Journal of Clinical Neuroscience xxx (2017) xxx–xxx

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Journal of Clinical Neuroscience

journal homepage: www.elsevier.com/locate/jocn

Review article

History of electromyography and nerve conduction studies: A tribute to

the founding fathers
Mohamed Kazamel ⇑, Paula Province Warren
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35294, USA

a r t i c l e i n f o a b s t r a c t

Article history: The early development of nerve conduction studies (NCS) and electromyography (EMG) was linked to the
Received 7 February 2017 discovery of electricity. This relationship had been concluded by observing the effect of applying electric-
Accepted 22 May 2017 ity to the body of an animal and discovering that nerves and muscles themselves could produce electric-
Available online xxxx
ity. We attempt to review the historical evolution of NCS and EMG over the last three centuries by
reviewing the landmark publications of Galvani, Adrian, Denny-Brown, Larrabee, and Lambert. In 1771,
Keywords: Galvani showed that electrical stimulation of animal muscle tissue produced contraction and, thereby,
Animal electricity
the concept of animal electricity was born. In 1929, Adrian devised a method to record a single motor unit
Edgar Adrian
History of electromyography
potential by connecting concentric needle electrodes to an amplifier and a loud speaker. In 1938, Denny-
History of neurophysiology Brown described the fasciculation potentials and separated them from fibrillations. Toward the end of
Luigi Galvani World War II, Larrabee began measuring the compound muscle action potential in healthy and injured
nerves of war victims. In 1957, Lambert and Eaton described the electrophysiologic features of a new
myasthenic syndrome associated with lung carcinoma. Overall, research on this topic was previously
undertaken by neurophysiologists and then later by neurologists, with Adrian most likely being the first
neurologist to be involved. The field greatly benefited from the invention of equipment that was capable
of amplifying small bioelectrical currents by the beginning of the 20th century. Significant scientific and
technical advances were later made during and after World War II which provided a large patient pop-
ulation with nerve injuries to study.
Ó 2017 Elsevier Ltd. All rights reserved.

1. Introduction eventual death of electrotherapy. On the other side, the field of

Nerve conduction studies (NCS) and electromyography (EMG)
are well-established electrophysiologic techniques that have been
instrumental in the diagnosis of neuromuscular disorders. Their
early development has been closely linked to the discovery of elec-
tricity. This relationship had been earlier elucidated from the his-
torical observations of the effect of applying electrical current to
the body of an animal and the discovery that nerves and muscles
could be sources of electricity. The former paved the way for the
practice of electrotherapy and the latter provided the basis of elec-
trodiagnosis [1]. Electrotherapy was a common practice in Europe
in treating cases of paralysis, whether functional or organic,
between the 17th and 19th centuries. However, the notion that
the muscle contraction could be obtained only at the moment of
direct stimulation with no lasting cure of the paralysis led to the
⇑ Corresponding author at: Division of Neuromuscular Diseases, University of
Alabama at Birmingham, 1720 7th Ave S, SC 271, Birmingham, AL 35294, USA. Fax:
+1 205 9756758.
E-mail address: mkazamel@uabmc.edu (M. Kazamel).
electrodiagnosis, including NCS and EMG, has continued to thrive
into a clinical neurologic subspecialty following years of extensive
research.
Prior to scientific experimentation on animals and humans,
electricity was the source of astonishment and amusement for
the public in Europe. The source of the charge used originated from
a friction machine or, occasionally, from lightening. However, a
constant and reliable source of electricity was needed to conduct
rigorous research in the field. Here we try to review the historical
evolution of NCS and EMG over the last three centuries, with a spe-
cial focus on the landmark publications of Galvani, Adrian, Denny-
Brown, Larrabee, Lambert, and their colleagues.
2. The 18th century
The interest in electricity increased after the Leyden jar (Fig. 1)
was invented independently by Dean von Kleist and Petrus van
Musschenbroek in Leiden, 1745–1746 [2,3]. A typical design con-
sisted of a glass jar with tin foil coating its inner and outer surfaces.
The foil coatings did not reach the mouth of the jar on either side in

http://dx.doi.org/10.1016/j.jocn.2017.05.018
0967-5868/Ó 2017 Elsevier Ltd. All rights reserved.

