Department of Neurology

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Department of Neurology

Electromyography (EMG) Laboratory

The University of Pennsylvania Medical Center's EMG Laboratory, based in the Department of Neurology, provides up-to-date diagnostic support for patients with neuromuscular disorders. This Laboratory combines the expertise of neurologists specializing in clinical neuromuscular disorders with state-of-the-art technology to offer the latest in diagnosis and treatment.

Electrical studies of muscles, ne rves, and the spinal cord are essential in understanding a wide range of neurologic disorders. The advanced technology used in these studies has resulted in increased diagnostic sensitivity and accuracy.

Electromyography Laboratory Services
The electrodiagnostic examination is an extension of the neurologic exam, and is guided by the examiner's knowledge of the patient's condition. The study is performed after a brief history and physical examination by a neurologist skilled in neuromuscular disorders. Each patient's electrodiagnostic test is completely unique.

Electrodiagnostic tests are divided into nerve conduction studies and electromyography (EMG). The results are useful in making a diagnosis and determining the prognosis of nerve and muscle disorders.

Examples of Disorders Studied by EMG

  • Carpal tunnel syndrome and other pressure neuropathies
  • Nerve root injuries (radiculopathy) and plexopathies
  • Acquired and inherited neuropathies
  • Muscle disorders, such as polymyositis, muscular dystrophies, and metabolic myopathies
  • Myasthenia gravis and other disorders of neuromuscular transmission
  • Amyotrophic lateral sclerosis (ALS) and motor neuron diseases

Special Studies

Single-fiber Electromyography (SFEMG)
Specialized electrophysiologic techniques are used to diagnose disorders of neuromuscular transmission such as myasthenia and the Lambert-Eaton Syndrome. Repetitive stimulation studies, combined with standard EMG, allow accurate diagnosis in most cases. For others with myasthenia gravis, further testing is sometimes necessary. For these we offer single fiber electromyography (SFEMG), an advanced, time-intensive and extremely sensitive study that offers the latest in testing capabilities.

Autonomic Nervous System Studies
We offer many noninvasive tests to assess peripheral autonomic function. These examinations are helpful in understanding problems such as:

  • Erectile dysfunction
  • Orthostatic hypotension
  • Gastrointestinal dysmotility

Tests of parasymptomatic function include heart rate response to deep breathing and the Valsalva maneuver. We also perform tests of predominantly sympathetic function, such as the sympathetic skin response to electrical stimulation.

Evaluation of Infants and Children
We provide full electrodiagnostic services from the newborn period through adolescence. These specialized studies are helpful in the diagnosis of acquired and inherited neuromuscular disorders, and traumatic or other neuropathies. They are also useful for screening for potential nerve or muscle biopsy sites in children with suspected metabolic disorders.

Other Specialized Studies

  • Cranial nerve testing (blink reflex, brainstem auditory evoked potentials, facial nerve)
  • Sacral studies (bulbocavernosus reflex, pudendal nerve, and sphincter EMG)
  • Somatosensory evoked potentials

About Penn's Neuromuscular Diseases Section
The Department of Neurology has been a major referral, training and research center for neuromuscular diseases for more than thirty years. The Department's Neuromuscular Diseases Section sees patients for long-term care or in consultation for second opinions. We also offer patients the opportunity to participate in clinical research, when suitable studies are in progress. Our diagnostic laboratories are available to referring physicians, locally and nationally.

The members of the Neuromuscular Diseases Section include internationally recognized experts in myopathies, neuromuscular junction disorders, neuropathies, and motor neuron diseases. We have a state-of-the-art electrophysiology laboratory that applies specialized methods such as stimulated single-fiber EMG and autonomic nervous system testing. Our diagnostic histopathology unit obtains and analyzes open and needle muscle biopsy specimens, and biopsied nerves. We study limb muscle metabolism in vivo with magnetic resonance spectroscopy. Our clinical Neurogenetics Unit serves patients with inherited disorders. We have extensive experience with therapies for immune-mediated disorders.

The Muscular Dystrophy Association supports many of these clinical activities, and provides other valuable services for patients with neuromuscular diseases.

Electromyography Laboratory Faculty

Shawn J. Bird, MD
Dr. Bird, an Associate Professor of Neurology, received his medical degree from Johns Hopkins University in 1983. He completed his residency in Neurology at the Hospital of the University of Pennsylvania. He is board certified in Neurology with added qualifications in Clinical Neurophysiology. Dr. Bird trained in electromyography and neuromuscular diseases at Penn and is Director of the EMG and Evoked Potentials Laboratory. He is certified by teh American Board of Electrodiagnostic Medicine. His special interests include myasthenia gravis and single-fiber EMG, peripheral neuropathies, and autonomic function studies.

Mark J. Brown, MD
Dr. Brown, a Professor of Neurology, received his medical degree from the Unviersity of Maryland in 1966. He was an internal medicine resident at McGill, a medical officer in the U.S. Navy, and did his neurology residency at the University of Rochester. Dr. Brown was a research fellow in peripheral nerve diseases at the University of California San Francisco before coming to Penn. He now heads Penn's Neuromuscular Diseases Section and directs the Peripheral Nerve Laboratory, which handles diagnostic nerve biopsies. His interests include human and experimental neuropathies, nerve pathology and clinical electromyography.

Steven S. Scherer, MD, PhD
Dr. Scherer is an Associate Professor of Neurology. He received his medical degree and PhD degrees from the University of Michigan. After a residency in Neurology at the Hospital of the Unviersity of Pennsylvania he completed a two-year fellowship in neuromuscular diseases. Dr. Scherer is board certified in Neurology. His clinical interests include the diagnosis and treatment of peripheral neuropathies and motor neuron disease. His research is focused on finding trophic factors that will be useful in treating these disorders.

Electromyography Laboratory Faculty and Staff

Shawn J. Bird, MD
Mark J. Brown, MD
Steven S. Scherer, MD, PhD
Julie Christine, R.EEG, R.NCST
Ashley R. Costanzo
Vicki Sexton, R.EEG, EP, R.NCST.

Communication with Referring Physicians

A written report of electrodiagnostic consultation is forwarded to the referring physician. A member of our staff is available for telephone consultation at any time. For consultation or to refer a patient:

Telephone: 215-662-2623
PENNHealth: 1-800-789-PENN
FAX: 215-662-3343

Location

Electromyography Laboratory
University of Pennsylvania Medical Center
Second Floor Ravdin Building
3400 Spruce Street
Philadelphia, PA 19104-6146

Penn Medicine Radnor

Our neurologists also see patients and perform nerve conduction studies and EMG at our Radnor location:

Penn Medicine Radnor
250 King of Prussia Road
Wayne, PA 19087

 

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