Electromyography and Nerve Conduction Studies
Why is my child getting an EMG?
Your child’s doctor has referred them for an EMG because they have determined that your child has signs or symptoms that may indicated a disorder of the peripheral nerves (nerves outside the brain and spinal cord), muscles, or the junction between the peripheral nerves and muscle (called the neuromuscular junction).
How to Prepare for the Test
Have your child bathe before the exam to remove skin oils and do not apply any lotion on the day of the test.
If your child is having a sedated EMG, please follow instructions on what time they need to stop eating and drinking. Otherwise no change in your child’s daily activity is needed before the test.
Please let the doctor know before the test if your child:
- Has a pacemaker, other electrical medical devices, or a central catheter
- Is taking any blood-thinning medications
- Has hemophilia (a blood-clotting disorder)
Common Questions
What is an EMG?
Generally this is a 2 part test:
- Part 1 - Nerve Conduction Study (NCS): During the NCS, a technologist places electrodes (stickers) on the part of your child’s body being tested and then send a small amount of electrical current through your child’s nerves using a handheld stimulator placed over the skin. This allows us to test the health of the nerves outside the brain and spinal cord. This electrical current feels a bit like static electricity/tingling sensation and can be surprising/uncomfortable to your child but will not cause any damage. This part of the test usually takes 20- 40 minutes depending on how many nerves need to be evaluated (this will depend on what question about your child’s nerves is being asked by their doctor).
- Part 2 - Electromyogram (EMG): This portion of the test evaluates the electrical activity of the muscles and can help determine the health of the muscles and the nerves that supply those muscles. During the EMG, the doctor will place a very thin needle electrode (similar in size to the needles used in acupuncture) into one or more of your child’s muscles (one at a time) and record the electrical activity in the muscle. There is no electricity applied during this part of the test. This part of the test usually takes 15-30 min (this will depend on what question about your child’s nerves and muscles is being asked by their doctor). Risks are minimal, including bleeding (which is typically very little or none at all). If your child is on anti-coagulation medications/blood thinners, please let us know.
Can my child have this study without sedation?
If your child is over 5 years of age, ideally the answer is yes (even for children under 5 years old the answer may still be yes.). The test can be uncomfortable, but children are usually able to tolerate it well particularly if they are mentally prepared and have some idea of what to expect. We can also have a child life specialist join us during the study to help provide some distraction for your child to make it a more pleasant experience. You are also able to stay in the room to help keep your child comfortable.
If your child is not sedated during the test, they will need to cooperate in the following ways:
- For the NCS, they will need to allow the technologist to place the electrode stickers on their skin and then hold reasonably still while the response of the nerves is being recorded. It is difficult to do the test well if they are being combative.
- For the EMG, they will need to allow the doctor to place the thin needle in the muscle being tested. We can place a numbing spray on the area of the skin before the needle is placed to make this more comfortable. Additionally, we will ask them to move their body to contract that muscle. Children with severe phobia of needles may not be able to tolerate this unsedated.
We recommend that you discuss with your child’s doctor who is ordering the test whether you both think your child will be able to tolerate the test unsedated. A sedated EMG can be arranged alternatively if the answer is no (this has to be arranged in advance; not the day of the test).
If your child is having a sedated EMG
Upon arriving in the Children’s Procedure Center, parents and patient will be consulted by a nurse practitioner as to the best way to administer sedation and different types of sedation. The patient is then brought back into the procedure room where parents may accompany them until they become relaxed from the sedation. Parents are then asked to relocate to the waiting room while EMG is done. The doctor will inform parents of the EMG results when finished. Parents will meet child again in recovery room. Effects of sedation may last the rest of the day.