ÖN TANI- ELEKTRODİYAGNOSTİK TANI; NE KADAR UYUMLU?

Amaç: Elektrodiyagnostik çalıĢma pratikte klinik muayenin devamı olarak görülen, altta yatan nöromuskuler bozukluk hakkında bilgi veren bir çalıĢmadır. Uygun protokollerde yapıldığında hastalığın tanı ve tedavisinde yardımcı olmaktadır. Ġstemler ne kadar doğru endikasyonda istenirse, o kadar yüksek oranda tutarlı sonuç elde edilir ve klinik fayda artar. Bu çalıĢmada Elektronöromiyografi (ENMG) ünitemizde elde edilen Elektrodiyagnostik tanı (EDT)’ların ön tanılar ile ne kadar uyumlu olduğunu saptamayı amaçladık. Materyal ve Metot: ġubat 2016-ġubat 2018 yıllarında Namık Kemal Üniversitesi Tıp Fakültesi FTR Kliniği Elektronöromiyografi (ENMG) Ünitesi’nde çalıĢılan elektrodiyagnostik (ED) istemler ve sonuçlar ön tanı ile EDT uyumluluğu açısından retrospektif olarak incelendi. Bulgular: Toplamda 204 Elektrodiyagnostik çalıĢmanın (EDÇ) ön tanı ve EDT’leri incelenerek, 200’ü çalıĢmaya dahil edildi. Ġstemlerin 55’i erkek, 145’i kadın olup ortalama yaĢları sırasıyla 48,89 ± 13,41 ve 47,62± 13,06 idi. EDÇ sonuçları; 53’ü normal, 142’si Tuzak Nöropati (TNP), 28’i Radikülopati/Pleksopati, 28’i Polinöropati (PNP) , 2’si Miyopati idi. Kliniğimizde yapılan EDÇ’lerin %26,5‘i normal bulundu. %73.5 anormal EDÇ ise %61,5 ön tanı ile uyumlu ED tanı ve %12 ön tanıdan farklı bir EDT’dan oluĢmakta idi. Sonuç: Ön tanı ile EDT’nin uyumlu olması EDÇ’lerin doğru endikasyonda istenmesine bağlıdır. Anamnez, fizik ve nörolojik muayenenin sonrasında uygun endikasyonda istenen ve uygun Ģekilde çalıĢılan EDÇ; tanıda, tedavi planlamada ve progresyon takibinde değerli bir tetkiktir. Endikasyon dıĢı istemler EDÇ’nin değerini düĢürebilir, gereksiz hasta yoğunluğuna bekleme süresinin uzamasına, vakit ve kaynak kaybına neden olabilir.

PREDIAGNOSIS- ELECTRODIAGNOSIS; HOW MUCH CONCORDANT?

Aim: Electrodiagnostic test is a study that gives information about underlying neuromuscular disorder, so practically it is accepted as an extension of physical examination. It aids in the diagnosis and treatment of the disorder, if it is done in appropriate protocole. The more right indication of the claims are, the higher the concordance and the better the clinical benefit. In this study we aim to evaluate concordance ratio of electrodiagnosis with prediagnosis in our Electroneuromyography (ENMG) Unit. Materials and Methods: According to concardance between prediagnosis and electrodiagnosis results, the electrodiagnostic requests and ouput in the Electroneuromyography (ENMG) Unit of Namık Kemal University Mecidine Faculty, Department of Physical Medicine and Rehabilitation were evaluated retrospectively, between February 2016- February 2018. Results: By evaluating prediagnosis and electrodiagnosis, 200 of totally 204 electrodiagnostic study were included in the study. 55 of the requests were male and 145 were female, they were respectively 48,89± 13,41 and 47,62± 13,06 years old. Electrodiagnostic results were: 53 normal, 142 entrapment neuropathy, 28 radiculopathy/plexopathy, 28 polineuropathy, 2 myopathy. In our clinic 26,5% of the electrodiagnostic studies were normal. 73,5% of anormal electrodiagnostic study composed of 61,5% of prediagnosis concordant electrodiagnostic result and 12% of different diagnosis from prediagnosis. Conclusion: The concordance between prediagnosis and elecrodiagnostic results of electrodiagnostic studies depends on the requests with well defined indications. After anamnesis, physical and neurological examination, the electrodiagnostic test with proper requests and practice is a valuable study in planning the treatment or follow-up of the progression. Request without any indication will decrease the value of electrodiagnostic test and results in elongation of waiting time, unnecessary patient intensity, lost of time and sources.

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