This list is intended to serve as a guide to texts and articles that the A.E.T.C.deems as significant and useful references in the study of Electromyography and specifically nerve conduction studies. Examination material will not necessarily be limited to information from these sources.
Brown, Bolton & Aminoff. Neuromuscular Function and Disease. Basic, Clinical and Electrodiagnostic Aspects.Volume 1 and 2. Saunders. 2002.
Chu, J. Electrodiagnosis - An Anatomical and Clinical Approach.
Dawson, M., Hallet,M.and Millender,L. H. Entrapment Neuropathies. Little Brown and Company, 1993.
Dong, M. M. and Levison, J.A. Nerve Conduction I - Handbook. F. A. Davis Co., 1983.
Dumitru, D. and Walsh, N.: Practical Instrumentation and Common Sources of Error. American Journal of Physical Medicine and Rehabilitation, 1988.
Dyck, PJ, Thomas PK. Peripheral Neuropathy, 4th Edition. Boston: Butterworth-Heinemann. 2004.
Ferrante, Mark. EMG: What We Measure and What it Means. AANEM. 2012.
Fuller,G.:Neurological Exam Made Easy. Churchill Livingstone 1993.
Gitter, A.: Practical Instrumentation and Troubleshooting in the Clinical Setting. AAEM Course 1995.
Johnson,E.Practical Electromyography, 2nd ed. Williams and Wilkins, 1988.
Kimura, J. Electrodiagnosis in Diseases of Nerve and Muscle: Principles and Practice, 4th ed. F. A. Davis, 2013.
Medical Research Council. Aids to the examination of the peripheral nervous system. Crown, 1976.
Ma, D. M. and Liveson, J. A. Nerve Conduction Handbook, Davis, 1983.
Oh, Shin J. Clinical Electromyography. Nerve Conduction Studies. Baltimore. Lippincott Williams & Wilkins. 2002.
Preston, David C, Shapiro, Barbara E., Electromyography and Neuromuscular Disorders. Clinical-Electrophysiologic Correlations 2nd Edition. Elsevier Butterworth Heinemann. 2005.
Stewart, J. Focal Peripheral Neuropathies. Elsevier, 2010.
Various authors: Minimonographs, Case Reports and Workshop handouts published by the American Association of Electrodiagnostic Medicine. (Also published in Muscle and Nerve.)
Prepared by Robert Grondin for EMG Technologists
This list is compiled as an aide to sifting the large amount of literature concerning EMG. It will present a piece of literature, its advantages and disadvantages as well as those sections useful to focus on. This is especially apt for those members studying for exams. This list is sectioned into literature concerned with:
Technical Aspects of EMG
Anatomy and Physiology
Clinical Aspects of EMG
It is of course impossible to avoid overlap within these categories and some books will be found in more than one section. I don’t pretend this is a complete list, nor that I have completely read each of these cover to cover, this list is a guide.
1. Technical Literature
Ma, D.M. and Liveson, J.A. Nerve Conduction Handbook, Davis, Philadelphia
Advantages: This book is really a must have for most EMG labs. It might be the best handbook for “How to do..” information. The good diagrams show you where to put electrodes and stimulate for a great number of tests including many that are not routinely done. Two main advantages are 1-a section on pitfalls encountered in particular NCS studies ie-what to be careful for, and 2-normal values for almost every study published up to 1983 and their technical features.
Disadvantages: It does not fully explain the technical basis for NCS ie-the explanations for technical recording factors and what makes up a SNAP or CMAP. The literature is as expected getting somewhat dated. A new volume is needed soon.
Focus On: The whole book is excellent to have read over before an exam. This is also a good reference text for when you just have to do for example a suprascapular nerve and need valid technique and normal values
Brown, W.F., The Physiological and Technical Basis of Electromyography, Butterworths, Boson, 1984.
Advantages: This is a text for those who want to know in depth what is really going on when they do a nerve conduction. Likely the best text for explaining the physiological basis for EMG and NCS. It is excellent for giving a strong scientific conceptual framework for electrophysiology, especially in terms of where the currents and voltages we record come from. The tables and diagrams are generally informative.
