A nerve conduction study (NCS) is a medical diagnostic test commonly used to evaluate the function, especially the ability of electrical conduction, of the motor and sensory nerves of the human body. These tests may be performed by medical specialists such as clinical neurophysiologists, physical therapists, physiatrists (physical medicine and rehabilitation physicians), and neurologists who subspecialize in electrodiagnostic medicine. In the United States, neurologists and physiatrists receive training in electrodiagnostic medicine (performing needle electromyography (EMG) and NCSs) as part of residency training and, in some cases, acquire additional expertise during a fellowship in clinical neurophysiology, electrodiagnostic medicine, or neuromuscular medicine. Outside the US, clinical neurophysiologists learn needle EMG and NCS testing.
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👉 Nerve conduction study in the context of Guillain–Barré syndrome
Guillain–Barré syndrome (GBS) is a rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system. Typically, both sides of the body are involved, and the initial symptoms are changes in sensation or pain often in the back along with muscle weakness, beginning in the feet and hands, often spreading to the arms and upper body. The symptoms may develop over hours to a few weeks. During the acute phase, the disorder can be life-threatening, with about 15% of people developing respiratory muscle weakness requiring mechanical ventilation. Some are affected by changes in the function of the autonomic nervous system, which can lead to dangerous abnormalities in heart rate and blood pressure.
Although the cause is unknown, the underlying mechanism involves an autoimmune disorder in which the body's immune system mistakenly attacks the peripheral nerves and damages their myelin insulation. Sometimes this immune dysfunction is triggered by an infection or, less commonly, by surgery, and by vaccination. The diagnosis is usually based on the signs and symptoms through the exclusion of alternative causes and supported by tests such as nerve conduction studies and examination of the cerebrospinal fluid. There are several subtypes based on the areas of weakness, results of nerve conduction studies, and the presence of certain antibodies. It is classified as an acute polyneuropathy.
Nerve conduction study in the context of Guillaume Duchenne de Boulogne
Guillaume-Benjamin-Amand Duchenne (de Boulogne) (September 17, 1806, in Boulogne-sur-Mer – September 15, 1875, in Paris) was a French neurologist who revived Luigi Galvani's research and greatly advanced the science of electrophysiology. The era of modern neurology developed from Duchenne's understanding of neural pathways and his diagnostic innovations including deep tissue biopsy, nerve conduction tests (NCS), and clinical photography. This extraordinary range of activities (mostly in the Salpêtrière) was achieved against the background of a troubled personal life and a generally indifferent medical and scientific establishment.
Neurology did not exist in France before Duchenne and although many medical historians regard Jean-Martin Charcot as the father of the discipline, Charcot owed much to Duchenne, often acknowledging him as "mon maître en neurologie" (my master in neurology). The American neurologist Joseph Collins (1866–1950) wrote that Duchenne found neurology "a sprawling infant of unknown parentage which he succored to a lusty youth."His greatest contributions were made in the myopathies that came to immortalize his name, Duchenne muscular dystrophy, Duchenne-Aran spinal muscular atrophy, Duchenne-Erb paralysis, Duchenne's disease (Tabes dorsalis), and Duchenne's paralysis (progressive bulbar palsy). He was the first clinician to practise muscle biopsy, with an invention he called "l'emporte-pièce" (Duchenne's trocar). In 1855, he formalized the diagnostic principles of electrophysiology and introduced electrotherapy in a textbook titled De l'electrisation localisée et de son application à la physiologie, à la pathologie et à la thérapeutique. A companion atlas to this work, the Album de photographies pathologiques, was the first neurology text illustrated by photographs. Duchenne's monograph, the Mécanisme de la physionomie humaine – also illustrated prominently by his photographs – was the first study on the physiology of emotion and was highly influential on Darwin's work on human evolution and emotional expression.