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Dr. Dr. Jitendra Prasad Yadav • Consultant Neurologist • NMC 8029
Tingling, numbness, weakness or burning pain in hands or feet? Nerve conduction studies (NCS) and EMG (electromyography) diagnose neuropathy, carpal tunnel syndrome, nerve injuries and muscle disorders. Dr. Jitendra Prasad Yadav (NMC 8029), Consultant Neurologist with 15+ years at National Trauma Center (NAMS), provides NCS/EMG testing at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, Opposite of Yak & Yeti Hotel, Kathmandu — ordered only when clinically indicated.
Nepal Medical Council Reg. No. 8029 • 15+ years National Trauma Center, NAMS
What are nerve conduction studies?
Nerve conduction studies measure electrical signal speed through nerves; EMG tests muscle electrical activity. Together they pinpoint neuropathy, entrapment, and neuromuscular problems.
Your peripheral nerves transmit electrical signals from brain and spinal cord to muscles and back from skin sensors. When nerves are damaged — by diabetes, compression (carpal tunnel), injury, vitamin deficiency, or other causes — signal transmission slows or weakens.
NCS procedure: Small electrodes are placed on skin over a nerve (e.g., median nerve at wrist for carpal tunnel). A brief electrical pulse stimulates the nerve. Recording electrodes measure how long it takes for the signal to travel and how strong the response is. This is repeated for multiple nerves in arms and legs depending on symptoms.
What NCS measures:
EMG tests muscle electrical activity using a fine needle electrode inserted into muscle. When you contract the muscle, the electrode records electrical patterns. Abnormal patterns indicate:
EMG is often done after NCS to complete the picture. If NCS shows nerve damage, EMG tells whether muscles are affected. If NCS is normal but weakness persists, EMG may reveal primary muscle disease.
Peripheral neuropathy (diabetic, chemotherapy, B12 deficiency, alcohol)
NCS shows slowed conduction velocity and reduced amplitude in length-dependent pattern (feet worse than hands). Distinguishes axonal vs demyelinating. EMG shows denervation in chronic cases.
Carpal tunnel syndrome (median nerve entrapment at wrist)
NCS gold standard: prolonged distal latency, slowed conduction across wrist, reduced amplitude in severe cases. Compared to unaffected side. EMG detects chronic denervation if surgery is considered.
Ulnar nerve entrapment (cubital tunnel at elbow)
NCS localizes slowing across elbow. Clinical correlation with hand numbness (ring/little finger) and weakness.
Radiculopathy (nerve root compression — herniated disc, spinal stenosis)
EMG shows denervation in muscles supplied by affected root (e.g., C6, L5). NCS is often normal because lesion is proximal to tested segment. Clinical correlation with MRI.
Guillain-Barré syndrome (GBS) and CIDP (chronic inflammatory demyelinating polyneuropathy)
NCS shows demyelinating features: slowed conduction, prolonged F-waves, conduction block. Distinguishes from axonal GBS. Repeat studies monitor progression and recovery.
Myasthenia gravis and Lambert-Eaton syndrome
Repetitive nerve stimulation during NCS shows decremental or incremental response. EMG shows characteristic patterns. Confirms neuromuscular junction disorder.
Myopathy (polymyositis, muscular dystrophy, metabolic myopathy)
EMG shows myopathic changes: short-duration, low-amplitude potentials. NCS is normal. Distinguishes from neuropathy. Muscle biopsy and CPK guide further workup.
Dr. Dr. Jitendra Prasad Yadav orders NCS/EMG when history and examination suggest nerve or muscle dysfunction and when results would guide treatment decisions. Not every tingling needs NCS — labs (glucose, HbA1c, B12, thyroid, kidney) and clinical assessment come first.
Typical scenarios for NCS/EMG:
Before the test: No fasting needed. Avoid lotion/cream on limbs. Inform clinic if you take blood thinners (minor bleeding risk with EMG needles). Wear loose clothing.
During NCS: Electrodes placed on skin over nerves. Brief electrical shocks (uncomfortable like static but tolerable). Multiple nerves tested depending on symptoms (median, ulnar, peroneal, tibial, sural).
During EMG: Fine needle inserted into muscle. You rest, then contract muscle while needle records. Feels like injection with mild aching. Multiple muscles may be tested.
Duration: 30-60 minutes total depending on number of nerves/muscles tested.
After the test: Resume normal activity immediately. Mild soreness at needle sites (EMG) for a few hours is normal. Results discussed same day or at follow-up visit.
