NCS are carried out by stimulating motor or sensory nerves electrically. Demyelination is characterized by slowing of nerve conduction velocities (NCV), dispersion of evoked compound action potentials, conduction block (decreased amplitude of muscle compound action potentials on proximal, as compared to distal, stimulation of the nerve), and prolongation of distal latencies. In contrast, axonal neuropathies exhibit reduced amplitude of evoked compound action potentials with relative preservation of NCV. EMG records electrical potentials from a needle electrode in muscle, at rest and during voluntary contraction; it is most useful for distinguishing myopathic from neuropathic disorders. Myopathic disorders are marked by small, short-duration, polyphasic muscle action potentials; by contrast, neuropathic disorders are characterized by muscle denervation. Denervation decreases the number of motor units (e.g., an anterior horn cell, its axon, and the motor end plates and muscle fibers it innervates). In long-standing denervation, motor unit potentials become large and polyphasic due to collateral reinnervation of denervated muscle fibers by axonal sprouts from surviving motor axons. Other EMG features of denervation include fibrillations (random, unregulated firing of individual muscle fibers) and fasciculations (random, spontaneous firing of motor units).
Treatment: Polyneuropathy
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