Please cite this article in press as: Kazamel M, Warren PP. History of electromyography and nerve conduction studies: A tribute to the founding fathers. J
Clin Neurosci (2017), http://dx.doi.org/10.1016/j.jocn.2017.05.018
2 M. Kazamel, P.P. Warren / Journal of Clinical Neuroscience xxx (2017) xxx–xxx
Fig. 1. The Leyden jar. Courtesy of the Wellcome Library digital collections.
order to prevent the charge from moving between the foils. A
metal rod electrode projected through the jar lid and was con-
nected to the inner foil by a hanging chain, thereby allowing it to
be charged. The source of the charge to the inner foil was a friction
machine while the outer foil was grounded. The inner and outer
surfaces of the jar stored equal but opposite charges and when they
were connected, an electrical current would flow. A few years after
this, Benjamin Franklin managed to charge the metal rod naturally
from lightening [1,4]. The Leyden jar gave physiologists a way to
store and to generate electricity in a more reliable manner. It has
been considered the precursor of current day capacitors or con-
densers [1].
Luigi Galvani (1737–1798) was a professor of anatomy at the
University of Bologna. One day he was dissecting a frog while some
of his colleagues were playing with a Leyden jar and, serendipi-
tously, a spark was thrown from a conductor at the same time Gal-
vani touched the frog’s nerve with his metal knife. He reported that
the body of the frog was shaken by a violent convulsion [3,1,5,4]. It
initially occurred to him that he had mechanically stimulated the
nerve with the knife. However, he noted that there was no recur-
rence of contraction when he touched the nerve again. Addition-
ally, when he used an ivory handled knife, no contraction
occurred [3]. He published his findings in the commentarius in
1791 [6]. He believed that the electricity was generated by the
body and conducted through the nervous tissue. He used the term
‘‘animal electricity” to refer to this phenomenon [6,3,4]. Galvani
felt that the oily sheath of the nerves made them good conductors
of electricity, and, like the Leyden jar, the muscles could receive the
animal electricity [3].
‘‘The electrical atmosphere was hit and vibrated by the spark
brought to the nerve. The spark instigated some extremely mobile
Please cite this article in press as: Kazamel M, Warren PP. History of electromyography and nerve conduction studies: A tribute to the founding fathers. J
Clin Neurosci (2017), http://dx.doi.org/10.1016/j.jocn.2017.05.018
principle existing in the nerve which excited the action of the neu-
romuscular force.” [6]
A serious scientific controversy developed in Italy between Gal-
vani and Alessandro Volta (1755–1832). Volta doubted the biolog-
ical nature of the phenomenon and put more emphasis on mere
physics. He argued that the current that was generated in Galvani’s
experiment was essentially flowing between two different metals
[7,3,1,5,4]. In Galvani’s case, the metals were the brass of the hooks
and the iron of the railings, and the frog’s body provided the elec-
trolytes [1].
Unfortunately for Galvani, Volta was right too. He showed that
muscle twitching was more reliably elicited if the metal arc con-
necting the muscle and nerve was comprised of two different met-
als [4]. At that time, Volta was working on his landmark discovery,
the Voltanic Pile. By placing alternative discs of zinc and silver
above each other with a piece of cloth that had been soaked in a
salty solution in between each pair, Volta was able to build a
steady source of electricity that later replaced the Leyden jar. He
travelled to Napoleon in Paris and to the British Royal Society in
London in order to demonstrate his new scientific achievement.
People started to wonder how such a brilliant scientist could be
wrong [4].
In 1794, Galvani and his nephew Aldini showed that a muscle
twitch can still happen, even with no metal involved, if the cut
end of the sciatic nerve was brought into contact with the leg mus-
cles (Fig. 2-A) [8,9]. Volta then argued that nerves and muscles, like
metals, are still dissimilar objects. Three years later, Galvani deliv-
ered the ultimate proof on his hypothesis by carefully positioning
the sciatic nerve of the first frog’s leg so its cut end touched the
sciatic nerve of the second leg. He found that contact between
the two nerves was sufficient to produce contraction of one muscle
(Fig. 2-B) [10]. Ultimately, Galvani’s work was overshadowed by
Volta’s after Napoleon invaded north Italy in 1796. Volta swore
allegiance to Napoleon; Galvani refused to do so and lost his posi-
tion in the university. Volta died as a well decorated international
figure while Galvani had a quiet burial that was attended by only a
few of his students [4].
3. The 19th century
In 1838, the concept of animal electricity was revived by Carlo
Matteucci who performed Galvani’s experiment in a different way.
He used a complete frog’s leg that was severed below the knee
