Author/Editor		Rigler, Igor; Podnar, Simon
Title		Vpliv najdb elektromiografske preiskave na izbiro in izid zdravljenja
Translated title		Impact of the electromyographic findings on choice of treatment and on outcome
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 75, št. 6-7
Publication year		2006
Volume		str. 355-61
Language		slo
Abstract		Background Clinical electromyographers often do not get adequate feedback information about further clinical course in patients seen in electromyographic (EMG) clinics. The aim of the present study was to asses the impact of the EMG examination on patients final diagnosis, choice of treatment, and final clinical outcome. Methods Three years after EMG examination, performed by one of us, a short questionnaire was sent to 300 consecutive patients, and their referral physicians. We asked about symptoms at the time of EMG examination, final diagnosis, type of treatment, and current symptoms. Responses were analysed using methods of bivariate and multivariate statistical analysis. Results We receivedfilled in questionnaires about 186 patients (39 % men). Of these 29 % patients were given diagnosis carpal tunnel syndrome, 19 % radiculopathy, 8 % other mononeuropathies, and 6 % polyneuropathy. No neurological diagnosis could be established during EMG consultation in remaining 39 % responding patients. On multiple linear regression analysis a significant association between EMG diagnosis and a final diagnosis was found. Furthermore, patients with pathological EMG findings had better final clinical outcome 3 years later, relationship persisted even after inclusion of treatment into multivariate model (exclusion of the effect). Patients with pathological EMG were also more often treated invasively, which further improved their final outcome. The most efficient treatment turned out to be surgery, followed by conservative management, and the outcome was the worst in patients that received no treatment. Conclusions The study demonstrated important impact of EMG findings on patients' final diagnosis, treatment choice, and on final clinical outcome. EMG examination thus presents an important part in management of patients with suspected lesion of the peripheral neuromuscular system.
Summary		Izhodišča Klinični nevrofiziologi pogosto ne dobimo povratnih informacij o nadaljnjem kliničnem poteku pri bolnikih, pregledanih v elektromiografski (EMG) ambulanti. Namen najine raziskave je bil oceniti vpliv, ki ga je imel EMG pregled na postavitev bolnikove končne diagnoze, na izbiro zdravljenja in na končni izid obravnave. Metode Tristotim preiskovancem, ki jih je eden od naju pregledal v EMG ambulanti, in njihovim napotnim zdravnikom sva 3 leta po pregledu poslala kratek vprašalnik, v katerem sva jih spraševala po težavah v času EMG pregleda, po končni diagnozi, vrsti zdravljenja in trenutnih težavah. Odgovore sva statistično ovrednotila z metodami bivariatne in multivariatne statistike. Rezultati Prejela sva izpolnjene vprašalnike o 186 preiskovancih (39% moških). Med njimi jih je 29% imelo diagnozo sindrom zapestnega prehoda, 19% radikulopatija, 8% ostale mononevropatije in 6% polinevropatija. Preostalim 39% preiskovancev med EMG preiskavo nismo postavili nevrološke diagnoze. Z ordinalno logistično regresijo sva našla značilno povezavo med diagnozo ob EMG preiskavi in končno diagnozo. Preiskovanci s patološkim EMG izvidom so imeli po 3 letih boljši izid zdravljenja; povezanost je vztrajala tudi po vključitvi zdravljenja v multivariatni model (po izključitvi vpliva). Preiskovanci spatološkim EMG izvidom so bili pogosteje tudi zdravljeni, karje njihov izid še dodatno izboljšalo. Najučinkovitejše je bilo kirurško zdravljenje, sledilo je konzervativno, najmanj učinkovito pa je bilo, če bolniki niso bili zdravljeni. Zaključki Raziskava je pokazala, da izvid EMG preiskave pomembno vpliva na postavitev končne diagnoze, na odločitev za vrsto zdravljenja in pripomore k boljšemu izidu zdravljenja. EMG preiskava je torej pomemben dejavnik v obravnavi bolnikov s sumom na okvaro perifernega živčno-mišičnega sistema.
Descriptors		ELECTROMYOGRAPHY NEURAL CONDUCTION PERIPHERAL NERVES NEUROLOGIC EXAMINATION CARPAL TUNNEL SYNDROME RADICULITIS QUESTIONNAIRES TREATMENT OUTCOME