EMG report of my mother

My mother who has a history of neckache radiating to right hand, is now going thru numbness in right hand for more than 3 months. The folloiwng report from EMG has the folloiwng details:

Interpretation:
Right median motor nerve has low amplitude, normal distal latency, normal conduction velocity and normal F-wave latency. Left median motor has normal amplitude, normal distal latency, normal conduction velocity and normal F-wave latency. Bilateral ulnar motor nerveshave normal amplitudes, normal distal latencies and normal conduction velocities and normal F-wave latencies. Right median sensory nervehas normal amplitude, prolonged peal latencyand slow conduction velocity. Left median sensory nerve from F2 and palm has normal amplitude, prolonged peak latency and normal conduction velocity. right ulnary sensory nerve has normal amplitude, normal peak latency, and normal conduction velocity. LEft ulnary sensory nerve from F5 and palm has normal amplitude, normal peak latency and normal condcution velocity.

Needle examination show above changes.

Impression:
This is an abnormal study.

Conclusion:
This study is suggestive of mild C5radiculopathyand severe median neuropathy at wristconsistent with the diagnosis of carpal tunnel syndrome on right  side. Further clinical correlation is advised.


Base don above report, I would like to have an opinion as to what treatment plan the patient has and what should be done about this condition. I will be very thankful for a detailed answer and treatmemt options.

Best Regards
Farhan

[Farhanq]

The age of my mother is 62.

[Godofredo MD]

Hi.

Based on the MRI findings and correlating them with the clinical presentation, your mother seems to be suffering from cervical radiculopathy and carpal tunnel syndrome, which would explain the neck pain with radiation to the right hand.

Cervical radiculopathy can have many causes, including cervical disc herniation, spinal stenosis, as well as degenerative disc disease. Initial treatment for this condition is conservative and includes limitation of movement/activities, pain medications (NSAIDs) and physical therapy. It is only when conservative treatment fails that surgery is considered.  

Initial treatment for carpal tunnel syndrome is also conservative and aimed at relieving the inflammation and pressure on the affected nerve. Aside from pain medications and physical therapy with splints, cortisone injection can also be helpful in this condition.

Hope this helps.

[Farhanq]

I would also like to include the MRI report of my mother at this time which says:

There is a straightening with reversal of normal cervical curvature.

There is evidence of diffuse disc herination at C5/C6 level causing pressure on thecal sac and encroachment and narrowing of neural foramina bilaterlly.

There is evidence of diffuse disc herination at C3/C4 level causing pressure on thecal sac and encroachment and narrowing of neural foramina bilaterlly.

Based on this please suggest some treatment as to which one is to be terated first.

Best Regards
Farhan

[Godofredo MD]

Hi.

As I have posted above, the initial treatment would be conservative. If surgical treatment is necessary, both disc herniations would most likely be treated during the same operation.

You should have your mother consult her neurologist for the most appropriate treatment available for her condition.

Hope this helps.