Name of the Procedure:

Nerve Conduction Studies (NCS); 13 or more studies, also known as Electroneurography (ENG)

Summary

Nerve conduction studies measure how well and how fast electrical signals travel through your nerves. By doing this, doctors can diagnose several nerve and muscle conditions. This procedure involves stimulating your nerves with small electrical pulses and recording how your nerves respond. If 13 or more studies are needed, it typically means detailed mapping of multiple nerves to get a comprehensive understanding of nerve function.

Purpose

Nerve conduction studies help diagnose conditions affecting your nerves and muscles, such as carpal tunnel syndrome, peripheral neuropathy, Guillain-Barré syndrome, and other nerve dysfunctions. The goal is to pinpoint the source of symptoms like numbness, tingling, or muscle weakness, guiding the appropriate treatment.

Indications

• Symptoms of nerve damage such as tingling, numbness, or muscle weakness
• Suspected nerve injuries
• Conditions like carpal tunnel syndrome, diabetic neuropathy, or radiculopathies
• Patients with a history of traumatic injuries affecting nerve function

Preparation

• Generally, no specific preparation is required.
• Patients should inform their healthcare provider about any medications they are taking.
• Avoid applying lotions or oils on the day of the procedure as they can interfere with electrode placement.
• Wearing loose clothing may help make the procedure more comfortable.

Procedure Description

1. The patient lies down or sits comfortably.
2. Electrodes are placed on the skin over the nerve to be tested and on the skin over the relevant muscle(s).
3. Electrical pulses are administered through the electrodes to stimulate the nerve.
4. The response time and strength of the muscle’s reaction are recorded.
5. This process is repeated 13 or more times for different nerves. No anesthesia is typically required as the electrical pulses used are low in intensity, though they may cause a brief discomfort.

Duration

The procedure usually takes between 60 to 90 minutes, depending on the number of nerves tested.

Setting

Nerve conduction studies are performed in a hospital, outpatient clinic, or a specialized diagnostic center.

Personnel

• Neurologist or a specially trained technician
• Nurses may assist with electrode placement and patient comfort.

Risks and Complications

While nerve conduction studies are generally safe, some risks include:

• Mild discomfort or pain during electrical stimulation
• Skin irritation where electrodes are placed
• Rarely, electrical shock if equipment is faulty or improperly used

Benefits

• Accurate diagnosis of nerve/muscle disorders
• Guides effective treatment plans
• Generally quick and well-tolerated with immediate results

Recovery

• Patients can usually return to normal activities immediately after the procedure.
• Some patients may experience slight soreness or tingling at electrode sites, but this typically resolves quickly.
• No significant downtime is involved; follow-up appointments may be scheduled based on results.

Alternatives

• Electromyography (EMG), often performed alongside NCS, evaluates muscle activity.
• Imaging tests like MRI or CT scans can visualize structural issues but won't evaluate nerve function.
• An MRI neurography for detailed nerve imaging.
• Each alternative has pros and cons; for example, MRIs do not offer functional information but are non-invasive.

Patient Experience

Patients may feel small shocks or tingling as nerves are stimulated, which is typically tolerable though fleetingly uncomfortable. After the procedure, there should be no lasting pain. Aligning with their healthcare provider’s instructions helps ensure better comfort and successful outcomes.