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Electroneuromyography (ENMG)

Electroneuromyography (ENMG) is one of the instrumental methods used to accurately diagnose suspected neuralgia of the pudendal nerve. It examines the conduction velocity and transmission speed of signals along the nerves. While the reliability of this method alone may not be absolute, when combined with other diagnostic procedures, it provides the opportunity to determine the localization of pathology.

Some diagnostic procedures are straightforward and accessible to all doctors. Many practitioners can interpret pathology on X-rays or electrocardiograms, and some can even interpret CT scans or MRIs, although specialized specialists are often consulted for detailed analysis. However, there are methods that only certain categories of doctors can understand and master, and the accuracy of diagnosis, the subsequent treatment strategy, and most importantly, the patient's hope for recovery depend on their qualifications.

Let's talk about one of these procedures. Few can decipher and understand the data obtained. Show a chart with recordings to any doctor, and not everyone will understand what it is. Specialists in this field include functional diagnostic physicians, neurologists, neurophysiologists, and physiotherapists. And we're going to discuss electroneuromyography and electromyography—complex examinations that are quite difficult to understand and master.

What is Electroneuromyography (ENMG)?

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Electroneuromyography

Electroneuromyography (ENMG)is a diagnostic method that studies the speed of electrical impulse conduction along nerve fibers and its transmission from nerves to muscles. Electromyography (EMG) evaluates the electrical activity of muscles at rest and during movement, as well as the contractile ability of the muscle system. Typically, the examination algorithm includes both methods as part of a comprehensive assessment.

Understanding the Complexities in Simple Terms

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Movement of Nerve Impulses

Correct and controlled body movements are facilitated by the complex structures of our bodies. The impulse originates in the brain and travels through a series of nerve pathways and plexuses on its way to the muscles. It switches in neurons of the spinal cord and finally reaches the neuromuscular junction. Only the coordinated work of all cells, mediators, and connections guarantees proper movement.

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Any damage at any stage manifests as involuntary muscle contractions, weakness, numbness, tremor, and increased muscle fatigue.


Pathology of the central nervous system can be detected on CT or MRI scans. But how do we find disorders in structures that are not visible to the naked eye?

Electroneuromyography is an indispensable method for accurately identifying the location of damage to any peripheral nerve.

Our Results

Countries
Countries
27
People seek accurate diagnostics from 27 countries.
Patients
Patients
2000+
Our experience over 20 years is more than 2000 cases
Experience
Experience
23+
More than 23 years of experience in neurophysiology.
Publications
Publications
100+
Over 100 monographs, articles, and patents for inventions.
Patients per year
Patients per year
400+
Over 400 individuals annually undergo examination at the Dilanyan Clinic.
Discomfort
Discomfort
0 points
Professionalism, experience, and high-precision equipment minimize discomfort to zero.

The examination of the peripheral nervous system and neuromuscular transmission is performed by functional diagnostic physicians.

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Dr. Oksana Yuryevna Fomenko, a functional diagnostic physician at the Dilanyan Clinic, specializes in this area.
Dr. Oksana Yuryevna Fomenko is a special honor and pride of the Dilanyan Clinic. Truly the best in her field, she is a professor, Doctor of Medical Sciences, and a highly qualified functional diagnostic physician. She is the author of over 100 scientific publications, a full member of the Society of Neuro-Muscular Diseases Specialists, and the Russian Association of Functional Diagnostic Specialists.
During the examination, the physician determines the localization and severity of damage to the neuromuscular apparatus also specifies its stage and track the progress of the treatment being conducted.

Indications for Electroneuromyography (ENMG) and Electromyography (EMG) include:

- Injuries, inflammation, and any other lesions of the spinal cord, plexuses, nerve roots, and peripheral nerves

- Injuries, inflammation, metabolic, toxic, and hereditary muscle diseases (polymyositis, myofascial pain syndromes, myalgia, endocrine and hereditary myopathies, and myodystrophies)

- Disorders of pelvic organs, urinary and fecal incontinence

- Chronic pelvic pain syndrome

- Spinal muscular atrophies

- Syringomyelia

- Amyotrophic lateral sclerosis and multiple sclerosis

- Consequences of brain and spinal cord strokes, traumatic brain injuries. Rehabilitation after operations on the brain and spinal cord, as well as preparation for them

- Myasthenia gravis and similar syndromes

- Pain and neurological manifestations of osteochondrosis and other bone and joint pathologies

- Parkinson's disease and other hyperkinetic disorders

- Nocturnal enuresis

- Facial nerve neuropathy

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Too many unfamiliar words for the average person? Correct. Moreover, there are times when there are complaints, but the diagnosis has not yet been established. And it's not even clear which doctor to consult. Let us help you understand the sensations and complaints that require electroneuromyography or electromyography.

