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Algorithm > 4 weeks - Neurologic Limb Symptoms? - Primarily Leg Pain?

Order EMG or SEPs?

Needle EMG and H-reflex tests of the lower limb may be useful in assessing questionable nerve root dysfunction in patients with leg symptoms > 4 wks. (regardless of whether patients also have back pain).

If the diagnosis of radiculopathy is obvious and specific on clinical examination, electrophysiologic testing is not recommended.

SEPs may be useful in assessing suspected spinal stenosis and spinal cord myelopathy.

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