Clinical Day with Myoguide

By Dr. Evan Friedman | November 28, 2009

We like to keep our feet wet in the clinics to observe real practices. We had the privilege of watching over a variety of procedures, from headache protocol injections to management of pain, and spasticity. Myoguide performed admirably. Clear and concise EMG signals and EMG audio heralded entry into muscle, each and every time. I found an interesting advantage for Myoguide’s built in EMG signal display. EMG audio is another useful clue, but it is the ability to view the signal itself that provides the finer focus. Clinicians can evaluate the current state of EMG activity in previously injected areas during re-injection appointments. This qualitative and quantitative evaluation can provide necessary information to formulate re-injection dosing decisions. This will ensure adequate amounts of drug can be re-injected, without the worry of overdosing the site. This can keep patients managed for their condition with a high degree of efficacy.


We were fortunate to have some procedures being carried out with a combination of ultrasound and needle EMG guidance. Identification of vital structure with ultrasound can be a very important part of certain procedures. There was some difficulty discerning the position of the needle, with ultrasound. Position was indicated more from visible tissue distortion as the needle penetrated, than by actual image. The needle EMG signal was a very helpful addition to the procedure to confirm position in muscle.

Myoguide’s new MUTE feature has been a helpful addition as it allows the clinician to mute the EMG audio while waiting to inject. A simple button press activates the EMG audio at the preset level, in an instant. We are always looking for ways to improve the Myoguide system, and look forward to continued feedback from clinicians using our products.

These clinical sessions afford us a first hand view into daily operations. Special thanks to our luminary sites for their support.