Dr Patel is a visiting neurologist who conducts neurophysiological studies viz. nerve conduction study (NCS) and electromyography (EMG) at Goulburn Medical Clinic. Nerve conduction/muscle tests can be arranged with the reception on 02 4823 0207. A referral for NCS and/or EMG addressed to Dr Patel is generally required. Your doctor may refer you for these studies for one of the following diagnosed or suspected disorders: carpal tunnel syndrome, peripheral neuropathy, peripheral nerve injury in arm or leg, ulnar neuropathy, brachial plexus injury/disorder, radiculopathy (nerve root compression in neck or back), sciatica, wrist drop, foot drop, peripheral nerve injury, tarsal tunnel syndrome, myasthenia gravis, myopathy, motor neurone disease etc. What is nerve conduction study (NCS), and what is electromyography (EMG)? Nerve conduction study (NCS) is a diagnostic test that assesses the function of specific large peripheral nerves. Electromyography (EMG) is also a diagnostic test that assesses the function of specific muscles and the nerves that control these muscles. EMG is often performed along with NCS as a complementary test and gives additional information to reach the answer sought by the referring practitioner. While the majority of the referrals are likely to require only NCS, a proportion of the referrals may require EMG in addition to NCS. What to Expect: You will be sitting or lying down on an adjustable examination table. The doctor will ask you questions about your symptoms and may perform a brief neurological examination. The doctor will attach electrodes (small stickers) attached to wires on the skin over a specific muscle or nerve. The doctor will then excite (stimulate) the specific nerve by delivering small electric shocks or current on the skin over the nerve, and record the electrical signals in the nerve/muscle on the EMG machine computer. You are likely to feel a tingling or a strange (electric) sensation; this could, for some people, be mildly unpleasant or mildly uncomfortable but unlikely to be painful. If you do find it painful, you just have to let Dr Patel know and the test can be abandoned at any stage without questions. Depending on the nerve being tested, you may also feel a sudden jerking of part of your fingers, hand, arm, foot or leg. This process is repeated multiple times as different nerves and muscles are tested until adequate information is obtained to allow for satisfactory interpretation of the results. If EMG is required after the NCS (a very small proportion of studies require EMG after the NCS), the doctor will insert a small needle attached to a wire into one of your muscles. You may understandably feel some discomfort or pain, but most people can endure and complete the test without significant difficulty. The computer converts the electrical activity in the muscle into sound and waves that the doctor can hear and see to assess the muscle's electrical activity. The doctor will then ask you to 'activate' or contract the muscle by making a certain movement and again evaluate the change in the electrical activity recorded by the computer. The doctor may repeat this process by testing other muscles until adequate information is obtained. The whole study (NCS +/- EMG) will usually take 20 to 50 minutes, although on some occasions, it may take upto 90 minutes depending on the number of nerves/muscles the doctor needs to test. The doctor will usually give you a provisional report verbally at the end of the test, and may also give you some management recommendations. The final report of the test will usually be completed by the doctor within 24-48 hours and will be sent to the referring doctor. Request Dr Patel if you also need a copy of the report to be sent to another doctor. What to do before/when you come for NCS/EMG: •Bathe or shower, and avoid putting cream, lotion or perfume on your skin. (Creams and lotions can affect the test’s accuracy.) •Wear comfortable, loose-fitting clothing. In the event that the doctor needs to perform the test on your legs, wear loose trousers or clothing that can be raised above the knees. •In cold weather, wear socks with closed shoes, and preferably gloves. (Cold skin temperature makes nerve signals slow and can affect the test's accuracy. The doctor may ask you to wash hands under warm running water for a few minutes before beginning the test, and may use warm mittens during the test.) •Bring a family member or a friend/colleague if possible. Avoid bringing infants and very young children if possible. •Switch off your mobile or leave it at the reception desk during the test. (Electrical devices cause interference and can affect the test's accuracy.) •Tell the doctor if you have any difficulty staying in a sitting or lying down position for longer than a few minutes. •Tell the doctor if you are on blood thinning medications such as aspirin, clopidogrel, ticagrelor, warfarin, apixaban (Eliquis), rivaroxaban (Xarelto), dabigatran (Pradaxa), enoxaparin (Clexane) etc. •Tell the doctor if you are allergic to latex or rubber gloves, or any other material contacting your skin. •Tell the doctor if you have a pacemaker or any other electrical medical device. Some References: https://my.clevelandclinic.org/health/treatments/24821-nerve-conduction-study https://my.clevelandclinic.org/health/diagnostics/4825-emg-electromyography