What are the limitations of EMG and nerve conduction studies in the evaluation of ulnar neuropathy?

Updated: Jun 08, 2018
  • Author: Charles F Guardia, III, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

It should be kept in mind that in any given case, it is impossible to know the exact course the ulnar nerve follows. Considerable anatomic variation exists from person to person, and even controlling the angle of the elbow does not determine exactly where the nerve is running beneath the skin. Thus, the examiner does not know precisely where the nerve is being stimulated. The takeoff point of the impulse may not be exactly under the stimulator.

A good percentage of experienced electromyographers believe that in many if not most cases, the best that can be done is to establish whether a blockage exists at the elbow, and often, even that cannot be accomplished with certainty. The relevant anatomic issues have been discussed more fully by Campbell. [41]


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