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-   -   EMG Results - help interpret? (https://www.neurotalk.org/peripheral-neuropathy/255261-emg-results-help-interpret.html)

gailveronica 03-12-2020 09:33 AM

EMG Results - help interpret?
 
My left sural nerve has been acting up, burning pain and numbness at the heel and through the toes - as well as now, my right foot (big toe) is being affected.

I had an EMG done back in January when it was just my left foot and here are the results:

All F Wave latencies were within normal limits

All H Reflex latencies were within normal limits

Needle evaluation of the Left abductor digiti quinti muscle showed slightly increased spontaneous activity and increased motor unit duration. All remaining muscles showed no evidence of electrical instability.

Impression: Inconclusive study

(EMG reviewed mild chronic and acute neurogenic changes in the left abductor digiti quinti muscle only. This could be consistent with tarsal tunnel syndrome affecting the lateral plantar nerve versus a mild S1 radiculopathy.)

Left AbdDigQuiniti LatPlantar S1-2:
Ins Act: Nml
Fibs: 1+
Psw: Nml
Amp: Nml
Dur: +Incr
Poly: 0
Int Pat: Nml
Recruitment: Nml

What does this mean? My Orthopedist said that it was a normal study... ?

gailveronica 03-12-2020 11:18 AM

To point out, I had an MRI of my lumbar/sac and it was fine, no notable impingement or anything... ?

echoes long ago 03-12-2020 01:48 PM

you might have small fiber neuropathy which doesnt show up on an emg

caroline2 03-12-2020 02:18 PM

I can't comment on all this testing, I've never done any. I had a period early this morning with my right foot and toes hurt and burned more than normal. Why this happens sometimes who knows, but FOR ME does not warrant trips to doctors. I keep my trusty Topricin handy and it does almost magic for this nerve pain issues.

agate 03-12-2020 04:53 PM

Hi gailveronica,

Like most people here I have no medical training, but I've had MS since the late 1970s (diagnosed 1980). The tingling and numbness you're having might be due to any number of problems and might be coaxed into going away if you just did something differently in your everyday life--resting an arm in a different position, doing less of some activity that you suspect might be tiring, experimenting with this change and that change to find out if anything works. On the other hand, maybe more testing will reveal something that can be corrected either by certain types of physical therapy or surgery, but surgery would be pretty drastic unless the symptoms are really limiting your life severely.

But in the past you've mentioned vertigo and heat intolerance. Those can be MS symptoms. You posted your brain MRI results in December:

Quote:

MRI brain: A few foci of subcortical, periventricular, and deep white matter T2 FLAIR hyperintensity which are stable and nonspecific but can be associated with demyelinating disease in the appropriate clinical setting.
There is a subtle T2 FLAIR hyperintensity in the left posterior frontal cortex, image 4 series #4 which is of uncertain significance.

3 years ago I presented to my GP with vertigo / heat intolerance / overall feeling of illness. I was sent to a neurologist who ordered an MRI and said it might be MS. My MRI from 3 years ago looks the same as my MRI now (with lesions), so new neurologist said it is *not* MS.
I'm not saying you have MS. But many people who turn out to have MS wait years before receiving a diagnosis. They go from doctor to doctor and have an assortment of tests. It's possible that you haven't yet found a doctor who is skilled enough to diagnose what is wrong--whether it's MS or something else.

The MRI report states that those "foci ... of deep white matter T2 FLAIR hyperintensity...can be associated with demyelinating disease in the appropriate clinical setting."

I take this to mean that you might have MS (or some other demyelinating disease but the rest of them are rarer) but that your symptoms and signs and general history need to be evaluated. Maybe the doctors you've seen haven't given enough attention to your vertigo and heat intolerance. Any problems with walking? Bladder or bowel function? Vision problems?

If so, mention them to a neurologist you have confidence in.

Sorry I can't be of any help with interpreting your EMG test--I've never had that test. The possible "tarsal tunnel syndrome" that is mentioned sounds like a problem to me. Maybe the orthopedist can suggest a way of dealing with tarsal tunnel syndrome if that is what is going on.

gailveronica 03-12-2020 05:03 PM

You’re totally right, agate. I had a great neuro who retired and now I feel like I’m not taken seriously. I know a NCV/EMG won’t show MS but it is showing SOMEthing, and my numb spots are only growing / multiplying. I don’t doubt I may have MS - I’m just so frustrated that no one listens. I see a new neuro in June and I made a list of all my symptoms (including heat intolerance, vertigo, swallowing difficulties). Thank you!


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