Can an EMG pick up a lesion that an MRI missed?

[blueskies609]

I was curious, I had a MRI of my c-spine, and T-spine...They both came back ok, I have mild disc bulges in 4 different areas along with flattening in two others.  I had a follow up EMG which indicated that my muscles were good, but there is slowed signals going to and from my spine.  Could the MRI have missed a lesion in my spinal cord?

I have a history of multiple white matter lesions in my brain, which was just assumed to be associated with my migraines. However we are still doing tests.  I have extreme fatigue.  My right leg goes completely "dead" and has caused me to fall multiple times.  The leg only stays that way for about 5 minutes.  I can move it and have feeling, but if I put weight on it I fall...

I am starting to get concerned that there is no dx yet and it has been 5+ years

[blueskies609]

I know it is difficult to diagnose online...I am at a loss of what to do.  I have an appointment in December, but it is really frustrating.  Is it something that I might consider getting a new Dr?

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

It is difficult for me to understand based on the description above what your EMG showed. In general an EMG can pick up a nerve problem not seen on MRI if the nerve problem is too small to be seen on MRI. However, EMG can sometimes cause false positives, meaning the EMG can show some non-specific abnormalities that do not imply a specific problem but perhaps an old injury or something insignificant.

The significance of your EMG findings in light of your normal spine MRI with the exception of the mild herniated discs really depends on your examination, your history, and the exact EMG findings. However, this is definitely worth pursuing further with your neurologist so that you can better understand the meaning of these findings, and continued follow-up with him/her is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.