offer expanded services to patients for whom that location is most convenient. The new equipment at the East Clinic will be continuously updated and is subject to the same quality control procedures that are standard throughout UW Health.


EMG services at the East Clinic are performed in an academic setting by University of Wisconsin School of Medicine and Public Health faculty members who are experts in the field of electrodiagnostic medicine. The UW Health EMG program is one of the largest in the area, with the majority of the testing performed at the UW Hospital and Clinics. EMG testing is also available at UW Health 20 S. Park Neurology Clinic as well as other outreach neurology clinics in the region.


"We're happy that we're able to expand this valuable service at this location to our referring providers," says Dr. Susanne Seeger, a clinical assistant professor of neurology who performs EMG testing at the East Clinic. Dr. Roland Brilla, clinical assistant professor of neurology, and Dr. Nathan Rudin, associate professor of rehabilitation medicine and medical director of the UW Health Pain and Headache Clinics, also perform the procedure at the East Clinic. Services are available at this location Monday through Friday.


Physicians may refer patients for EMG testing if a clinical exam indicates that there is a problem with muscles, a nerve or group of nerves. Symptoms include numbness, weakness, pain or parasthesias (tingling) in the extremities, either generalized or focal. Physicians may perform imaging prior to the EMG testing. Other times EMG results can help guide the imaging process.


When the test is performed, a full hour is devoted to each appointment. This includes a brief consultation with the patient to target problem areas before the actual testing begins.


There are two parts to the testing, which are almost always performed together. The first part involves a nerve conduction study (NCS). During this procedure, electrodes are taped to the patient's skin, allowing the physician to stimulate the nerve with electrical current at predetermined intervals. Wave forms recorded on a computer screen are used to measure latencies, amplitudes and conduction velocity.


In the second portion of the testing, called the EMG, a very tiny needle electrode is inserted in the muscle. The physician will look for activity in several areas in the muscle, both while the muscle is relaxed and while it is activated. Muscles that might be tested include the deltoid, triceps, forearm muscles, various leg muscles and sometimes paraspinal muscles.


In the nerve conduction study, the patient may feel a tingling sensation from the electrical current. In the EMG portion, there is no electricity being applied anymore, yet some mild discomfort may come from the needle being inserted into the muscle.


"We try to minimize discomfort, and the vast majority of patients tolerate the procedure very well," notes Dr. Seeger.


When patients are taking blood thinners such as Coumadin (warfarin), the EMG portion of the study may have to be limited and sometimes cannot be performed. The NCS can still be performed.


EMG/NCS testing can help the patient and referring physician make a diagnosis. The most common conditions diagnosed with EMG are entrapment neuropathies, such as carpal tunnel syndrome and cervical and lumbar radiculopathies. For example, if a patient is experiencing numbness, weakness, or pain in the hand, EMG may help localize where a nerve or nerve root is compressed. This information would then guide surgery to free up that nerve. Generalized weakness may be a sign of ALS or a treatable condition such as inflammatory myopathies.


To refer patients to the UW Health East Clinic for electromyography and nerve conduction study services, physicians can call (886) 260-0290. Patients can also be referred to UW Hospital and Clinics EMG/NCS lab by calling (608) 263-7247 or to the 20 S. Park Neurology Clinic EMG services by calling (608) 287-2090.