with only the isolated nerve above it. He noted the ability of the
frog’s muscle contraction to stimulate the nerve at another
muscle-nerve set-up, when the former was laid across it [11].
Overall, Galvani’s discoveries were important in the sense that they
discredited the belief that the nervous system was activated by the
soul, a historical example of vitalism giving away to materialism
[1].
The center of research on this topic then moved from Italy to
Germany and northern Europe during the 19th century. Oersted
discovered that passing a current through a single coil of wire
led to an electromagnetic field that could deflect a needle, thereby
inventing the first galvanometer [12]. Emil Du Bois-Reymond
(1818–1896) improved Oersted’s machine by increasing the num-
ber of coils to 24,000, which were formed from five kilometers of
wire. Thus, he was able to increase the sensitivity of the
galvanometer to detect an electrical impulse propagated on the
surface of a voluntarily contracting muscle [13]. With Du
Bois-Reymond’s work, experimentation on human subjects started.
‘‘If I do not greatly deceive myself, I have succeeded in realizing in
full actuality the hundred years’ dream of physicists and
physiologists to wit, the identification of the nervous principle with
electricity.” [13]
 M. Kazamel, P.P. Warren / Journal of Clinical Neuroscience xxx (2017) xxx–xxx
Fig. 2. Galvani’s experiments to prove the concept of animal electricity with no metal involved. (a) The 1794 experiment: when the severed nerve end touches the muscle, the
leg contracts. (b) The 1797 experiment: when the severed right sciatic nerve end touches the intact left sciatic nerve, both legs contract [69,4].
Guillaume Benjamin Duchenne (1806–1875) entered medical
school in Paris in 1825. Upon graduation, he returned home to
Bologna to practice medicine. In 1833, he was able to demonstrate
that muscles can be stimulated percutaneously. In 1842, he
returned to Paris again to establish connections with Pierre Paul
Broca, Francois Aran, and Jean Martin Charcot [3]. He worked on
developing the stimulators and electrodes needed for his experi-
ments. He called this technique ‘‘Localized Electrization” [14]. He
was aware of the fact that different muscles would respond more
briskly if stimulated by electrical current at certain spots on their
surface. However, he did not publish the location of these spots.
Robert Remak visited Paris to watch Duchenne demonstrating
the ‘‘Localized Electricity”. However, he criticized Duchenne for
not explaining the technique to his visitors [3]. Later on, Remak
determined that these points represent the nerve entry zones, or
the muscle motor points [15]. In 1861, Wilhelm Erb used faradic
and galvanic currents for electrical stimulation. He also identified
the points at which the brachial plexus can be proximally stimu-
lated (Erb’s point) [16].
4. The 20th century
By the beginning of the 20th century, the stage had been set for
the development of clinical electromyography through the inven-
tion of more sensitive recording equipment. d’Arsonval had already
managed to covert the action current of muscles to sound by using
a telephone in 1878 [17]. The cathode ray tube was invented by
Braun in 1897 [18]. Then, Einthoven designed the string gal-
vanometer in 1903 [19] and Lapicque developed more accurate
equipment that had a circuit breaker in 1907 [20]. Piper made
use of these inventions in performing NCSs on the ulnar nerve
and recording muscle potentials during voluntary contraction. He
considered the frequency of these potentials recorded from the
surface of the muscle as the frequency of neural impulses they
receive. He explained his experiments in the first book on the topic
of electromyography in 1912 [21,3].
In 1909, Lapicque defined rheobase, as the minimal continuous
current intensity needed for muscle excitation, and chronaxae, as
the minimal current duration needed to excite the muscle tissue
using a double rheobase intensity, [22]. These concepts enabled
Edgar Adrian to report the muscle strength duration curves in
1916. His curves were consistent in healthy muscles with pre-
dictable shifts during muscle degeneration or recovery [23].
Edgar Douglas Adrian (1889–1977) was the youngest son of a
London local government lawyer. In the Cambridge Natural Science
Tripos, he picked five subjects rather than the usual three, gaining
Please cite this article in press as: Kazamel M, Warren PP. History of electromyography and nerve conduction studies: A tribute to the founding fathers. J
Clin Neurosci (2017), http://dx.doi.org/10.1016/j.jocn.2017.05.018
3
the highest mark in class in each. He went into medical studies at
St. Bartholomew’s hospital in London, somehow managing to finish
in one year rather than the regular three. Then, he completed his
clinical neurology training in Queen Square [4]. He collaborated
with Detlef Bronk, a US physiologist, in an experiment aimed at
measuring the action potential generated from a single nerve fiber;
they attempted to cut all the nerve fibers except one in the phrenic
