Needle electromyography using single fiber electrode, with quantitative measurement of jitter, blocking and/or fiber density, any/all sites of each muscle studied
CPT4 code
Name of the Procedure:
Needle Electromyography (EMG) using Single Fiber Electrode
Summary
Needle Electromyography (EMG) with a single fiber electrode is a diagnostic test that measures electrical activity in muscles. By inserting a thin needle electrode into a muscle, doctors can evaluate its function and detect abnormalities.
Purpose
The procedure is used to diagnose neuromuscular disorders, such as myasthenia gravis, peripheral neuropathies, and other conditions that affect muscle and nerve function. The goal is to assess muscle fiber jitter (variability in the time it takes for a muscle to contract after a nerve signal), blocking (failure of the muscle to contract), and fiber density, providing quantitative data on muscle performance and integrity.
Indications
- Unexplained muscle weakness
- Fatigue
- Muscle cramps or spasms
- Suspected neuromuscular diseases
- Abnormal nerve conduction study results
- Conditions like myasthenia gravis
Preparation
- Patients may be advised to avoid caffeine and tobacco before the test.
- Review of current medications, as some may need to be paused.
- No need for fasting unless specified.
- Patients are often asked to wear loose-fitting, comfortable clothing.
Procedure Description
- The patient is positioned comfortably and the target muscle area is cleaned.
- A very fine needle electrode is inserted into the muscle.
- The patient is instructed to contract the muscle at varying levels of strength.
- The electrode records electrical activity, displaying data on a screen.
- The procedure measures jitter, blocking, and fiber density for comprehensive analysis.
Tools include the single fiber electrode, EMG machine, and computer display. Typically, no anesthesia is required, but local numbing may be used for patient comfort.
Duration
The procedure usually takes about 30-60 minutes.
Setting
Needle EMG is typically performed in a hospital, outpatient clinic, or specialized medical center.
Personnel
A neurologist or a trained specialist conducts the procedure with the assistance of a technician.
Risks and Complications
- Mild discomfort or pain at the needle insertion site
- Minor bruising or bleeding
- Rare risk of infection at the insertion site
- Temporary numbness or weakness in the tested muscle
Benefits
- Accurate diagnosis of neuromuscular disorders
- Helps in planning treatment strategies
- Useful for monitoring disease progression and treatment efficacy
- Results are usually available immediately or within a few days
Recovery
- Minimal downtime; patients can usually resume normal activities immediately.
- Post-procedure care may include instructions for muscle rest or applying a cold compress to the site.
- Follow-up appointments may be scheduled based on test results.
Alternatives
- Nerve conduction studies (NCS)
- Standard EMG with larger electrodes
- Imaging studies like MRI or CT scan
- Blood tests for specific antibodies related to neuromuscular diseases
Each alternative has its own pros and cons regarding specificity, invasiveness, and diagnostic capability compared to needle EMG with single fiber electrodes.
Patient Experience
During the procedure, patients might feel a mild pricking sensation and slight discomfort. Some might experience muscle soreness afterward. Pain management typically involves over-the-counter pain relief if needed, and any discomfort usually resolves quickly.
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