If some symptoms are due to psychiatric issues like depression, anxiety, emotional crisis, stress etc. psychotherapy is one of the major therapeutic tools. Medicines like antidepressants and anxiolitic drugs can be also used together with psychotherapy.
EMNG is consist of 2 tests: electro-myo-graphy (EMG) and electro-neuro-graphy (ENG).
EMG is performed using an electromyography unit consisting of electrodes and a computer-based recording unit. Electrodes are used to detect electrical activity generated by stimulating the muscles. Muscles are stimulated by signals from nerve cells called motor neurons. This stimulation causes electrical activity in the muscle, which in turn causes contraction. This electrical activity is detected by the EMG electrode and recorded by the electromyography unit computer. During an EMG test, the electrode is applied or inserted into the muscle to be tested. Surface, needle, and fine-wire electrodes may be used, depending on the type of stimulation required. Needle electrodes may cause some discomfort, similar to that of an injection. Recordings are made while the muscle is at rest, and then during the contraction. The person performing the test may move the limb being tested, and direct the patient to move it with various levels of force. The electrode may be
repositioned for further recording. Other muscles may be tested as well. A typical session lasts from 30–60 minutes.
Electro-neuro-graphy (ENG), also caled nerve conduction velocity (NCV-test), is often performed at the same time with the same equipment. In this test, stimulating and recording electrodes are used, and small electrical shocks are applied to measure the ability of the nerve to conduct electrical signals. This test may cause mild tingling and discomfort similar to a mild shock from static electricity. ENG test requires that the nerve being tested is relatively close to the skin surface, although needle electrodes can be used to test deep nerves. Two sets of electrodes are used to perform the test, stimulating and recording. Normally, the stimulating electrodes are metal or felt pads placed on the surface of the skin, about 0.6 to 1.1 inches (1.5 to 3 cm) apart. Correct placement requires a strong understanding of neurological anatomy and varies from nerve to nerve. Conduction cream can be applied to maximize the effectiveness of the connection. Usually, the cathode (typically the black-colored electrode) is placed down the nerve from the anode (typically the red-colored electrode) in the direction of conduction. Recording electrodes are placed according to the type of response that is being sought. If muscular reaction is the goal, the active recording electrode is placed over the belly (thickest area) of the muscle being tested, while the second recording electrode, called a reference electrode, is place on a tendon. If a nerve is being tested, the active electrode is placed directly over the nerve. The reference electrode is placed distally (pointing away from the electrode).
The test will run from about 20 minutes to about two hours, depending on the number of nerves being tested