nerve of a cat. Adrian and Bronk assumed that there would be 3–4
nerve fibers remaining and that if the nerve impulses were uniform
in shape and regular in frequency then they would still represent
only one nerve fiber. They also used a concentric needle electrode
and a loudspeaker to record the electrical activity of muscle fibers
that are supplied by a single nerve fiber, later to be known as
‘‘motor unit potential” [24]. Adrian later won the Nobel Prize in
1932 and Bronk became the 6th president of Johns Hopkins
University [3].
Joseph Erlanger (1874–1965) was the only college educated son
of a California farmer among seven siblings. He graduated from
Johns Hopkins School of Medicine and completed his internship
under William Osler’s supervision. In 1906, he was appointed as
chair of the physiology department at the University of Wisconsin,
where Herbert Gasser was his student. Six years later, Erlanger
moved to establish his new physiology department at Washington
University in St Louis and invited Gasser to join [4]. They managed
to use Braun’s Cathode Ray Oscilloscope to graph the action poten-
tial of a frog’s sciatic nerve [25]. They also discovered that nerve
fibers with different diameters have different conduction veloci-
ties. The three types of nerve fibers that they proposed were type
alpha fibers with nerve conduction velocity (NCV) 100 m/s, type
beta (NCV of 2–14 m/s), and type gamma C (2 m/s) (Fig. 3). They
suggested that the type alpha fibers were the afferent fibers for
muscle spindles [26]. For this landmark discovery, they were
awarded the Nobel Prize in medicine in 1944.
Derek E. Denny-Brown (1901–1981) obtained his medical
degree from Otago University, New Zealand in 1924. He completed
a 3-year fellowship at Oxford in the laboratory of Nobel Laureate
Sir Charles Sherrington. Then, he finished his neurologic training
at Queen Square where he was appointed as a staff member. In
1939, he accepted directorship of the Harvard Neurological Unit
at the Boston City Hospital. However, his move to the US was
delayed until 1941 due to World War II [27].
The spontaneous muscle twitching, seen in patients with amy-
otrophic lateral sclerosis (ALS), was commonly referred to as fibril-
lation until Denny-Brown’s report was published in 1938.
‘‘This phenomenon commonly called fibrillations, but more prop-
erly called fasciculations, may therefore represent the intermittent
involuntary discharge of single nerve impulses by an abnormal
4 M. Kazamel, P.P. Warren / Journal of Clinical Neuroscience xxx (2017) xxx–xxx
Fig. 3. Recording from different points along the frog’s sciatic nerve by Erlanger and
Gasser. The longer the distance between stimulation and recording points, as seen
in lower traces, the clearer the separation between the alpha and beta components
of the action potential. Erlanger and Gasser referred this to the slower conduction in
the beta fibers [26], with permission from The University of Pennsylvania Press.
motor neuron. These abnormal action currents are in fact compara-
ble in size and shape to the individual discharge of single moderate
sized motor units.” [28]
He later emphasized on the absence of fibrillation potentials in
patients with weak muscles due to conduction block and their
presence in case of axonal degeneration [29]. He also described
other EMG phenomena like myotonia [30] and myokymia [31].
Later in his career, he started to get interested in neuromuscular
pathology. He published the first textbook of pathology of skeletal
muscles and nerves. In this book, he tried to explain the pathologic
nature of certain EMG findings. Examples of this included the
reduced amplitude and duration of motor unit potentials (MUPs)
in patients with muscular dystrophy, which is explained by the
random muscle fiber necrosis within the motor unit. He also
referred to the long duration polyphasic MUPs in patients with
chronic neurogenic disorders, which is due to the presence of axo-
nal sprouting and grouping of reinnervated muscle fibers [32].
Fritz Buchthal (1907–2003) joined medical school at the
University of Freiburg in 1925. A year later, he fled to California
for fear of the rise of the German Nationalism movement. He
worked as a shoemaker and a janitor due to the lack of financial
Please cite this article in press as: Kazamel M, Warren PP. History of electromyography and nerve conduction studies: A tribute to the founding fathers. J
Clin Neurosci (2017), http://dx.doi.org/10.1016/j.jocn.2017.05.018
support from his family. In 1927, he passed the admission exams
to Stanford University where he studied anatomy, genetics, and
physiology. In 1928, he went back to Germany to finish his medical
degree from the University of Berlin [33]. He then moved to the
Kaiser Wilhelm institute where he developed a microelectrode to
record single muscle fiber potential in 1934 [34]. Shortly after
Hitler took over, Buchthal was no longer allowed to enter his lab.
He fled again to Denmark, and then to Sweden, after the Nazis
