The electrodiagnostic examination with myopathies.

The values and limitations of the electrodiagnostic examination in assessing patients with possible myopathies are discussed. Limitations include: (1) no findings are specific for muscle disease; (2) the particular changes may be quite diverse; (3) myopathies of different etiologies may have the same presentation, whereas the same myopathy may have different presentations at different times; (4) a specific myopathy cannot be diagnosed; and (5) the ability to diagnose myopathy may be seriously compromised by the presence of certain disorders. Benefits include: (1) widespread muscle sampling; (2) help in determining most appropriate muscle for biopsy; (3) ascertaining, to some extent, the type of myopathy present, depending on the particular findings; (4) distinguishing entities often confused clinically with myopathies; (5) recognizing abnormalities (e.g., myotonic discharges) otherwise undetectable. Both the clinical and electrodiagnostic presentations of myopathies are discussed. Regarding the latter, the potential or actual changes seen with each component of the electrodiagnostic assessment (nerve conduction studies, late responses, repetitive stimulation studies, needle electrode examination, quantitative electromyographic studies) is reviewed.