Electrodiagnosis of neuromuscular disorders in Sierra Leoneans: service utilisation and problems of sustainability

ABSTRACT

The indications for nerve conduction studies and electromyography on 642 patients were referred to the neurology unit over a ten year period are reviewed. Mononeuropathies; peripheral neuropathies and proximal nerve lesions were the main clinical indications for the investigations and diagnosis was substantially aided in mononeuropathies; peripheral neuropathies; traumatic nerve damage; myopathies and myasthenia gravis. Conversely; patients referred with unilateral sensory disturbances; movement disorders and burning feet syndrome did not benefit. Skilled manpower and the high recurring cost of the tests were the most serious limiting factors threatening the sustainability of the service. Discretionary referrals and involvement of non-specialized medical officers in the performance of tests will improve service delivery; but fiscal contribution from the health sector to complement cost recovery is vital to sustain and expand this service