[divingdeep]

Hi folks, how did you come to understand details about the type of PN you have? I’ve looked at the diagnostic flowcharts and seen all manner of categories – small fiber, large fiber, non-length dependent, focal, multifocal, diffuse, symmetric, proximal, distal, demyelenating, axonal, etc. etc. etc. My current neurologist just says that I have generalized sensory (mainly) neuropathy and that a latent autoimmune disease is the likely cause.

My first neurologist – the one who did my electrodiagnostic tests several years ago – was tight-lipped and kept his cards close to his chest. He said only that I might have MS. We were talking about my MRI results when he said it (there were two tiny WMLs on my brain scan), but since he never told me that any of my other test results were abnormal, I assumed MS was his working theory for me. When I was switching neurologists, I formally requested copies of the tests he performed on me and learned for the first time that my EMG, NCV, and EP studies were abnormal.

Here are the first neurologist’s conclusions on those test reports:

UPPER EMG: “This study is abnormal”; “mostly consistent with a C6 and C7 radiculopathy.” In the details section, he talks about “significant fibrillation potentials and prolonged insertional activity,” as well as “spontaneous activity on left paraspinal musculature.”

UPPER NCV: “median and ulnar sensory nerves had somewhat reduced velocities”; “mild sensory polyneuropathy evident.”

LOWER EMG: “Bilateral L5 and left S1 chronic radiculitis.” “The study demonstrated bilateral EDB muscles to have enlarged and polyphasic motor unit potentials with reduced recruitment.” He also mentions “prolonged insertional activity at L5-S1 bilaterally.”

LOWER NCV: “Right posterior tarsal tunnel syndrome”; “prolongation of H-reflex on left side.”

Is it just me, or does it sound like my EMG results were worse than my NC results? What does that say about the kind of PN I have? Now here is the test result that scares me:

LOWER EVOKED POTENTIAL: “Prolongation of interpeak latencies is consistent with sensory fiber lesion at or above L1 and C5 spinal level. Prolongation of N45z latency suggests subcortical pathology.”

I know no one can diagnose me, but many of you sound like you have a detailed understanding of the type of PN you have. I am trying to find my way in to understanding my case better, but I don’t match up well with the most common type of PN, and I don’t have the right language to locate myself on the flowcharts, so to speak. I am wondering if anyone can gather any tidbits from the key words in the test reports above.

Thanks for listening.