Help with EMG/NCS findings

I had an EMG/NCS done on my legs because of new numbness in my small toes of both feet. I have had long standing tingling in both feet for years.  When I sit on the floor I will lose feeling in one or both legs sometimes up to my rear end.

FINDINGS:

Evaluation of the Left Sural Anti Sensory nerve showed prolonged distal peak latency (4.2 ms). All remaing nerves were within normal limits.

All F Wave latencies were within normal limits.  All F Wave left vs. right side latency differences were within normal limits.

Question how can I find out what normal limits are for this kind of test?

Needle evaluation of the Right MedGastroc and the Right AbdHallucis showed increased insertional activity, increased motor unit duration, and increased polyphasic potentials.  

The Left MedGastroc showed increased insertional activity, slighty increased spontaneous activity (Fibs 1+), increased motor unit duration, and increased polyphasic potentials.

The Left AbdHallucis showed increased insertional activity, moderately increased spontaneous activity (Fibs 2+), increased motor unit duration, and increased polyphasic potentials.

The Right LumbPara Low shoed increased insertional activity and slightly increased spontaneous activity (Fibs 1+).

The Left LumbPara Low showed increased insertional activity and moderately increased spontaneous activity (Fibs 2+).

All remaining muscles showed no evidense of electrical instability.

IMPRESSIONS:

1. The above electrodiagnostic study reveals evidense of acute and chronic bilateral L5 -S1 radiculopathy.

2. The above electrodiagnostic study reveals an asymmetric sural SAP with mild prolongation of the left.  A mild axonal polyneuropathy may be present, correlate clinically.


When I talked with the doctor he seemed certain about the L5-S1 envolment of my back and ordered an MRI of Lumbar area.  I asked for the rest of the spine be added.  I have more pain in my cervical neck area and between the shoulder blades on my right side than in my lower back.  Although I had some severe lower back pain 10-12 years ago.  The polyneuropathy he says is complicated by the damage from the back so he didn't have much to say about it except to perhaps repeat test in 6 months.  I asked about diabetes causing the damage and he says that just being prediabetic would not cause that much damage to the nerves.  When I did some research regarding polyneuropathy I came across Shrojen's Sydrome as a possible link to PN's.  Should I get an appointment with a Rhumatologist?  

Also I hurt my right knee (hyper extention) two months ago would that injury cause the findings on the NCS/EMG?

[Quixotic1]

Here is something I wrote about EMG's.  I hope it helps.  I know very little about interpreting EMG/NCS reports'

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. I

f 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.


I hope this helps a little.

Quix