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We have several significant concerns regarding the article titled "Prognostic Value of Laryngeal Electromyography [LEMG] in Vocal Fold Paralysis," which was published in the February 2001 issue of the ARCHIVES.¹ There are several methodological flaws that limit the potential positive aspect of this article.

The use of Seddon's² classification system is not appropriate for LEMG. To the modern electromyographer, Seddon's classification system is useful only for the interpretation of nerve conduction study findings. Neurapraxia is a condition in which stimulation of a motor nerve distal to a lesion produces a normal compound muscle action potential, whereas stimulation above a lesion produces little or no response. Axonotmesis is determined when low-amplitude compound muscle action potentials are recorded with nerve stimulation above and below a suspected lesion. Laryngeal electromyography cannot by itself differentiate these 2 processes with total clarity because there are no clinically useful motor nerve conduction studies available. In both . . . [Full Text of this Article]

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