Although existing guidelines address electrodiagnostic (EDX) testing in identifying neuromuscular conditions, guidance regarding the uses and limitations of serial (or repeat) EDX testing is limited. By assessing neurophysiological change longitudinally across time, serial electrodiagnosis can clarify a diagnosis and potentially provide valuable prognostic information. This monograph presents four broad indications for serial electrodiagnosis in adult peripheral neurological disorders. First, where clinical change has raised suspicion for a new or ongoing lesion, EDX reassessment for spatial spread of abnormality, involvement of previously normal muscle or nerve, and/or evolving pathophysiology can clarify a diagnosis. Second, where diagnosis of a progressive neuromuscular condition is uncertain, electrophysiological data from a second time point can confirm or refute suspicion. Third, to establish prognosis after a static nerve injury, a repeat study can assess the presence and extent of reinnervation. Finally, faced with a limited initial study (as when complicated by patient or environmental factors), a repeat EDX study can supplement missing or limited data to provide needed clarity. Repeat EDX studies carry certain limitations, however, such as with prognostication in the setting of remote or chronic lesions, sensory predominant fascicular injury, or mild axonal injury. Nevertheless, serial electrodiagnosis remains a valuable and underused tool in the diagnostic and prognostic evaluation of neuromuscular conditions.

中文翻译：

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系列电诊断测试：成人神经系统疾病的实用性和适应症

尽管现有指南涉及通过电诊断 (EDX) 测试来识别神经肌肉状况，但有关连续（或重复）EDX 测试的用途和限制的指南仍然有限。通过纵向评估神经生理学变化，连续电诊断可以澄清诊断并可能提供有价值的预后信息。本专着提出了成人周围神经疾病系列电诊断的四种广泛适应症。首先，当临床变化引起对新的或正在进行的病变的怀疑时，EDX 重新评估异常的空间扩散、先前正常的肌肉或神经的受累和/或不断变化的病理生理学可以澄清诊断。其次，当进行性神经肌肉疾病的诊断不确定时，第二个时间点的电生理学数据可以证实或反驳怀疑。第三，为了确定静态神经损伤后的预后，重复研究可以评估神经支配的存在和程度。最后，面对有限的初始研究（如因患者或环境因素而变得复杂时），重复 EDX 研究可以补充缺失或有限的数据，以提供所需的清晰度。然而，重复 EDX 研究存在一定的局限性，例如对远端或慢性病变、感觉主导束损伤或轻度轴突损伤的预测。尽管如此，连续电诊断在神经肌肉疾病的诊断和预后评估中仍然是一种有价值且未得到充分利用的工具。