The origins of neuromuscular electrodiagnosis. 1800-1950: a crucial period.

Abstract

The two components of today's electroneuromyography (i.e. neurography and myography) gradually emerged from the harmful practice of electrotherapy during the crucial period of 1800-1950. At the beginning of the 19th century, galvanism was supplemented by the fashionable induction coils created by Heinrich Daniel Ruhmkorff (1803-1877). In the same decades, major physiological research was performed by the Italian Carlo Matteuci (1811-1868), the Germans Emil Heinrich du Bois Reymond (1818-1896) and Eduard Pflüger (1829-1910) and the French Claude Bernard (1813-1878). This led to the description of the nerve action potential and to the measurement of the speed of nerve impulses in frogs by Hermann von Helmholtz (1821-1894). In the mid-19th century, Guillaume Duchenne de Boulogne (1806-1875) designed his own electrical equipment to perform faradisation, a focal electrification using induction current. Duchenne's methodology and conclusions led to a heated debate with Robert Remak (1815-1865) about the use of galvanic current, and with Hugo von Ziemssen (1829-1902) about the points which were to become the motor point. In the following years, the galvanic polar method was developed. Rudolf Brenner (1821-1884) formalised a literal notation of this method, expressing the muscle contraction formula by a system of letters. From the 1880s, a standardisation of electrodiagnostic exploration began. The German neurologist Wilhelm Erb (1840-1921) formalised a more complex situation called Entartungsreaktion (degenerative reaction). During WW1, a bipolar method was used and André Strohl (1887-1977) performed the electrical recording of tendon reflexes. Myography emerged in the first years of the 20th century thanks to the physiological work of Keith Lucas (1879-1916) and Charles Sherrington (1857-1952). The concentric needle, designed by Edgar Adrian (1889-1977) and Detlev Bronk (1807-1975), and the development of the cathode-ray oscilloscope were of great interest for electromyography. Such oscilloscopes also allowed Joseph Erlanger (1874-1965) and Herbert Gasser (1888-1963) to graph the action potential of a frog's sciatic nerve. During WW2, the American James G. Golseth (1912-2003) and James A. Fizzell (1912-1995) worked with the Canadian Herbert H. Jasper (1906-1999). They demonstrated the importance of interpreting myography and neurography together. In England, Herbert Seddon (1903-1977) and Graham Weddell (1908-1990) described the evolution of nerve injuries and muscle denervation on wounded soldiers. In the 1950s, the first widespread marketing of electromyographic devices allowed a new generation of neurologists to be invested in this novel topic.