Disadvantages: It’s completeness is an advantage as well as a disadvantage. Unless you remember your basic physiology and read carefully, the review of physiology literature can leave you bogged down. There is a lot of information in there. This book is not made for skimming through. There are no end of chapter summaries for quick reference. Although the title says “Technical AND Physiological Basis” the emphasis is definitely on the physiology. There is little information concerning electronics.
Focus On: Chapter 1 – complete explanation of why we can record voltages Chapter 2- good section on pathophysiology Chapter 3- again information on what we actually record but keep in mind that he often refers to monopolar crushed nerve preparations.
Sethi, R.K. and Thompson, L.L. The Electromyographers Handbook, 3rd Ed., Little Brown and Co., Boston, 1989.
Advantages: This is a low cost, easily read and relatively comprehensive introduction to NCS and EMG. Most of the basic EMG and NCS information to do the AETC exam can be found in this book. They supply some normal values but little in the way of literature review.
Disadvantages: It’s simplicity is also a disadvantage. The explanations of electronic factors in electrophysiology are short and sweet and give only a surface understanding of what is happening. This section as well as safety and infection control would NOT necessarily be adequate for AETC exam.
Focus On: The whole book is useful. It is short (200 pages) and therefore manageable.
Basmajian, J.V. and DeLuca, C.J. Muscles Alive: Their functions revealed by EMG, 5th edition, Williams and Wilkins, 1985.
Advantages: This is a revamp of a classic text written by Dr. Basmajian. DeLuca’s expertise, understanding and explanations of technical details makes this book very useful. In fact almost anything written by DeLuca will contain excellent technical information. They explain in detail amplifiers, differential recording, filters, summation of signals and a general description of the EMG and NCS signals. The diagrams within illustrate many concepts well.
Disadvantages: The explanations presented usually include more mathematics than most people are comfortable with ploughing through and this can be discouraging. Thankfully, the math can be skimmed over without missing too much. This is mainly a Kinesiological text and it’s emphasis is definitely not clinical. Some of the specific technical suggestions are at odds with those usually used in clinical labs. Chapters 6-21 are all very kinesiological and not too useful clinically except where you may want to know how to record during some activity or when co- contraction is a factor.
Focus On: Chapters 2 and 3 – good for electronics. Chapter 4 – theoretical description of the EMG signal. Chapter 5 – motor unit control information (skim).
Ruch, T.D. and Patton, H.D., Physiology and Biophysics, W.B. Saunders, Philadelphia, 1965. (Although this is an old text, it is a classic. There is a new 4 volume set out there now. I don’t know the cost but likely it is high).
Advantages: this book contains probably the best review of resting membrane and action potential mechanics as well as a good description of the solid angle theory and recording of electrical potentials in a volume conductor. A complete (to 1965) review of physiology that may be useful if you need to know more about the subject to understand some disorder.
Disadvantages: This is a big, heavy and expensive book. It is perhaps more than you may want to deal with especially if it is for the exam. The book has 63 chapters of which only 4 or 5 can be linked to EMG.
Focus On: Chapter 1 resting membrane potential (basics of ion gradient). Chapter 2 action potential. Chapter 3 solid angle theory and recording in a volume conductor. Chapter 5 Muscle physiology (NMJ and muscle).
Desmedt, J.E. New Developments in Electromyography and Clinical Neurophysiology S. Karger, Basel, 1973.
Advantages: This is another old but classical text (3 volumes). As you read newer articles you will often see this series referred to for original work. If you want good background articles this is a good book.
Disadvantages: Obviously the information is dated so you may not know when new information has superseded the stuff in here. It can be fairly dense going at times and will contain lots more than you may want to read. This is NOT recommended for studying for the exam.
Focus On: This book is for reference only. Don’t try to read through it, you’ll wear yourself out.
B) Journal Articles and Monographs
The essential journal for anyone involved in EMG is Muscle and Nerve. This is a great journal and will have technical clinical new research and reviews and monographs. On a lesser known scale you can look at the Journal of EEG and Clinical Neurophysiology. They have a journal every few months called EMG and Motor Control that has good articles and reviews. Since Kimura took over the editorship this journal has become increasingly excellent. You may not want to use these to study for the exam except maybe the minimonographs from Muscle and Nerve.
