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EMG Guided Injection References

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MANUAL NEEDLE PLACEMENT: ACCURACY OF BOTULINUM TOXIN A INJECTIONS ; October 2012; Muscle and Nerve 46 531-534; ALEXIS SCHNITZLER, MD,1 NICHOLAS ROCHE, MD, PHILIPPE DENORMANDIE, MD,  CHRISTINE LAUTRIDOU, MD,  BERNARD PARRATTE, MD, PhD, and FRANC¸ OIS GENET, MD

Findings show a poor success rate, regardless of injector experience.  Muscle palpation and anatomical landmarks are insufficient to ensure the accuracy of BoNt-A injections, even for large, superficial muscles. 

Both novice and expert injector groups did significantly better with EMG guidance 

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