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The focus of the cervical radiculopathy by dermatomal pain in comparison with results of electrodiagnosis and imaging

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Objectives The dermatomal pain related to a cervical radiculopathy is often misunderstanded by physicians because in most cases there is a discordance between it, imaging and electromyography (EMG). The aim… Click to show full abstract

Objectives The dermatomal pain related to a cervical radiculopathy is often misunderstanded by physicians because in most cases there is a discordance between it, imaging and electromyography (EMG). The aim of this study is to compare trajectory of dermatomal pain, imaging and EMG findings. Methods It's a retrospective study over a year that regrouped patients referred to the department of functional explorations of Sfax for electrodiagnostic test. These patients had clinical signs of cervical radiculopathy and underwent a cervical imaging (MRI or CT) that confirmed it. They underwent a nerve conduction study with a needle EMG examination that examined one muscle from the affected root and others upper and lower depending on its result and clinical finding. The Fisher's exact test was used for comparison of different clinical, imaging and EMG signs. Results Sixteen patients (sex-ratio 1/3) were collected with a mean age of 54.8 ± 11.15 year. These patients had not yet motor signs. In 6 patients the pain was not dermatomal. When the pain was dermatomal, there was a concordance between clinic and respectively imaging and EMG in 3 cases and 8 cases. Dermatomal pain was not correlated with imaging (P = 0.8) nor with EMG (P = 0.9). There was a correlation between imaging and EMG (P = 0.05). Conclusion Because the radiculopathy is due to a motor ventral nerve root compression, the most important symptom is the myotomal weakness [1] , [2] . However, dermatomal pain was the most sensitive symptom but less specific in Hassan's study [2] . In fact this symptom can be due to a combination of mechanical and inflammatory mechanisms. Imaging and EMG are often in concordance with the affected nerve root but EMG gives more evidence of the functional lesions and a more specificity [3] .

Keywords: dermatomal pain; cervical radiculopathy; imaging emg; study; pain

Journal Title: Neurophysiologie Clinique
Year Published: 2018

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