Could electrical needle stimulation reduce diagnostic errors in electromyography?

During the electromyographic examination there is a risk of wrongly inserting the needle in a muscular area contiguous to the muscle of investigation. The objective of the work is to verify the mistakes chance during the needle placement into the muscle target. We have investigated on 45 patients the identification of the insertion site by electrical stimulation of the muscle, where the needle electrode is inserted, through the same recording needle and calculated how many times the needle can be inserted incorrectly in a muscle close to muscle target. The results showed that during standard needle electromyographic there are a significant error prevalence (33.3%) in the examination of some deeper muscles such as pronator teres (26.3%) and tibialis posterior (40.5%). In conclusion, a correct identification of the muscles tested may a useful practice for all patients especially in patients with motor recruitment problems avoiding other serial examinations and reducing patients discomfort. In other hand, this kind of method can be helpful during a training for a neurophysiologist to improve their technical skill. Copyright © 2008 American Clinical Neurophysiology Society.