Sarcouncil Journal of Medical Sciences

Abstract: Peripheral nerve and muscle disorders are important to evaluate with peripheral nerve and muscle tests, such as pediatric electromyography (EMG) and nerve conduction studies (NCS). The purpose of this study was to assess the clinical results of pediatric EMG, to determine whether there is a difference between surgical and neuromuscular disease, to identify independent electrophysiological predictors for surgery, and to evaluate the functional and electrophysiological outcome of treatment at 12 months. A cohort of 113 children with various diagnoses of childhood neuromuscular disorders was therefore analyzed and divided into a surgical group (62) comprising patients with obstetric brachial plexus palsy, traumatic nerve injuries, spinal dysraphism, and entrapment neuropathy, and a neuromuscular group (51) comprising patients with muscular dystrophies, spinal muscular atrophy, CIDP/GBS, CMT, and myasthenia. Multivariable logistic regression was used to determine predictors of surgical intervention, and 12-month follow-up data were used to analyze functional and electrophysiological improvements. There were large differences between the two groups at baseline: the surgical group was younger and had a shorter duration of symptoms. The surgical group had significantly lower motor and sensory nerve conduction velocity, lower amplitude of compound muscle action potential (CMAP), and higher percentages of fibrillation potentials and neurogenic patterns. The presence of fibrillation potentials, the age <3 Years and complete denervation were strong independent predictors of surgical intervention in multivariable regression. Patients at 12 months had significantly improved MRC muscle strength (+0.8), active ROM (+20.5%), and Functional Independence Score (+15.4%) with an 87.1% EMG-surgical concordance rate. Overall, pediatric EMG allows for the identification of unique electrophysiologic patterns useful for distinguishing surgical and neuromuscular disease. Certain EMG characteristics are good discriminators of the need for surgical treatment.