NCS/EMG is a functional test, not structural imaging. It quantifies nerve/muscle dysfunction but does NOT show the cause. Labs, imaging (MRI for radiculopathy, ultrasound for entrapment), and clinical history identify etiology.
Small fiber neuropathy (burning pain, allodynia) may have normal NCS/EMG because small fibers are not tested by standard NCS. Skin biopsy or quantitative sensory testing is needed.
Early or mild neuropathy may show borderline findings. Serial studies over months quantify progression.
Dr. Dr. Jitendra Prasad Yadav (NMC 8029), Consultant Neurologist with 15+ years at National Trauma Center (NAMS), performs NCS/EMG at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, Opposite of Yak & Yeti Hotel, when clinically indicated based on symptoms, examination, and initial labs.
Book NCS/EMG Testing
Kathmandu Neurology Clinic & Cognitive Center
Durbar Marg, Opposite of Yak & Yeti Hotel, Kathmandu 44600, Nepal
Phone: 974-7736624
Sun-Sat 9AM-7PM • By Appointment • 27.7172, 85.3240
Book Nerve TestingRelated Neuropathy & Nerve Pages
What NCS/EMG Cannot Do
NCS/EMG tests nerve and muscle function but does NOT show the cause. Labs, imaging, and clinical history identify etiology (diabetes, B12 deficiency, entrapment). Small fiber neuropathy may have normal NCS/EMG. Clinical correlation is essential.
Nerve conduction studies (NCS) measure how fast electrical signals travel through peripheral nerves. They help diagnose neuropathy (diabetic, chemotherapy-related, nutritional), carpal tunnel syndrome, ulnar nerve entrapment, radiculopathy, and other nerve injuries. At Kathmandu Neurology Clinic & Cognitive Center, Dr. Dr. Jitendra Prasad Yadav (NMC 8029) orders NCS when symptoms suggest nerve dysfunction and when results would guide treatment.
NCS (nerve conduction studies) test nerve transmission speed by stimulating nerves with surface electrodes and recording responses. EMG (electromyography) tests muscle electrical activity using a fine needle electrode inserted into muscle. They are often done together: NCS evaluates nerve function, EMG evaluates muscle and nerve-muscle junction. Combined, they distinguish neuropathy, radiculopathy, myopathy, and neuromuscular junction disorders.
NCS involves brief electrical shocks through skin electrodes — uncomfortable but tolerable, like static electricity. EMG needle insertion feels like an injection with mild aching during muscle activation. Most patients tolerate the procedure well. Total time: 30-60 minutes depending on how many nerves and muscles are tested. Local anesthetic is not used as it would interfere with results.
Consider NCS if you have: persistent tingling/numbness in feet or hands (length-dependent pattern suggesting diabetic or other neuropathy), hand tingling/weakness at night (carpal tunnel), progressive weakness without clear cause, or asymmetric nerve symptoms suggesting entrapment or focal injury. NCS quantifies severity, distinguishes axonal vs demyelinating patterns, and provides baseline for follow-up. Not every tingling needs NCS — examination and labs come first.
Yes. NCS is the gold standard for confirming carpal tunnel syndrome (median nerve entrapment at wrist). It measures median nerve conduction velocity and compares affected side to unaffected side and to other nerves. Severe carpal tunnel shows prolonged distal latency and reduced amplitude. Mild cases may show borderline findings; clinical correlation is essential. EMG checks for chronic denervation if surgery is being considered.
NCS distinguishes patterns — length-dependent polyneuropathy (diabetes, B12 deficiency), focal entrapment (carpal/ulnar tunnel), radiculopathy (nerve root), demyelinating neuropathy (GBS, CIDP) — but does NOT identify the underlying cause. Labs (glucose, HbA1c, B12, thyroid, kidney function) and clinical history identify etiology. NCS quantifies severity and type, guiding prognosis and follow-up.
Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, Opposite of Yak & Yeti Hotel — Dr. Dr. Jitendra Prasad Yadav (NMC 8029), Consultant Neurologist with 15+ years at National Trauma Center (NAMS). NCS/EMG is performed when clinically indicated based on history, exam, and labs. Book via /book-appointment or call 974-7736624, Sun-Sat 9AM-7PM. Bring prior reports, medication list, and glucose/diabetes records if applicable.
No fasting needed. Avoid applying lotion or cream to arms/legs on test day (interferes with electrodes). If you take blood thinners, inform the clinic in advance (EMG needle insertion has minor bleeding risk). Wear loose clothing for easy access to limbs. Bring prior nerve studies if you have them for comparison. Results are typically discussed same day or next visit.
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