Proper way to do a EMG/NCS test
 

Among numerous other neurologic injuries - which I'll write about elsewhere sometime - I have some damage to my spine. It appeared without trauma one night in 2007 and has been consistent since then, not getting worse nor better. MRI and CAT shows nothing.

If I keep my neck strainght and my shoulders back, I'm fine. If I let either shoulder slump forward, I get parasthesia in the corresponding ring finger and little finger. If I bend my neck forward, I get parasthesia in those two fingers on both sides.
I experience it on one or both sides almost every night because I tend to curl up a bit when I sleep. Based upon comments from my wife, once I get curled up, it takes about 10 minutes to become painful enough to wake me up. It happens once or twice every night. This has been going on nightly since 2007.

I had a EMG/NCS test the other day. I assumed that I should be in a position to provoke the parasthesia. The tech told me that I should just lie down flat on my back on the table. I replied that then the symptoms would not be present to be measured. She assured me that 6 years of nightly parasthesia - over 2000 events - would leave plenty of evidence of the location of the injury, even if it was not an active symptom during the test.

Was she right? If the report comes back saying that no damage was found, should I tell my doc that the testing was faulty?

Thanks

I would tend to think--
 

--they they would have been able to document the damage, providing they were testing the correct affected nerve pathways, and provided there was enough damage to leave an observable deficit (which is not always the case--damage can be patchy and incomplete, and not show up definitively).

Nerve conduction studies and EMG's are notoriously difficult to standardize--the placement of the electrodes has a lot to do with documenting the nerve damage--not everyone's pathways are in the same places--and the skill of the doctor or technician is very important. If the compression only happens in certain positions, I do think they may have wanted to try in that position. And other things can enter into this--the test is supposed to take place in a relatively cool room--heat is the enemy of nerve conduction--and several different series of readings are supposed to be taken and averaged.

FWIW, I just got email from my neurologist: "...Your EMG did show an underlying neuropathy in your hands and feet..." No mention of the spine. :confused:

What kind of work or hobbies/activities do you do?
The parts I quoted from your post sound quite a bit like Thoracic outlet syndrome (TOS). Especially if you had no injury or trauma to speak of.
Was the MRI/CT scan of your cervical spine?
TOS rarely shows on EMG/NCV , but it could be showing as a double or triple "crush" which might be TOS plus carpal tunnel and/or cubital tunnel.
Besides the hand sx and I saw a mention of headaches (a possibly related TOS thing also) due to trigger points and neck muscles spasms.
Is your neck tight and upper back have sore spots?
If any of those sound familiar we have a thoracic outlet syndrome forum here where you can read more about it.
http://neurotalk.psychcentral.com/forum24.html


If you have many various symptoms I suggest posting a new thread on our New Members forum and listing everything in one place - someone may see a pattern or have a clear idea for you to look into.
http://neurotalk.psychcentral.com/forum88.html