Buschbacher's Manual of nerve conduction studies

Buschbacher’s Manual of Nerve Conduction Studies, 3rd Edition. D Kumbhare, L Robinson, R Buschbacher, eds, Demos Medical Publishing, New York, 2016, 299 pages, ISBN: 9781620700877, $85.00 OVERVIEW: Nerve conduction studies (NCS) are an essential component of a neuromuscular electrodiagnostic study. Learning the techniques of NCS can be difficult, because one must learn the location and setup for the many different nerves that can be tested. Buschbacher’s Manual of Nerve Conduction Studies, 3rd Edition, edited by Drs. Kumbhare, Robinson, and Buschbacher is a concise manual of NCS techniques and reference values that can serve as an essential resource for physicians and technologists in any office or laboratory that performs NCS. As the authors note in the Preface, the book is not intended to be an all-inclusive teaching manual of the techniques and theory behind the performance of NCS. It is meant to serve as a concise, easy-to-use bedside reference to help physicians or technicians in the setup and technical performance of a study and provide them with sets of normative reference data that can be used in the interpretation. Similar to previous editions of this manual, the authors nicely meet these intentions in their third edition. EDITORS: The editors are experienced electromyographers and have published extensively in the area of electrodiagnostic medicine. Their vast experience in performing NCS is evident throughout the manual in their concise, easy-to-understand descriptions of each study. READERSHIP: This manual will serve as an essential resource for residents and fellows who are learning the techniques of NCS and physicians and technologists in any office setting or EMG laboratory that performs NCS. CONTENT: The manual consists of descriptions of NCS for over 50 nerves. For each nerve, placement of the recording electrodes, stimulation site, machine filter and sensitivity settings are detailed, and the layout makes it easy to identify each of these descriptions. Additionally, each nerve contains a “Helpful Hints” section, which is mostly similar to previous editions and provides practical, “real life” points that are frequently encountered and affect technical performance and interpretation of the results. The third edition includes a new section on two anomalous innervation patterns that often produce confusing patterns of findingsdMartin Gruber anastomosis and accessory deep fibular nerve. In particular, the Martin Gruber anastomosis is often a source of frustration for those trying to understand the NCS pattern seen with this anatomic variation. The authors describe the findings well. STRENGTHS: The textual layout of the description of the setup remains the same as in previous editions and is mostly concise and clearly described. Compared with previous editions, the many individual nerves described, as well as the figures and setup descriptions have also largely remained unchanged. As previously noted, the “Helpful Hints” for each nerve provide additional practical information that may help with the performance of the study and reduce technical problems. WEAKNESSES: There are no significant identified weaknesses of this manual. In the new section on the Martin Gruber anastomoses, the illustrations demonstrating the pattern of findings in Martin Gruber anastomosis are very simple and appear to be handdrawn. Although the quality of these could be improved and the numerical values of the amplitudes in each trace included, the simplicity of the drawings may be beneficial to some readers. COMPARISON TO OTHER BOOKS: Although there are many textbooks dedicated to electrodiagnostic medicine, and other manuals that demonstrate the actual technique and setup of individual nerve conduction studies, this book differs in the inclusion of extensive reference values included for each nerve. REFERENCES: One of the main differences of this manual from other NCS manuals, and a strength of this manual, is the inclusion of comprehensive, literature-derived reference values for each nerve. The reference values are expanded to include the upper or lower reference value, as defined by the 3rd or 97th percentile, when available. Additionally, side-to-side comparison reference values, when available, are also included in this edition. The inclusion of all of these reference values is particularly useful for electrodiagnostic laboratories that have not established their own set of reference values, assuming that the techniques described in this manual are followed. FIGURES: The third edition of the manual continues with the same, simplified illustrations from the previous editions that can be used to assist with the placement of the recording electrodes and stimulator. Although the use of actual patient photographs to identify landmarks would have been a benefit in certain illustrations, the simple black-and-white drawings do allow for quick identification of stimulating and recording electrodes. RECOMMENDATIONS: This manual continues to be a concise, easy-to-use guide with updated and comprehensive reference values and updated literature references. It is an asset for any electrodiagnostic laboratory or practice setting in which NCS are performed. The third edition of the manual would greatly assist residents and technicians learning to perform these studies as well as experienced electrodiagnostic physicians and technicians.