Referral Guidelines

These guidelines are designed to help providers determine when a referral for an electrodiagnostic medicine consultation may be useful for a patient. The consultation evaluates nerve and muscle function and is a direct extension of the clinical history and neuromuscular examination. This list is not exhaustive, but serves as a reference for frequently encountered problems.


Symptoms


Diagnosis


Generalized Weakness

Neuropathies
Myopathies
Motor system disease (e.g., amyotrophic lateral sclerosis)
Neuromuscular junction disorder (e.g., myasthenia gravis)


Neck Pain


Cervical radiculopathy
Brachial plexopathy
Focal neuropathy (e.g., spinal accessory nerve)


Thoracic


Thoracic radiculopathy


Back pain


Lumbosacral radiculopathy
Lumbosacral plexopathy


Shoulder and arm pain, numbness,
altered sensation (e.g., pins and
needles), weakness, cramps,
fasciculations, muscle atrophy
or hypertrophy (focal or diffuse)


Cervical radiculopathy
Brachial plexopathy
Polyneuropathy
Focal neuropathy (e.g. carpal tunnel syndrome, ulnar nerve injury at the elbow, suprascapular nerve injury at the shoulder)
Myopathy
Motor system disease (e.g., amyotrophic lateral sclerosis)


Hip and leg pain, numbness, altered sensation
(i.e., pins and needles), weakness, cramps,
fasciculations, muscle atrophy
or hypertrophy


Lumbosacral radiculopathy
Lumbosacral plexopathy
Polyneuropathy
Focal neuropathy (e.g., tarsal tunnel syndrome, femoral [focal or diffuse] mononeuropathy)
Myopathy
Motor system disease (e.g., amyotrophic lateral sclerosis)


Distal Paresthesias


Carpal Tunnel Syndrome
Peripheral Neuropathy


Cramps


Peripheral Neuropathy
Motor Neuron Disease (early)
Myopathy


Distal weakness


Polyneuropathy
Focal mononeuropathy (e.g., carpal tunnel syndrome, ulnar neuropathy)
Myopathy (e.g., inclusion body myositis, distal myopathy)


Proximal weakness


Myopathy
Plexopathy

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