Abstract
Needle electromyography (EMG) is a valuable diagnostic tool in the evaluation of the PNS and yet the risk of complications with this procedure in patients on anticoagulant or antiplatelet medications is unknown. Guidelines recommend caution when performing needle EMG in patients with disturbances of hemostasis because of the risks of intramuscular hemorrhage or other bleeding. This commentary reviews a study by Lynch et al. that investigated the risk of hematoma formation following needle EMG of the tibialis anterior muscle in 158 patients on antiplatelet or anticoagulant medications. The authors used a standardized approach to the needle examination, followed by application of direct pressure to the insertion site after removal of the needle. Three hematomas were detected—two in patients on warfarin, and one in a patient taking clopidogrel. None of the patients had symptomatic bleeding. These results indicate that the risk of hematoma formation is low following needle EMG when direct pressure is applied after removal of the needle.
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References
Al-Shekhlee A et al. (2003) Iatrogenic complications and risks of nerve conduction studies and needle electromyography. Muscle Nerve 27: 517–526
Farrell CM et al. (2003) Acute compartment syndrome of the leg following diagnostic electromyography. Muscle Nerve 27: 374–377
Vaienti L et al. (2005) Compartment syndrome of the forearm following an electromyographic assessment. J Hand Surg [Br] 30: 656–657
Gruis KL et al. (2006) Survey of electrodiagnostic laboratories regarding hemorrhagic complications from needle electromyography. Muscle Nerve 34: 356–358
American Association of Electrodiagnostic Medicine (1999) Guidelines in electrodiagnostic medicine: risks in electrodiagnostic medicine. Muscle Nerve 8 (Suppl): S53–S69
Caress JB et al. (1996) Paraspinal muscle hematoma after electromyography. Neurology 47: 269–272
Lynch SL et al. (2008) Complications of needle electromyography: hematoma risk and correlation with anticoagulation and antiplatelet therapy. Muscle Nerve 38: 1225–1230
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Patwa, H. Is needle electromyography safe in patients on anticoagulation or antiplatelet therapy?. Nat Rev Neurol 5, 78–79 (2009). https://doi.org/10.1038/ncpneuro1005
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DOI: https://doi.org/10.1038/ncpneuro1005
