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

Objectives: To describe the findings of Snap Crackle and Pop in different patients referred forelectromyographic evaluation.Methodology: From August 2007 to December 2010 total of 2098 patients were referred toneurophysiology laboratory for evaluation in three different hospitals namely The Aga Khan UniversityHospital, 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 andPop. All 4 patients were male and they are giving history of vigorous exercise. All four patient exhibitabnormal insertional activity with diffuse positive sharp waves in different muscles. In one patientoccasional fibrillation potentials were noted.Conclusion: Snap Cracle and Pop is rare disorder in male gender. Having characteristic EMG findingsand can be misinterpreted easily.