Electromyography (EMG) – tetanus test

Electromyography (EMG) – tetanus test

Tetanus is a disease of the muscular system caused by calcium and magnesium deficiencies in the bodye. The disease occurs in two forms with different symptoms:

• the marked form, which is manifested through characteristic seizures. They begin with a tingling sensation in the fingers and mouth area. Next, all the facial muscles, as well as the muscles of the arms and legs, start to manifest strong and hard-to-control spasms. In extreme cases, the spasms affect the laryngeal muscles which may prevent the patient from breathing and cause a life-threatening situation. Moreover, the seizures are accompanied by psychological symptoms, such as anxiety, restlessness and strong agitation.
• the latent form, which has a very wide range of diverse symptoms. Instead of seizures, it generates – amongst others – chronic states of muscular pains and spasms, fatigue, anxiety, difficulties in concentration, occasional panic attacks, stammering, shaky hands, and circulatory disorders.

What does the examination look like?

The tetanus test belongs to a group of electromyographic examinations which analyse the electrical potentials in muscles and nerves. This examination involves, above all, identification of the electrostatic potential of muscles typical of tetanus or exclusion of this disea.

The examination is carried out with the patient in a horizontal position. During the examination, the patient wears an inflated cuff for 10 minutes to have his/her blood pressure measured. It may be worn either on the left or on the right upper limb (or, more precisely, around the biceps muscle). During this 10-minute compression of the upper arm (the arm becomes numb), there are also 2 minutes of deep breathing (similar to hyperventilation). After 10 minutes of compression, a small thin needle is inserted into the patient’s 1st intercostal dorsal muscle (between the index finger and the thumb) in order to register the muscle’s activity during the examination.

The whole examination lasts approximately 15 minutes.

Once the examination is over, the patient may resume all the daily activities.

Since the electrode performs the measurement on an ongoing basis, it is not necessary to wait for the results. The physician reads out and interprets the measurements right away, confirming or excluding the presence of tetanus.

The EMG examination requires no medical referral.

On the examination day in the morning, please wash the body part to be examined, using water with soap. Do not apply any creams, ointments, emulsions, balms, oils, etc. to the skin area to be examined.

It is necessary to discontinue, 24 hours before the examination and upon prior consultation with the attending physician, all coumarin group anticoagulants that affect the INR (e.g. acenocoumarol, warfarin). Acard and Polcard are not contraindications to the examination. Moreover, it is necessary to discontinue electrolyte supplementation 5-7 days before the examination. This primarily concerns preparations with magnesium, calcium, potassium and vitamin D.

Contraindications to the examination include:

• permanent orthopaedic equipment (e.g. plaster) that prevents the electrode to reach the limb under examination,
• a foreign body in the limb under examination,
• artificial limb,
• intake of anticoagulants, e.g. Clexane, Xarelto, Warfarin – they must be discontinued (upon consultation with the attending physician) 24 hours before for examination,
• high blood pressure (above 160 mmHg.

Prior to the examination, the patient should inform the physician about the current medication use, as the presence of certain pharmacological substances in the body (e.g. Aspirin) may affect the examination result.

If the patient has an IPG (pacemaker), or an ICD (implantable cardioverter defibrillator), it is necessary to provide the physician with relevant written information.