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Journal of the Korean Academy of Rehabilitation Medicine 1998;22(4):903-907.
Clinical Utility of the Diaphragmatic Needle Electromyography in Patients with Respiratory Dysfunction.
Park, Dong Sik , Lee, Hee Sook , Park, Sang Wook , Jang, Ki Eoun
Department of Rehabilitation Medicine, Hallym University, College of Medicine.
호흡부전 환자에서 횡격막 침근전도의 임상적 유용성
박동식, 이희숙, 박상욱, 장기언
한림대학교 의과대학 재활의학과
Abstract

Objective
To confirm the clinical utility of diaphragmatic needle electromyography (EMG) in patients with respiratory dysfunction.


Method
Needle electorode was inserted into the muscle just above the lower costal margin between anterior axillary and medial clavicular lines. Case 1 who showed no response bilaterally in a phrenic NCS and a complete denervation of the diaphragm on needle EMG was unable to be weaned off from the ventilator. Case 2 who showed normal electrodiagnostic findings was successfully weaned off from the ventilator. Case 3 who showed a respiratory insufficiency from organophosphate intoxication had normal electrodiagnostic findings and was able to be successfully weaned off from the ventilator with a psychiatric support.

Result: We ruled out the possibility of lack in central respiratory drive and weaned off patients from the ventilator, based on a normal firing pattern of motor unit potentials.


Conclusion
Phrenic nerve conduction study (NCS) alone is not sufficient to find out the nature of respiratory dysfunction. Needle EMG of the diaphragm can be helpful in determining the pathogenesis, but its utility has been limited due to its potential risks. However we have confirmed that the needle EMG of diaphragm is a safe and easy study to perform and can provide a valuable information in the evaluation and management of respiratory dysfunction.

Key Words: Diaphragm, Phrenic nerve, Respiratory dysfunction, Electromyography


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