EMG & NCV Findings:

[Tiger347]

EMG & NCV Findings:

Evaluation of the left Peroneal nerve showed prolonged distal onset latency (6.6 ms). The right peroneal motor nerve showed prolonged distal onset latency (5.8 ms). The left Saphenous Anti Sensory nerve showed reduced amplitude (2.5 uV). The right Saphenous Anti Sensory nerve showed peak latency (3.7 ms).  The left Sup Peroneal Anti Sensory nerve showed reduced amplitude (4.7 uV).  All remaining nerves were within normal limits.

All F wave latencies were within normal limits.  All H Reflex left vs. right side latency differences were within normal limits.

All examined muscles showed no evidence of electrical instability.

Impression: No evidence of lumber radiculopathy, peripheral neuropathy, or peripheral nerve entrapment.  There is a mild Peroneal neuropathy seen bilaterally, etiology unknown.  Patient will be going for a lumber MRI in January, which may be helpful.  His symptoms are consistent with lumber stenos is.

I had the MRI today and the orthopedic doctor told me there was nothing there causing my symptoms.  What does all this mean?

[Tommy757]

Yes it helps a lot, the only thing I'm not clear on is what the Chiropractor told me about the results of the test - that it ruled out ALS.  Is that true?

[JainMD]

Hi,
Multiple Sclerosis have definite pattern.
Multiple sclerosis is a chronic remitting disorder characterized by multiple white lesions in the CNS separated by time and location. The most frequent presenting symptom is unilateral weakness or ataxia. Headache is common, ill defined paresthesias are noted, Visual symptoms like diplopia, blurred vision are also present initially.
MRI is the neuro-imaging of choice, small plaques of 3- 4mm can be identified, particularly those located in brain stem and spinal cord.
MS can cause changes in sensation, muscle weakness, abnormal muscle spasms, or difficulty in moving; difficulties with coordination and balance; problems in speech or swallowing, visual problems, fatigue and acute or chronic pain syndromes, bladder and bowel difficulties, cognitive impairment, or depression.
The initial attacks are often transient, mild and self-limited. The most common initial symptoms reported are: changes in sensation in the arms, legs or face (33%), complete or partial vision loss (optic neuritis) (16%), weakness (13%), double vision (7%), unsteadiness when walking (5%), and balance problems (3%); but many rare initial symptoms have been reported such as aphasia or psychosis.
Your symptomatology as of now do not sound like you are having MS, but there are definitive guidelines, on which the diagnosis of Multiple Sclerosis is based. There are definitive lesions (suggestive of MS) on MRI also.
Once internationally accepted criteria’s are satisfied, then diagnosis of multiple Sclerosis can be made.
If you are concerned then you should consult a neurologist and decide regarding further course of action.
Needle EMG and nerve conduction studies are the tests of choice for confirming the diagnosis of ALS. The confirmation of ALS is facilitated by demonstrating diffuse denervation signs, decreased amplitude of compound muscle action potentials, and normal conduction velocities.
Hope this helps.
Bye.

[Tiger347]

My biggest fear is ALS or MS - The chiropractor & doctor that perform the test told me the findings would rule out both MS & ALS - do I have any reason to still be worried?

ThankYou!!!

[JainMD]

Hi,
The term dizziness is used by pts to describe a variety of head sensations or gait unsteadiness.
I think what you might have is vertigo.
Vertigo is an illusion of movement, most commonly a sensation of spinning. Usually due to a disturbance in the vestibular system; abnormalities in the visual or somatosensory systems may also contribute to vertigo. Frequently accompanied by nausea, postural unsteadiness, and gait ataxia, and may be provoked or worsened by head movement.
I think you need to consult an ENT specialist and neurologist to re-evaluate your case.
Keep me informed if you have any queries.
Bye.

[Tiger347]

Thanks for the response,

I'm 36 years old, male.  My symptoms are I've had a stiff neck, lower back burning and discomfort and some mild balance problems and fatigue and dizziness.  Also had a brain MRI which was clean could this be a systemic issue?

[JainMD]

Hi Tiger,
Your NCV and EMG findings suggest that the cause for your symptoms might be peroneal neuropathy.
This can be due to Vitamin B12 deficiency or Nerve entrapment at lower back or can sometimes be due to Diabetes.
A Lumbar MRI was ordered to look for any nerve entrapment at your lower back.
As it is been reported normal, which says there could be other cause for your symptoms.
How old are you and what are your symptoms?
Keep me informed if you have any queries.
Bye.