EMG EMG Documentation & Reporting

Question 1

According to AANEM guidelines, which elements are required in a complete EMG/NCS report?

Accepted Answer

Patient demographics, clinical indication, detailed NCS data with normal values, needle EMG findings by muscle, and an electrodiagnostic impression correlating findings to the clinical question

Answer

Only the electrodiagnostic impression and a list of muscles tested

Answer

NCS waveform images with patient name and date only

Answer

A summary paragraph without individual muscle or nerve data

Question 2

When documenting needle EMG findings, which four key parameters should be recorded for each muscle examined?

Accepted Answer

Insertional activity, spontaneous activity at rest, motor unit potential morphology, and recruitment pattern

Answer

Amplitude, latency, conduction velocity, and F-wave latency

Answer

Fibrillation grade, MUAP duration, polyphasia percentage, and CMAP amplitude

Answer

Pain level, muscle depth, needle gauge, and examination duration

Question 3

What does a grading of '2+' fibrillation potentials indicate in standardized EMG reporting?

Accepted Answer

Fibrillation potentials present in more than 2 but fewer than 6 areas of the muscle, persisting throughout the recording

Answer

Only one fibrillation potential seen in the entire muscle

Answer

Fibrillation potentials in all areas of the muscle with high frequency

Answer

Occasional fibrillation potentials seen in only one needle position

Question 4

In an EMG report, the term 'reduced recruitment' most accurately refers to which finding?

Accepted Answer

Fewer motor units firing than expected for the level of patient effort, indicating a loss of motor axons or upper motor neuron inhibition

Answer

Motor units firing too rapidly before additional units are activated

Answer

Motor units that are excessively polyphasic during voluntary contraction

Answer

Early activation of high-threshold motor units at minimal effort

Question 5

Which statement about documenting conduction velocity in a motor NCS report is correct?

Accepted Answer

Conduction velocity should be calculated between two proximal stimulation sites and reported in meters per second along with the segment measured

Answer

Conduction velocity is measured between the stimulating and recording electrodes for distal stimulation only

Answer

Conduction velocity is not required if distal latency is within normal limits

Answer

Conduction velocity should be reported in milliseconds per meter

Question 6

Why is it important to include temperature documentation in an EMG/NCS report?

Accepted Answer

Cool limb temperature slows nerve conduction velocity and prolongs latencies, which can mimic neuropathy if not documented and corrected

Answer

Temperature affects only needle EMG findings, not nerve conduction studies

Answer

Temperature documentation is required by CMS only for pediatric patients

Answer

Warm temperature increases CMAP amplitude and can mimic myopathy