Referral and diagnostic trends in pediatric electromyography in the molecular era

Introduction: Major advances in genetic analysis and neuroimaging have modified the traditional diagnostic approach for neuromuscular disorders. The purpose of this study was to investigate the role of electromyography (EMG) in the molecular era. Methods: We retrospectively surveyed reports of all EMG studies performed at Boston Children's Hospital from 2001 through 2011. Data were collected on study numbers, patient ages, referring provider subspecialty, study indication, electrophysiological diagnosis, and study utility. Results: A total of 2100 studies were performed. The volume increased from {reversed tilde}160 to {reversed tilde}250 studies/year. There was a trend toward studying older children. Neurologists, including neuromuscular specialists, constituted the major referral pool, whereas referrals from orthopedics increased steadily. Polyneuropathies followed by mononeuropathies were the most common indications and diagnoses. Fifty-seven percent of studies were normal. EMG provided meaningful information in 94% of cases. Conclusion: EMG continues to play a cardinal role in the diagnosis of pediatric neuromuscular disorders, although its practice paradigm is evolving.