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To the Editor:
I read with interest the report of the AAN Therapeutics and Technology Assessment (TTA) Committee on the clinical utility of surface electromyography (EMG).1 Although the review dealt comprehensively with most possible indications, I was surprised to find no discussion of the use of surface EMG in the investigation of sleep disorders (apart from citations 79 and 81, quoted to illustrate EMG activity of breathing in general).
Surface EMG has been routinely used in polysomnography for more than 30 years. Submental and anterior tibial EMG are routinely recorded, and intercostal and arm EMG are monitored in some laboratories. Surface EMG plays a vital role in the staging of sleep, specifically in the determination of skeletal muscle atonia associated with REM sleep.2 This is particularly essential when a multiple sleep latency test is used for the diagnosis of narcolepsy. It is helpful in detecting arousals, especially from REM sleep.3 It is fundamental to the diagnosis of a number of neurologic motor disorders of sleep, including REM sleep behavior disorder4 and periodic limb movement disorder.5 In addition to polysomnography, surface EMG of leg muscles is monitored in the suggested immobilization test for restless legs syndrome.6
Thus, the diagnosis of sleep disorders should be added to the list of accepted indications for surface EMG recordings.
Clinical utility of surface EMG: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology
To the Editor:
I disagree with the opinion of the TTA Subcommittee concerning the use of surface EMG for evaluating low back pain.1 The Subcommittee appears to consider surface EMG as a generic technology applied in a universal manner by all researchers, practitioners, and product developers. One cannot assume technologic homogeneity, as other well-accepted evaluative procedures such as electrocardiography and nerve conduction velocities also rely on surface sensors. Was the Subcommittee’s mission statement to consider surface EMG …
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