The Consistency Between Clinical and Electrophysiological Diagnoses

Esra E. Okuyucu; Ayşe D. Turhanoğlu; Taşkın Duman; Nazan Savaş; Necdet Mengüllüoğlu; İsmet M. Melek

Esra E. Okuyucu¹, Ayşe D. Turhanoğlu², Taşkın Duman¹, Nazan Savaş³, Necdet Mengüllüoğlu¹, İsmet M. Melek¹

¹Faculty Of Medicine, University Of Mustafa Kemal, Department Of Neurology, Hatay, Turkey
²Faculty Of Medicine, University Of Mustafa Kemal, Department Of Physical Therapy And Rehabilitation, Hatay, Turkey
³Faculty Of Medicine, University Of Mustafa Kemal, Department Of Public Health, Hatay, Turkey

Keywords: Electromyography, neural conduction, clinical diagnosis, electrodiagnosis, consistency.

Abstract

OBJECTIVE: The aim of this study was to provide information concerning the impact of electrophysiological tests in the clinical management and diagnosis of patients, and to evaluate the consistency between referring clinical diagnoses and electrophysiological diagnoses.

METHODS: The study included 957 patients referred to the electroneuromyography (ENMG) laboratory from different clinics with different clinical diagnoses in 2008. Demographic data, referring clinical diagnoses, the clinics where the requests wanted, and diagnoses after ENMG testing were recorded and statistically evaluated.

RESULTS: In all, 957 patients [644 (67.3%) female and 313 (32.7%) male] were included in the study. Mean age of the patients was 45.40 ± 14.54 years. ENMG requests were made by different specialists; 578 (60.4%) patients were referred by neurologists, 122 (12.8%) by orthopedics, 140 (14.6%) by neurosurgeons, and 117 (12.2%) by physical treatment and rehabilitation departments. According to the results of ENMG testing, 513 (53.6%) patients’ referrals were related to their referral diagnosis, whereas 397 (41.5%) patients had normal ENMG test results, and 47 (4.9%) patients had a diagnosis that differed from the referring diagnosis. Among the relation between the referral diagnosis and electrophysiological diagnosis according to the clinics where the requests were made, there was no statistical difference (p= 0.794), but there were statistically significant differences between the support of different clinical diagnoses, such as carpal tunnel syndrome, polyneuropathy, radiculopathy-plexopathy, entrapment neuropathy, and myopathy based on ENMG test results (p< 0.001).

CONCLUSION: ENMG is a frequently used neurological examination. As such, referrals for ENMG can be made to either support the referring diagnosis or to exclude other diagnoses. This may explain the inconsistency between clinical referring diagnoses and diagnoses following ENMG.