Retired from Great Ormond Street Hospital in December 2019. Spent 30 years working in all aspects of clinical neurophysiology but specialising in paediatric EMG. Numbers of patients seen increased from around 30 a month to approximately 70. Particular interests were the diagnosis of myasthenia using a variation of stimulated single fibre EMG as well as interest in obstetric brachial plexus palsy and bulbar palsy. Author of Paediatric EMG published by Oxford University Press.

This is an important sub speciality of Electro myography. It has many similarities to the tests performed in adults but important and at times most significant differences. Most tests can be done on standard commercial EMG machines. The consumables particularly stimulating electrodes have to be tailored to the smaller size of the patients. It is important to have programmes for motor unit analysis as well as stimulated single fibre EMG. The patients themselves demand a different approach. Reduced tolerance of the technique determines that it must be done quickly and with a very focused strategy. These strategies are dependent also on the varying pathologies seen in children. Obtaining normative data was a problem but with the recent discovery of the E-norm methodology much more feasible, and data is available for all the tests done. Special techniques that will be discussed are the modification of stimulated single fibre EMG which is particularly useful in children. Also demonstrated will be investigation of obstetric brachial plexus palsy and the bulbar palsy. The lecture will conclude with an analysis of how the test may evolve in the future.