The authors compared the yield of limb and thoracic paraspinal muscle examination for revealing lower motor neuron (LMN) dysfunction on electromyography (EMG) in amyotrophic lateral sclerosis (ALS) in a retrospective review of 354 patients with clinically definite or probable ALS. Seventeen limb muscles and thoracic paraspinal muscles were evaluated for the presence of both active and chronic denervation. The authors found that the distal limb muscles showed the highest EDX sensitivities of LMN dysfunction in ALS regardless of onset region and diagnostic certainty at the time of diagnosis, that EDX yield was higher in muscles from the onset limb, that noncontiguous spread of lower motor neuron degeneration is present in ALS, and optimally selected 6 upper and 5 lower extremity muscles yielded >98% of potential positive cervical or lumbosacral segments. They concluded that an algorithmic approach to needle EMG in ALS based on pretest probability of individual muscles optimizes electrodiagnostic yield, thus possibly minimizing test duration and patient discomfort.
Dr. Li has served as a staff neurologist in the NM Center at the Cleveland Clinic Foundation since 2012. He has been a member of AANEM since 2010 and currently serves on the AANEM’s EDX Self-Assessment Exam Committee.
“I enjoy a lot of things AANEM offers,” said Dr. Li. “In particular, I love the constant opportunities of learning new things by interacting with colleagues via conferences, symposiums, and committee meetings.”
Dr. Li completed his neurology residency at University of Cincinnati in 2002, where he was elected chief resident. This was followed by a 1-year fellowship in clinical neurophysiology that was also at the University of Cincinnati. He is board certified in neurology and EDX medicine. Dr. Li practiced at Lehigh Valley Physician Group-Lehigh Neurology as a NM specialist for 9 years before joining Cleveland Clinic.