[confused0711]

So last week I posted a thread (I can't post links yet, but it's thread163643.html) about a friend of mine who is dealing with a mysterious loss of feeling/motor function in her left hand. You guys recommended a bunch of useful stuff, particularly the idea of some kind of nerve compression in the cervical spine, which made a lot of sense to me and I told her to follow up on it.

This is the conversation she had with me tonight on AIM after seeing the neuro again for further EMGs.

Her: I do have mild neuropathy in my feet--nothing unusual for a baseline diabetic

Her: my sugar is under control so it shouldn't get worse

Her: totally unrelated to my left hand

Her: which is nothing cervical

Her: I have to go back in 6 mos to have the left hand tested again to see if it continues to worsen or call if it gets worse before then

Her: and ..that's it for now

Me: why did she say it wasn't cervical?

Her: because there is no blockage

Her: the entire nerve tests the same

Her: if there was something cervical one area would test much lower than the other

Her: it tests the same all the way up the arm

Me: hmm

Me: i guess that seems like it would be *more* of an indication that it was something in the spine, not less.

Her: no, nothing to do with the spine

Her: she'd actually ruled that out to her satisfaction but hadn't mentioned it

Am I crazy here thinking that this analysis doesn't make sense? Is what the neuro is saying correct? Does anyone have any suggestions on what I should tell her, or should we indeed just sit back and wait for the check in six months? I'm really confused here and I'm not sure I trust her doctor (but then, what do I know about it?)

Anyway, I'd be grateful for anything anybody can tell me or suggest.

[mrsD]

This sounds confusing to me. I don't think anyone here can interpret this.

Since she is diabetic, that offers a clue. It could be carpal tunnel. It doesn't look like "dead" to me.... since the doctor is monitoring for worsening.

Was she offered the carpal tunnel splints? to wear to keep the wrist from pinching the nerves? Was she offered a steroid shot in the wrist? Was carpal tunnel mentioned at all?

I would get some thyroid testing too. Low thyroid can deposit tissue in the carpal tunnel which causes the compressive issues.
The doctor should think of this as a matter of fact.

There is a condition called Thoracic Outlet syndrome...and we have a forum about it:
http://neurotalk.psychcentral.com/forum24.html

Carpal tunnel symptoms often appear with TOS.

[glenntaj]

--and has she had any imaging of the cervical spine and or brachial plexus/shoulder area? It is possible for compression there to produce symptoms lower down, and EMG/NCV tests may be unreliable, depending on how carefully and under what conditions they were done.

There might be a "double crush" situation here--nerves already compromised by impaired glucose tolerance, thyroid, etc. are further compromised by compression with the result that the symptoms are more than the sum of the component parts.

[confused0711]

mrsD, glenntaj, thank you both for responding.

From what I understand, the doctor wrote off carpal tunnel as well, and I don't think she's gotten any sort of testing/imaging done besides the EMG. Not really sure, though...I'll have to ask her.

I understand this is not really enough information for you guys to go on so thanks for giving me what you can; I guess at this point I'm just wondering whether I should encourage her to find someone for more tests or just sit back, stay out of it, and see what they say in six months. This is very out of my range of experience... :/

[daniella]

Is your friend concerned? I ask because of the responses she gave to your questions.
If it were me I would ask for an mri of brain and spine.
Is that arm not usable at all? Is there pain? Is she looking into therapy for it?

[confused0711]

Originally Posted by daniella

Is your friend concerned? I ask because of the responses she gave to your questions.
If it were me I would ask for an mri of brain and spine.
Is that arm not usable at all? Is there pain? Is she looking into therapy for it?

The arm is usable (just weak and she has trouble grasping things) and there's no pain. I saw her today and it seems like the majority of the trouble is in her ring and pinky fingers. She demonstrated that on her right hand she can stretch her fingers apart and resist a force pushing her pinky finger back towards the other fingers, but on her left hand that finger offers no resistance at all.

I've learned a bit more...evidently the neuro has just declared it idiopathic neuropathy, and has suggested that in the meantime until the next set of tests that my friend do stress ball exercises, etc., to try to keep working the muscles in that area (which I've heard is a good idea).

I'm going to suggest to her that she at least keep in mind the possibility of getting a second opinion and an MRI. (Evidently she had one about a year and a half ago but I'm guessing that wouldn't have necessarily showed anything manifesting now). I think partially she doesn't want to spend the money if she's not sure it will show anything, but at least the option will be on the table.

Thanks again, all, for your help.