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Conclusion

Pediatric electrodiagnostic studies are a useful diag­nostic tool that aid in the localization of abnormalities within the lower motor neuron, and often providehelp- ful prognostic information.

Electrodiagnostic stud­ies have been less utilized in the diagnosis of many myopathic disorders and anterior horn cell diseases due to the importance of molecular genetic studies and/or muscle biopsy for determination of disease subtypes. However, there remains a use for EMG and nerve conduction studies in many focal and gener­alized lower motor neuron conditions. For children suspected of having hereditary neuropathies with no family member possessing genetic confirmation, a directed nerve conduction study may guide the acquisition of more specific and less costly molec­ular genetic studies. In other conditions, such as Guillain-Barre syndrome, or focal neuropathic con­ditions, electrodiagnostic studies remain critical for diagnostic confirmation.

Practical suggestions relating to the pediatric elec­trodiagnostic evaluation have been provided. Study results must be interpreted in light of developmental and maturational issues affecting both clinical findings and electrophysiological processes. A skilled electrodi­agnostic evaluation utilizes careful strategic planning to provide the most important diagnostic information needed in an expeditious manner, with the least dis­tress possible to the child and parent. Ongoing elec­trodiagnostic experience with the pediatric population provides increasing diagnostic acumen regarding pediatric lower motor neuron disease processes and sufficient technical skills to provide the referring phy­sician with accurate diagnostic information.

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