Common complaints that should alert you:
Limited range of motion,
Limited range of motion,

 pain, increased fatigue, or weakness in a specific limb or muscle group

Distortion of skin sensitivity,
Distortion of skin sensitivity,

 either decreased or increased, in a specific area

Recurring pain in the back
Recurring pain in the back

 coccyx, or buttocks, radiating into the leg or arm

Any emerging asymmetry in movements
Any emerging asymmetry in movements

recurring muscle twitching, or tremors

Dysfunction of pelvic organs,
Dysfunction of pelvic organs,

pelvic pain, changes in sensitivity, and urinary or fecal incontinence.

To deeply and fully investigate the functionality of the peripheral nervous system and its connection to muscles, various techniques of electroneuromyography (ENMG) and electromyography (EMG) are used. At Dilanyan's Clinic, well-practiced and even rare techniques are available to patients, considered to be the pinnacle of expertise, requiring particularly precise skills and consistent practice.
Interferential surface electromyography (EMG):
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Needle EMG:
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Surface stimulatory electroneuromyography (EMG):
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Needle stimulatory electroneuromyography (EMG):
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But what if the problem lies deep within? After all, there are conditions where the muscles of the pelvic floor, sphincters, and nerve fibers are affected, and reaching them is not so simple. The Dr. Dilanyan Clinic has the equipment to address even such delicate issues:

- Interferential transrectal and transvaginal electromyography:This method evaluates the pelvic floor muscles located deep within the body. Using this method, the specialist examines the electrical bio-potentials at rest and when the patient attempts to tense the muscles.

- Electroneuromyography using St. Mark's sensors: This is a truly ingenious invention for transrectal and transvaginal examinations. The muscles in question cannot be seen but only palpated by the specialist. Conductive elements are applied to a glove, run along the palm, and end at the fingertip of the physician. After accurately identifying the desired muscle, the neurophysiologist delivers an electric discharge and records the response.

And don't let the term "electric discharge" scare you!


It is not felt as an electric shock; there's no need to expect intense pain or fear it. You may only feel a slight tingling sensation or vibration. The examination is relatively quick and does not cause significant discomfort to our patients.

Which doctor refers for ENMG and EMG:

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Duration of the procedure

The duration of the procedure ranges from 20 minutes to 1 hour. This depends on the extent of the examination and the number of muscle groups involved. No special preparation is needed. You can eat and drink as usual, engage in sports, and take a shower.

Important

Just inform your doctor if you are taking anticoagulants and muscle relaxants. In this case, you can discuss the need and timing for discontinuing them before the procedure.

How is the examination conducted?

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St. Mark's Sensor

Before starting the procedure, our specialist will explain in detail all the stages of the examination and the possible sensations. The examination is conducted without anesthesia so that sensory disturbances do not distort the results. There is no need to fear pain; there will be no significant discomfort.

Are there any contraindications to ENMG and EMG?
This type of diagnostic procedure is not performed on patients with a permanent pacemaker or defibrillator. The risks outweigh the benefits for patients with epilepsy, psychiatric disorders, and severe cardiovascular disease.
Acute infectious diseases are not so much a contraindication as they require rescheduling the procedure until recovery.

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Doctors of the Pelvic Pain Treatment Center

After receiving the results, you have the opportunity to consult our doctors for further treatment. The Dr. Dilanyan Clinic is exactly the place where high-quality medical care is combined with warmth, where modern high-tech diagnostic and treatment methods are complemented by warm relationships between the doctor and His patient. More accurately, between the patient and His doctor.

How to get an appointment

Make an appointment for a consultation and appointment

You can call:

+374 55 17 0303

Choose your own convenient day and time -

through the online form on the website.

We are always glad to see you and will help you with any, even the most difficult health situation.

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