Ulnar Compression

[bio43]

A cervical MRI with contrast impression:foraminal narrowing moderate-marked at left C5-C6, C7-T1; Mild cord impingement, C5-C6, C7-T1on left by disc osteophyte complexes. EMG/NCS study of left arm and hand. " Abnormal study with electrophuysiologic evidence of a left ulnar mononeuropathy at the elbow. No evidence of a radiculopathy or a myopathy." "Motor nerve conductin studies of left median nerve shows normal amplitude, normal distal latency and slightly slow conduction velocity with prolonged F-wave tminimal latency. The left ulnar nerve shows normal amplitude, normal distal latency and slow conduction velocity across the elbow segment with prolonged F-wave minimal latency.  Sensory nerve conduction studies of the left median nerve shows low amplitude, prolonged peak latency and slightly slow conduction velocity. The left ulnar nerve shows borderline amplitude, prolonged peak latency and slow conduction velocity.  Needle EMG examination L.Deltoid, L. Bicepts L. C6 C7 PSP, L C8,T1 paraspinals are normal. Left FDI and FCU show complex motor units with reduced recruitment and rapid firing." Motor NCS B. Elbow: Amp mV B. Elbow 9.4,  Area mVms 31.7, Dur ms 7.60, d-lat ms 5.40, Vel 64.8. Motor NCS A. Elbow: Lat ms 10.70 Amp mV 8.0 Dur ms 8.70 d-lat 3.70 Vel m/s 37.8. Motor Inching studies around elbow Vel ms: 50.0, 50.0, 14.3, 40.0, 11.1, 16.7. F Wave L. Ulnar M Lat ms 30.10 F Lat 45.10, L. Median M Lat ms 15.00, F Lat ms 38.85.

Questions: Has an Ulnar nerve entrapment been demonstrated. Has slight carpel tunnel been demonstrated by these studies. Or a Conduction block?

[CCF-Neuro-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.    

Your EMG findings are consistent with ulnar nerve entrapment at the elbow (the most common site).  There is no evidence presented here that suggests "slight carpal tunnel".  The EMG findings here demonstrate slowing of nerve signals in the ulnar nerve as it goes past the elbow (also called the "funny bone").  This is a common condition and may be related to trauma, chronic compression (leaning on your elbow/ hanging your elbow out of the car window) or compression of the nerve by the connective tissue that surrounds the elbow.  Your imaging also suggest that you have significant degenerative disease in your neck that could also lead to pain, weakness and atrophy in the future if it continues to progress.  However, you EMG at this point does not show a significant effect of your neck on your nerves.  I would recommend that you see an orthopedic surgeon to evaluate your elbow and your neck.

I hope this has been helpful.