SNAP, CRACKLE & POP: A NORMAL VARIANT OF INCREASED INSERTIONAL ACTIVITY: MAY BE MISLEADING FOR ELECTROMYOGRAPHER

Abstract

Objectives: To describe the findings of Snap Crackle and Pop in different patients referred for
electromyographic evaluation.
Methodology: From August 2007 to December 2010 total of 2098 patients were referred to
neurophysiology laboratory for evaluation in three different hospitals namely The Aga Khan University
Hospital, Karachi, Pakistan, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh,
Pakistan and Armed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia. Electromyography
(EMG) needle examination was done by single electromyographer in the above mentioned hospitals. EMG
findings were then confirmed by qualified consultant Clinical Neurophysiologist. Clinical information and
EMG data were collected in text form.
Results: Out of 2098 patients only 4 patients showed characteristic EMG findings of Snap Crackle and
Pop. All 4 patients were male and they are giving history of vigorous exercise. All four patient exhibit
abnormal insertional activity with diffuse positive sharp waves in different muscles. In one patient
occasional fibrillation potentials were noted.
Conclusion: Snap Cracle and Pop is rare disorder in male gender. Having characteristic EMG findings
and can be misinterpreted easily.