invaded Denmark in 1943. After the end of World War II, he went
back to Denmark to direct the new Neurophysiological Institute at
the University of Copenhagen [33]. His major achievement was
reporting the currently used normative data of amplitudes and
durations of MUPs in different individual muscles at different ages
[35–38]. He also described the different nerve conduction findings
in axonal and demyelinating neuropathies [39].
Martin Glover Larrabee (1910–2003) graduated from Harvard
University in 1932 and received his PhD in biophysics from the
University of Pennsylvania in 1937. Toward the end of World
War II, he worked with Robert Hodes at the army hospital in Fram-
ingham, MA and collaborated with William German, a neurologist
at the Philadelphia Naval Hospital [40]. Larrabee’s group aimed at
measuring what they called nerve-evoked electromyograms,
which was the combined potential of individual muscle fibers from
the surface of the muscle after supra-maximal stimulation of the
supplying nerve percutaneously; later known as the compound
muscle action potential (CMAP). They were able to quantify the dif-
ferences in CMAP waveforms by stimulating above and below the
site of peripheral nerve injury in war victims. They reported that
the normal conduction velocity of the fastest nerve fibers supply-
ing the intrinsic muscles of the hand and foot could range between
46 and 67 m/s. They also found that recovery rates following nerve
suture were more uniform than spontaneous recovery without
suturing and indicated that most of the recovery happens in the
first year after suturing [41].
Around the same time, George Dawson was working on record-
ing the sensory nerve action potentials (SNAPs) in Queen Square.
Dawson developed the signal averaging and photographic super-
imposition techniques that were necessary to record reproducible
SNAPs [42] and measure the sensory NCV [43]. Dawson later devel-
oped the technique for digital stimulation in orthodromic sensory
NCS in an effort to isolate them from the motor component found
in the antidromic techniques [44].
Roger W. Gilliatt (1922–1991) was born into a distinguished
British medical family. He was awarded the Military Cross for his
courage in the World War II northwest Europe battles. After the
war, he returned to Oxford to finish his studies in the School of
Natural Science. He completed his medical degree at Middlesex
Hospital, London (1949). In 1955, he entered a neurology residency
at Queen Square, where he ultimately became the neurology chair
from 1962 until 1987. He then moved to the US National institute
of Neurological Disorders and Stroke as a senior visiting scientist
and director of the EMG lab [45].
The work of Dawson was expanded and brought into clinical
application by Gilliatt. The latter managed to establish normative
values for the median and ulnar sensory studies and compared
these values to data from cases with ulnar and median neu-
ropathies [46]. Gilliatt is also known for his accurate description
of the clinical and electrophysiologic findings seen in the true neu-
rogenic thoracic outlet syndrome [47,48]. The preferential wasting
of the thenar, rather than the hypothenar, eminence in such cases
has been frequently referred to as ‘‘Gilliatt hand.”
Work on neuromuscular junction transmission disorders began
with Friedrich Jolly (1844–1904) of Germany, who described the
early fatigability of the orbicularis oculi muscle of myasthenia
gravis patients when exposed to repetitive faradic currents [49].
However, the description of the repetitive nerve stimulation
 M. Kazamel, P.P. Warren / Journal of Clinical Neuroscience xxx (2017) xxx–xxx
Fig. 4. James Golseth, in the center, with medical personnel from the US Army showing the first EMG machine. Courtesy of the US Army Medical Department, Office of
Medical History artwork and image collection.
(RNS) test, that was named after him, and the positive decrement-
ing response in myasthenia gravis were actually reported by Har-
vey and Masland in 1941 [50]. Bernard Katz, after fleeing to the
UK in order to escape Nazi persecution, described several physio-
logic aspects of the process of neuromuscular junction transmis-
sion. His work focused on the miniature end plate potential [51],
the role of the presynaptic voltage gated calcium channels
[52,53], and the quantal release of acetyl choline [54,55]. For this
work, he was awarded the Nobel Prize in 1970.
Edward H. Lambert (1915–2003) completed his MD degree at
the University of Illinois in 1938 before obtaining his PhD degree
from the same institution. He joined Mayo Clinic in 1943 where
he established the first clinical EMG laboratory in the US. He was
awarded the Presidential Certificate of Merit in 1947 for his role
in the development of the G-suit for aviators [56]. In 1957, Lambert
and Lee Eaton, who was the chair of the neurology department at
Mayo Clinic at the time, described a series of six cases that had a
disorder resembling myasthenia gravis and intra-thoracic malig-