Guidelines in Electrodiagnostic Medicine.; American Association of Electrodiagnostic Medicine. Muscle & Nerve 15:229-253, 1992
AAEE Minimonograph #33: Electrodiagnostic approach to defects in Neuromuscular Transmission – John C. Keesey, MD, Muscle & Nerve 12:613-626, 1989
2. Anatomical References
While Gray’s Anatomy may be the most widely known anatomy text, it is very difficult to actually study from. An atlas of anatomy such as Grant’s Atlas may be more useful, although many atlases are long on pictures and short on descriptions and explanations. EMG Labs need anatomy texts to:
Locate bony landmarks to direct us to muscles and nerves
Locate muscles for EMG
Procedures for activating appropriate muscles.
Netter, F. The CIBA Collection of Medical Illustrations, volume 1 The Nervous System, CIBA Pharmaceutical Co., 1983
Advantages: This book has detailed, visually accurate, easy to follow diagrams to help located nerves, muscles and appropriate bony landmarks. The physiology explanations and diagrams are simple and useful. The anatomy pictures even photocopy well for home study.
Disadvantages: The functions of muscles are not described much in this book We must keep in mind that these are drawings and therefore are only representations of reality, these are not dissections and the nerves and plexi are not so clean cut.
Focus On: For EMG Technologists studying for exams, Section VI – nerve plexi and peripheral nerves are invaluable. Section V – good presentation of cranial nerves
Rasch, P.J. and Burke, R.K. Kinesiology and Applied Anatomy: The science of human movement, Lea and Febiger, Philadelphia.
Advantages: The applied examples and the functional nature of the explanations in this book are very useful. The system of presenting the muscles make you aware of their movement functions. The diagrams are clear and well presented however do not photocopy too well. Examples are given of the functional deficits seen with weakness of different muscles. They present many real world examples of activities and the muscles needed to perform them. Tables supplied are good reminders that many muscles are activated in unexpected movements.
Disadvantages: This is not a clinical book, it is kinesiological in scope. It will not help with finding stimulus or recording points and cutaneous nerves are almost never mentioned. Outside of kinesiology graduates few people may have used this book.
Focus On: Chapter 8-9 are useful for their descriptions of the muscles, origins, insertions and actions.
Chu-Andrews, J. and Johnson, R.J. Electrodiagnosis: An anatomical and Clinical Approach, Lippincott, 1986.
Advantages: This is a decent book for anatomy if you like studying using dissections as a guide. The dissections are useful to see the relative sizes and positions of muscles, nerves and bones on a ‘real’ body. The section on clinical EM shows you the muscles examined, where to insert the needles and some instructions for activation and relaxation. There is a section on NCS with setups and normal values, but his is all found in other books.
Disadvantages: Although they present tables of NCS normal values, these are not referenced. I might assume that these numbers are their own normals using the setup suggested. Very little is presented concerning the technical and equipment aspects of NCS and EMG. The clinical information is not as in depth as other books (notably Kimura and the Bolton and Brown book). This is not a widely used book so if you refer someone to it they may not have it.
Focus On: Chapter 1 is a good anatomy reference for locating muscles and nerves in real life. Chapter 2 will help in localizing muscles for needle EMG.
Goodgold, J. Anatomical Correlates of Clinical Electromyography, Williams and Wilkins, Baltimore, 1984.
Advantages: If you are capable of thinking in cross section this book will give you a good 3-D representation of anatomical structures. This is especially useful when doing needle EMG of deep lying muscles and for determining which muscles are likely to be recorded through volume conduction. It presents angles for approaching deep muscles so you can avoid vessels and nerves as well as other muscles that would complicate the clinical analysis.
Disadvantages: The mental gymnastics of switching back and forth between cross section and surface anatomy can be difficult. There is little written anatomical description, pictures and diagrams carry all the information.
