Anyone know how to decipher NCS/EMG report?
 

I only have the last page of my latest NCS and EMG report (a summary of findings), but the physiatrist who did it wasn't much for explanations. I'm pretty well educated, but words like latency and amplitude are not part of my vocabulary. Skipping the bits where there are no abnormalities, here's what I want to know about:

Right & Left upper extremity EMG shows no acute or chronic muscle membrane instability, but chronic neuropathic motor unit abnormalities are seen in the median innervated abductor pollicis brevis.

Right and left upper extremity NCS show slowing of median sensory and motor conductions through carpal tunnel area.

Bilateral lower extremity EMG shows muscle membrane instability and chronic neuropathic motor unit abnormalities in distal leg and foot intrinsic muscles.

Bilateral H-reflexes are prolonged

Bilateral peroneal sensory NCS show delayed latencies

Right peroneal and tibial motor ncs exams show slowed distal conductions.



From what I understood, he found I have carpal tunnel and some kind of underlying peripheral neuropathy, but he wasn't clear why. Does this sound about right? Anyone care to take a stab at translation?

I'm otherwise healthy and in my 30s and have had problems with constant numbness and weakness and sore muscles for about a year now... mainly in my hands, but also a bit in my feet and calves. I've had pretty extensive labwork done and it's been almost entirely normal, so no help there. Thoughts?

You're pretty much on target--
 

--from my knowledge; you do seem to have some sort of systemic neuropathy (so I don't think it's just "typical" carpal tunnel).

Without getting into incredible amounts of jargon, the results you reported over all seem to imply mostly demyelination of nerves, with possibly some secondary axonal deterioration. For the "large fiber" nerves--all nerves to muscle, and those sensory nerves that monitor position, vibrational, and mechanical touch--a series of fatty coverings, the myelin, covers the nerve fiber, or axon, and helps to conduct impulses down it. Slowed conduction times imply a deterioration of the myelin "insulation".

The "small fiber" nerves, autonomic ones and those sensory nerves that subsume the sensations of pain and temperature, might also be affected but they cannot be tested by nerve conduction studies or EMG as they are just too thin to isolate.

There are numerous causes of demyelinating neuropathies:

http://neuromuscular.wustl.edu/nother/myelin.html

You say you've had an extensive lab work-up, but in my experience unless it's been at a tertiary center or a neuropathy center of excellence, where research is also done, it probably hasn't been extensive enough, particularly in regard to possible autoantibody testing.

Take a look at :


www.lizajane.org

http://www.questdiagnostics.com/test...ripheralNeurop

Any family history of symptoms such as you are experiencing? DNA blood testing might be in order. It is very expensive but might be worth it. Also, see a good neurologist who is privy to all kinds of diseases.

Thanks! My neurologist called to say he was going to refer me to a university neurology dept and ordered some additional labs that hadn't yet been done. There does seem to be thousands of reasons for these problems. My family are all pretty healthy, so it's a bit weird.