Variation in the neurophysiological examination of amyotrophic lateral sclerosis in Europe

Kirsten Pugdahl, Anders Fuglsang-Frederiksen, Birger Johnsen, Hatice Tankisi, Mamede De Carvalho, Peter R W Fawcett, Annick Labarre-Vila, Rocco Liguori, Wilfred Nix, Ian S. Schofield

Research output: Contribution to journalArticlepeer-review


Our objective was to analyse how patients with amyotrophic lateral sclerosis (ALS) are examined neurophysiologically at different European centres in order to identify possible areas with variation or disagreement in the neurophysiological examination of ALS. Ninety-three prospectively collected examinations from six out of seven neurophysiologists in the European ESTEEM project were analysed. All examinations were peer reviewed with an electromyographic consensus diagnosis of motor neuron disease and the diagnosis of ALS confirmed by clinical follow-up. The examinations were analysed for differences among the physicians in EMG techniques and number and distribution of examined and abnormal muscles and nerve segments. Considerable variation was found among the physicians regarding the average numbers of performed and abnormal EMG and nerve conduction studies per patient, the EMG techniques used, and the topographical distribution of the examined muscles. The existence of two different examination approaches, one with quantitative EMG analyses and relatively few muscles studied, and one with more muscles studied using qualitative methods was clearly confirmed in the present study. The large variation among the physicians indicates that different criteria were used, or that criteria were used inconsistently.

Original languageEnglish
Pages (from-to)443-448
Number of pages6
JournalAmyotrophic Lateral Sclerosis
Issue number5
Publication statusPublished - Oct 2010


  • ALS
  • Electromyography
  • Multicentre database
  • Nerve conduction studies
  • Neurophysiology

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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