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Normal NCV, but Abnormal EMG???
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Normal NCV, but Abnormal EMG???

This is quite a complicated question, so please read it carefully:

I had a Cervical Herniation which was decompressed surgically after 2 months.  It has been 1 month since the operation.

SYMPTOMS:  Persistent Arm Weakness.  Atrophy of - Deltoid, Bicep

I had a Nerve Conduction Study, and it came back normal.  HOWEVER, my EMG showed "Active Denervation" as there was increased insertional activity, and fibrillations, and reduced motor recruitment.

My Questions:

1. I have been told that a normal NCV means that most of the axons are intact.  Is it possible that my nerve injury is Neurapraxia?

2. I am confused that my EMG is abnormal, but my NCV is normal.  Could the abnormal EMG findings be produced because of mixed injury i.e. a combination of Neurapraxia and Axonotmesis?

3. Is it possible for a very small amount of damaged axons in the nerve to produce abnormal EMG?  i.e. is it possible that my Nerves are conducting normally because the damage is 90% Neurapraxia, and 10% Axonotmesis?

4.  In regards to muscle atrophy, is it possible for Neurapraxia to cause muscle atrophy?  in the EMG, my Deltoids and Biceps showed no fibrillations, yet there muscles are visibly smaller, and weaker.  

Thank you so much for your help.  Very much appreciated.

Warm Regards,

Tony
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