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Neurological Exam and Neurophysiologic Evaluation for the Pain Patient

  • Andrew C. Young
  • Brian J. WaingerEmail author
Chapter

Abstract

The neurological evaluation plays an integral role in the evaluation and management of the pain patient. The conceptual approach is to identify the pathology and the underlying etiology, which then guides treatment and prognosis. The neurological exam is at the core of this evaluation, and experienced providers can diagnose diseases of the central nervous system and the peripheral nervous system. Nerve conduction study (NCS) and electromyography (EMG) are useful neurodiagnostic tools that enable the clinician to more precisely localize the pathology through detailed assessments of individual peripheral nerves and muscles. Not only can NCS/EMG aid in localization, it provides further information regarding the chronicity of disease and the possible mechanisms of injury. There are multiple etiologies that result in spine pain and many more disease mimics; the neurological exam and NCS/EMG aid the pain physician in obtaining the correct diagnosis.

Keywords

Neurological exam Nerve conduction study/needle electromyography (NCS/EMG) Radiculopathy Myelopathy Meralgia paresthetica Parsonage turner Carpal tunnel Diabetic amyotrophy Thoracic outlet syndrome 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of NeurologyMassachusetts General HospitalBostonUSA
  2. 2.Departments of Anesthesia, Critical Care and Pain Medicine and NeurologyMassachusetts General HospitalBostonUSA

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