Chemodenervation & Neurolytic Procedures

By Dr. Evan Friedman | November 16, 2019

Motor point chemodenervation or chemical neurolytic procedures require low current stimulation location in the order of 0.2-0.5 mA, depending on the stimulation pulse width.  Pulse width is an essential part of the stimulation delivery.  Narrower pulse widths deliver the current pulse over the duration of the pulse width.  This means that the energy delivered is short for short pulse width and presented over a longer time for wider pulse widths.  Wider pulse widths generally allow use of lower currents to evoke equivalent responses when compared to narrower ones.

Issues:

  • Are you using old injection guidance machines not capable of stimulation below 1mA and pulse widths less than 100ms?
  • Are you using anaesthesia stimulators capable of 0.1mA stimulation current steps? If EMG monitoring is needed, do you need to bring aboard a second device?

Myoguide Features and Benefits Support Chemodenervation and Chemical Neurolytic Procedures:

Myoguide has several features that are unique and important when considering adding an injection guidance device to your armamentarium.  

Continuously upgradable: Myoguide can be upgraded as new features are brought online (https://www.intronixtech.com/myoguide-system/).  This ensures that Myoguide stays relevant and operating at peak performance.

EMG and stimulation integration:  This packages two useful tools needed for injection guidance procedures.

Accurate EMG bandwidth: Myoguide has an amplifier bandwidth from 20-600 Hz.  This coincides with bandwidth of the EMG signal. 

Accurate EMG audio: High Fidelity EMG audio is presented exactly as measured through a 2.5” high fidelity waterproof speaker.  This ensures that auditory EMG signal recognition is true to the source.

Audio Mute: This is an important feature to silences the audio between patient encounters, keeping Myoguide at the ready for the next treatment delivery.  Namely, those procedures where audio might startle patients.  

Visual signal display:  Large LCD signal display allows monitoring EMG signals for additional feedback.  (useful when operating with the Audio muted) . Adjustable vertical size and horizontal sweep supports pre-injection evaluations.

Integrated stimulation:  Multifunction stimulator has the capability of stimulating from 0.1-20mA with a high enough compliance voltage to ensure accurate stimulation at higher current levels.  Pulse width choices: 50uS, 100uS, 200uS, and 500uS.  Pulse frequency choices: 1Hz, 3Hz, 5Hz, 7Hz, and 10Hz. This ensures that you can craft the stimulation parameters to match a wider variety of applications.

Stimulation pause:  This feature is useful when repositioning the needle during patient encounters.  This allows the clinician to maintain the current stimulation level, saving the need to start the stimulation set up from the beginning.

Batteries:  Myoguide is designed to use readily available AA batteries and is designed to use rechargeable batteries as an alternative.