EMG

[Freespirit24]

Has any one had a Normal EMG test and still had nerve pain. I also have a partial left foot drop but thta is now of unknown cause as EMG is normal. There has to be a reason for my nerve pain. I get it in many different places all over my body and it is most definately nerve pain.

thanks
Sarah

[Freespirit24]

Wow thanks for so much info.

This is what was done

Motor Nerve study. Sensory nerve study. EMG study, All on lower leg and ankle.
all normal.  He also said He is unable to attribute the absence of voluntary recruitment in left lower leg to peripheral neurological dysfuction.  (I have partial left foot drop)

MY nerve pain is of different kinds but here is the list: Burning sensitive to to touch on left outer thigh, electric shock type pain down back into arms and around into stomach and abdomen. They feel like short stabbing type pains. Sometimes pain will run into arm and shoot from elbow down to hands. My toes and fingers tingle and loose sensitivity, my feet burn like i am walking on burning hot sand specially if they get hot. Have also felt like i was wearing something up to my calf, and it felt heavy. I have even had short stabbing pain in my head.  Sometimes just one toe or one finger will hurt with pain that almost makes me cry.

I have a nerve near my mouth that will feel like something is crawling.
Have also had a sensation like warm running water in my right thigh, this was so strong i thought i spilt something and looked down but nothing there. Have had this twice so far. All these symptoms started 12 months ago . But did have a bad time with Vertigo some years back and the vertigo along with other symptoms started last summer.

The tegretol is doing wonders it is like a miracle to me........no more nights sitting up crying not getting any relief and taking cocktails of pain meds just to see if anything would help. I still get some nerve pain but it is bearable.


Hope this helps clarify further.

Thanks Quix for that more in depth answer it helped a great deal.

[Quixotic1]

I need to clarify a couple things.  Sarah, did you have just an EMG or did you also have Nerve Conduction Studies?

The EMG tests the muscle itself.  ElectroMYO (myo=muscle)gram.  It is looking for muscle disease, but can also show if the nerve signal to the muscle is disturbed.  It does not test for peripheral neuropathy.

The NCS or NVS does test directly for peripheral neuropathy.  If the NCS is abnormal it means that they found a defect in a peripheral nerve, which is a nerve that is outside the spine.  I wrote this some time ago:

The EMG (Electro-Myo-Gram) is a test that measures the function and health of the muscle itself and, to some extent, the health of the nerve signal ARRIVING at the muscle. The EMG stimulates the muscle directly to see check a couple of things. The test is done by inserting a fine needle (which is wired to a recording device) into the belly of the muscle and recording the electrical activity of the muscle first at rest (as the needle is inserted) and then when the patient uses (contracts) the muscle smoothly. The electrical activity is recorded on paper or by a computer and also there is often a sound generated which may be recorded along with the measurement and which also gives auditory information.

1) A resting muscle is electrically quiet. There is a short burst of electrical activity from the irritation of the needle insertion. The needle is left to record the muscle at rest. The normal muscle should then become quiet. If there is spontaneous electrical activity when the muscle is at rest, this can indicate either muscle damage or disease or an abnormal nerve impulse arriving at the muscle.

2) The patient then begins to contract the muscle smoothly. The needle electrode measures what is called the "Action Potential" of the muscle. Initially just a few of the muslce fibers contract and their potential are measured. As the muscle contracts more and more fully, more muslce fibers join in and the EMG records more and more wave forms. The wave form of the electrical activity is examined for it's height (amplitude), it's shape, and it's duration.

3) Muscle disease is indicated by a short duration of the action potential and by abnormalities in calculated ratios between the various measurments.

In doing an EMG of a muscle, the needle is inserted deeply, analyzed, then pulled back a few miilimeters, analyzed again and such until the needlele is out of the muscle. It is then reinserted in other parts of the same muscle until enough data is collected.

4) EMGs can give indirect information on neurologic problems, that is problems with the nerve signal that is stimulating the muscle to contract. These findings might include a markedly prolonged action potential Also, there may be a greater amplitude in the action potential.

This procedure may be painful for some people and less so for others. The muscles tested may be sore for days after the test.

If both of the EMG and the NCS are negative and you have nerve pain, it indicates that the pain is coming from the Central Nervous System or within the brain and/or spinal cord.  The nerve pain would be central in origin.

The best tests for central nerve problems are the Evoked Potential Studies.

This was just a quickie.  I can't seem to keep from looking onto the forum to my family, and answering some.

Quix

[monotreme]

Mrsturbo is correct.  The EMG tests for peripheral neuropathy.  Normal EMG's in the presence of abnormal neurological findings may indicate a problem with the central nervous system.

I saw on your other post about your MRI findings.  MS is a clinical diagnosis.  Your neurologist needs to take into consideration your MRI, the EMG and other test results, and your clinical exam to come up with a diagnosis.

Where is your nerve pain?  Do you have any other symptoms.  I am sorry if I am forgetting something that you may have posted earlier.

Elaine

[shoshin]

I think you could still have small fiber peripheral neuropathy which can be very painful and wouldn't show up on an EMG. Or you could have pain from a problem with the central nervous system like MS. Are they planning more testing?

[mrsturbo]

My EMG also was normal, okay my neuro saw diminished something or other and said it was so little that she would wright it off.  From my understanding, Quix can correct me, but an EMG is testing for peripheral neuropathy.  The normal EMG would be ruling out peripheral neuropathy and heading more towards MS.  I could be wrong, but that is my understanding.  And MS does cause nerve pain.  Was your EMG painful? Mine was.  My neuro said she has had patients who don't even feel a thing.