nancy at the same time. They found that a series of electric stimuli
resulted in a transient decrease followed by a remarkable increase
in CMAPs, with comparable increases in the muscle power after
repetitive voluntary activity. They also reported that these patients
did not respond to neostigmine, as would be expected in myasthe-
nia gravis [57].
‘‘Should this syndrome prove to be of some clinical importance,
electromyography and stimulation of nerves must be given the
greatest credit. Without these techniques, the syndrome would
have been confused with myasthenia gravis and its significance
would have continued to elude us.” [57]
Please cite this article in press as: Kazamel M, Warren PP. History of electromyography and nerve conduction studies: A tribute to the founding fathers. J
Clin Neurosci (2017), http://dx.doi.org/10.1016/j.jocn.2017.05.018
5
He continued to work with his wife and colleague Vanda Len-
non on further characterization of the clinical, electrophysiologic,
and serological aspects of the now known Lambert Eaton Myas-
thenic Syndrome [58,59]. Ultimately, they helped to differentiate
pre- from post-synaptic neuromuscular junction transmission
disorders.
Inspired by a paper published by Buchthal [60], Erik Stålberg
began to study propagation velocities of electrical impulses to
muscle fibers. He was able to build an electrode that was much
smaller than Buchthal’s with appropriate amplifier and filters. He
finally managed to isolate a reproducible sharp single, sometimes
multi, spike signal after 18 h of recording trials on his adductor pol-
licis muscle. However, the signal was very different from what was
reported by Buchthal. He hypothesized that he was recording from
a single muscle fiber based on the fast decay of volume conduction
over 500 mm, the all or none behavior with curare and ischemia,
and the constant shape of consecutive discharges [61,62]. Later
on, he discovered that the variation in peak latencies between
the two spikes, when seen, was increased in a myasthenia gravis
patient, calling it ‘‘jitter” [63]. Normative mean jitter values were
reported in several muscles [64]. This led to the discovery of single
fiber EMG as the most sensitive diagnostic tool for detection of
neuromuscular junction transmission disorders.
James Golseth (1912–2003) conducted research at the North-
western University School of Medicine on the relative clinical val-
ues of different electro-diagnostic parameters like chronaxae,
rheobase, and galvanic tetanus ratio in different nerve injuries
[65]. His main work was under the War Manpower Commission
at Percy Jones Hospital where a large number of soldiers injured
6 M. Kazamel, P.P. Warren / Journal of Clinical Neuroscience xxx (2017) xxx–xxx
in World War II were being treated. With the help of James A. Fiz-
zel, he developed the constant current impulse stimulator [66,67].
Fizzel was an electrical engineer and the chief of the Illinois Testing
Laboratory. He contributed to the project for the benefit of patients
and for no compensation [3]. Both scientists communicated with
Herbert Jasper (1906–1999) at McGill University, who was per-
forming EMGs on Canadian war victims using monopolar needle
electrodes [68]. The two parties started exchanging visits to Chi-
cago and Montreal in 1943, where Golseth and Fizzel performed
NCS and Jasper did the EMGs. By 1948, the team of Jasper, Golseth
and Fizzel was able to design and build the prototype of the first
EMG machine made commercially available for clinical use
(Fig. 4) [3].
5. Conclusion
The earlier historical evolution of NCS and EMG was coupled to
the modern discovery of electricity in the mid-18th century. Signif-
icant progress had to wait until the early 20th century when equip-
ment capable of amplifying and recording the fine bioelectric
potentials were invented. Early on, progress in the field was pri-
marily made by physiologists. Later, however, neurologists began
to contribute not only by describing the electrophysiologic find-
ings, but also by attaching clinical and sometimes pathologic sig-
nificance to them. Of note, Edgar Adrian was most probably the
first formally trained neurologist to be involved. World War II sig-
nificantly helped the progress as it provided a large patient popu-
lation with nerve injuries for researchers like Larrabee, Golseth,
and Jasper to study. However, it slowed the careers of some others
like Katz, Buchthal, Denny-Brown, and Gilliatt. As any scientific
accomplishment, the development of NCS and EMG has been a
combination of human intellect, hard work, perseverance, as well
as chance and politics.
Source of support
This research did not receive any specific grant from funding
agencies in the public, commercial, or not-for-profit sectors.
Conflict of interest
The authors declare that they have no conflict of interest.
Acknowledgment
The authors would like to thank Dr. Shin J. Oh for his critical
revision of the manuscript.
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