Focus On: This is a good on site reference but probably not a good book to study from.
Kimura, J. Electrodiagnosis in Diseases of Nerve and Muscles, 1985
Advantages: The anatomy is presented in terms of localization of nerve lesions and is therefore clinically relevant.
Disadvantages: The anatomy section is short and sweet. It assumes you already have a good grounding in anatomy. It is likely to be difficult to study from unless you have other texts handy or are already good with anatomy.
Focus On: Chapter 1 for peripheral anatomy in terms of localization as well as the chapter dealing with specific anatomical areas (ie-Chapter 23 deals with mononeuropathies). If you want the combination of clinical and anatomical information this book is excellent, but not if you want just basic anatomy.
Delagi, E.F. and Perotto, A. Anatomical Guide for the Electromyographer 2nd ed., Charles C. Thomas, Springfield Ill., 1980.
Advantages: If you don’t have this book in your EMG lab, you should get it. Perhaps the classic and best book for needle EMG and anatomy. Diagrams are clear, they show how to measure to find the muscle, test maneuvers, etc. A must have.
Disadvantages: Except for the difficulty in obtaining a copy in recent years, there are not real disadvantages to this book. Some of the positions for needle EMG are debatable but a good point to start from.
Focus On: If you’re studying from this book it is dry to just read but makes an excellent quiz master.
Steward, J.D. Focal Peripheral Neuropathies, Raven Press, New York, 1993.
Advantages: The anatomy is short clear concise and quite clinically related. You don’t get too bogged down with minutae like in Gray’s
Disadvantages: The anatomy is presented in a short paragraph that is not very complete but hits the highlights. The anatomy is depicted in drawings for the most part.
Focus On: This is an excellent reference book but I would NOT recommend using it to directly study anatomy except as it pertains to focal neuropathies ie – in exactly which spots is the peroneal nerve subject to entrapment?
Gray’s Anatomy The grandfather of anatomy texts is an excellent reference work that each lab likely should have somewhere. Don’t try to study from it unless you have superhuman stamina. Hall, H. The Back Doctor, Seal Books, Toronto, 1995.
Advantages: The advantages of this book lie in it’s de-mystifying approach to back pain. Dr. Hall gives a clear and concise explanation of cause and treatments of back pain. The anatomy of the back and the structures causing pain are simply described in a way that can be passed on to patients. Recommended for both techs and patients alike.
Disadvantages: For medical personnel this may be a bit oversimplified.
Focus On: Not recommended for exam studying. Chapter 2 we may recognize ourselves as part of the revolving door Chapter 3 a short painless course in back anatomy Chapter 5 causes of back pain.
3. Clinical References
Kimura, J. Electrodiagnosis in Diseases of Nerves and Muscles, 1985
Advantages: The clinical portions of this book are really it’s strength which probably explains why so many electromyographers follow it. It is difficult to pick a specific chapter as the best to focus on since they are quite complete. This is an excellent clinical reference book and everyone should have it in their lab.
Disadvantage: It is hard to find disadvantages with such a complete clinical book however it is a difficult book to sit down and read for very long.
Focus On: All of the clinical sections are very good and deserve attention.
Bolton, C.F. and Brown, W.F. 2nd ed. Clinical Electromyography, Butterworth and Heinemann, Mass., 1993
Advantages: This is an excellent book that is somewhat easier to read than Kimura. Don’t let the first few chapters throw you off. They are the least readable of the book. This book has really made reading about EMG actually enjoyable.
Disadvantages: I have had a few residents bring this book back the day after taking it away saying it is hard to read for long. They each have started from Chapter 1 then quit. True Chapter 1 is a tough go. The rest of it is better.
Focus On: Just about any of these chapters are very useful for clinical information. In fact, if you were to read just one EMG text, I would actually recommend this one over Kimura. It is just far more readable.
Steward, J.D. Focal Peripheral Neuropathies, 2nd ed. Raven Press, New York, 1993.
Advantages: This is a complete book written specifically for focal neuropathies. The style of presentation flows well from problem to problem and makes easy reading.
Focus On: Using this as an excellent reference text.