Help with EMG Results
 

Hi, hoping someone here can give me some clarification - endless googling hasn't helped me much. I had colorectal cancer last year with chemo/radiation/surgeries. Two months after the major surgery I experienced neuropathy in right calf and foot & foot drop (other than occasional intense right leg cramping I have no pain, in back or leg/foot). Ortho spine doc ordered MRI which showed herniated disks, stenosis, etc. (I have a history of sciatica). He wanted to do "decompression" surgery but me being on chemo and having an ileostomy scared him. Dumped him, now seeing a neurosurgeon who ordered an EMG. He didn't go in depth with results, wants to consult with colleagues but he thinks I have radiation induced nerve damage and says surgery won't help. Anyway, here are the results:

The H-reflexes are are unobtainable bilaterally. This could reflect bilataeral S1 nerve root dysfunction. Occasionally this is technical in origin.
Otherwise, this is a normal nerve conduction study of both lower extremities. There is no entrapment or peripheral polyneuropathy.
This is an abnormal needle EMG.
Increased insertional and spontaneous activity is seen in right lower lumbosacral paraspinal muscles, at the L5-S1 level, consistent with an active radiculopathy.
There is no evidence for myopathy.

Now he wants me to do two nerve blocks - which has me confused because I'm not in pain. I get the leg cramps, but not daily - diagnostically, what could the injections show? My surgeon says no to the blocks and wants to refer me to PT. I'm now using a cane to get around since my leg goes out without warning. Anyone have advice/suggestions/help?

Thanks in advance.

There are other people around who probably know more about this than I do but they may not show up today as its Sunday. I'm always more confortable in starting conservatively which in your case would be PT, I've had it a couple of times, the last for cervical radiculopathy, and the PTs really know what they are doing. Maybe they can help but even if they cant its possible they could add information that would help define appropriate next step treatment.

I'd be a little confused about the nerve block as well, I don't know if it would make things worse or if it would 'release' the foot drop and help. Maybe someone else will post who has an idea. Did you google 'nerve block foot drop"?

I hope you find some answers.

judi

Welcome to NeuroTalk:

There are papers on PubMed about using acetyl carnitine for patients on chemo. The chemo drugs may damage the nerves, and acetyl carnitine which is OTC helps block this damage.

Before having any invasive procedure done, I'd try this, starting at 500mg a day and increasing to 2000 mg daily if needed. Try this for a month and see if it helps.
http://www.ncbi.nlm.nih.gov/pubmed/22271810

Also magnesium may help you too. Cramping and nerve issues may improve some if you are low. Some chemos deplete magnesium as a side effect.

Aim for 1/2 the RDA to start, and use a good chelate type (not OXIDE type--which is not appreciably absorbed).
Also you can try epsom salt baths, as the magnesium will be somewhat absorbed that way too, thru the skin.