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EMG Results and Epirdural Shot question
Good afternoon,
Got the following test results from EMG, I was 100% my issues were spine related as some of my MRIs showed pinched nerves on lumber and Thoracic spines.
My family and I are nervous as you can understand but not sure if any one can provide any feedback or have experience similar test results with good or bad outcomes, any information would help.
Thanks,
Summary
The right median, ulnar, peroneal, and tibial motor NCS demonstrated normal distal latencies, normal CMAP
amplitudes, and normal conduction velocities. F-wave latencies were normal.
The right median, radial, superficial peroneal and sural sensory NCS showed normal SNAP amplitudes and
conduction velocities. The right ulnar NCS demonstrated a low SNAP amplitude and normal conduction velocity.
Needle testing of the right arm and leg demonstrated rare fasciculations in scattered muscles of the legs (EHl,
vastus, tibalis anterior) as well as polyphasic MUAP configuration diffusely in the leg along with reduced
recruitment and interference patterns. The triceps muscle produced similar findings. The right pronator teres
demonstrated rare fibrillations and fasiculations. Fasiculations were present in the tongue.
Conclusions
Abnormal study. There is evidence of chronic denervation changes in the right leg in the presence of
diffuse fasciculations, clinical correlation is advised. Early lower motor predominant motor neuron
disease cannot be entirely excluded and repeat study is suggested in 3-6 months to evaluate for
progression.
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We share some similarities. I have per EMG lumbosacral polyradiculopathy. Along with autoimmune psoriatic arthritis in sacrum. It’s left me with chronic and severe nerve damage in both legs and feet. Causing me to spasm, pins and needles, cramp, tingling. A mess. I get the leg crawls/twitching too. I also have it in neck. I had a shot in back that helped the Paraspinal muscle spasm which I need to have repeated because its back. I take lyrica/pregabalin. I’m not sure how much its helping. I also have weakness in my legs that cause imbalance. I use a cane. Not a walker yet. I have had lots of physical therapy for it and for neurological reeducation. I was instructed to go on strict anti inflammatory diet that is not sustainable. I’m doing my best with it. I was told an epidural woud make the leg weakness worse. If I could get rid of foot pain I could do so much more and have quality of life. I’m sorry I’m in a similar boat. I have a nm doctor appointment in the early summer. I will insist on finding a dx to what is causing the Polyradiculopathy. My PT recommended a second optionion. She said a more complete therapy program could address my condition better. So, its off to a new doctor. This has been going on since 11/2021. Does this sound familiar?
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1 ReactionNemo 1, do you have a lumber MRI especially concerning is l 4-5, l5-S1 where there is ongoing denervation. Pain coming on with revenge could be an inflammatory response (very common) to the steroid. The numbing agent in the injection wears off within 6-12hr depending on the agent. You may get some relief from the steroid, yet. PT is (almost) always useful. But you probably have obstruction of the neural pathways (could also be causing the fasciculations). If you haven't had an MRI ask your primary to order one to save time. Be sure and tell the technicians exactly where your pain is. Are you seeing a pain specialist?
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5 ReactionsHi Gently,
I had two MRI’s of the lumbar area. The lower spine and the sacrum (Im pretty sure, going from memory). About one year apart from each other. The first mri did not indicate stenosis the second did. The original nm doctor originally was going to do a spinal tap. She postponed it wanting me to follow the anti-inflammatory diet. She dropped the ball. So I’m going elsewhere to complete my work-up where I’m going to flat out ask for a dx. To get appropriate therapies. Medicinal/PT/other. I have not seen the pain doctor in a while. I have to make time to go to my doctors. I need to get them all reports so they don’t do the wrong thing. My old NM doc said what they wanted do to numb the legs/feet would make legs weak. If I recall it was epidural or another procedure I need someone advising me who will advise me what will help. So, I’m kinda waiting until June (the earliest time she had) to find out next steps. I’ve been wondering if this could cause me to ultimately collapse due to severe leg weakness. I appreciate your thoughts and time! Feel better!
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2 Reactions@soccer1477 Are you planning on seeking opinions from other surgeons? It sounds like you don't have any clear answers right now for the cause of the polyradiculopathy.
Spinal epidural injections usually only provide temporary relief. When I had one as a diagnostic procedure, I had only 5 days of being pain free, and after that pain started coming back and building back to where it had been and by a month later, it was all back. Often they are used as a a diagnostic because they reduce inflammation a little bit and it may tell a surgeon what could be improved by a surgical procedure.
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3 ReactionsI remembered what the other treatment she (pain mgmt) wanted to do, ablation.
An epidural can make the legs weak. The weakness can resolve in days or weeks. I always want friends to avoid them because they can damage the spinal cord. I suspect the pain on the opposite side is also from the steroid, sometimes called a flare. It's a sort of immune reaction after which the anti inflammatory effects can be helpful
Radiofrequency ablation is usually done at the facets--more distant from the canal and not affecting the cord. It is very effect, if the pain is from the nerve exiting there. A spinal tap would be frightening. I wonder if NM thought there might be inflammation from infection.
There are lots of procedures that a good pain management specialist can offer.
But I think you are wise to be looking on this site. And I think you'll get more ideas here.
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4 ReactionsThank you for your help and sharing the knowledge!
Ps; my physical therapist asked if I heard of (If I’m recalling correctly) CIDP. It may stand for chronic inflammatory demyelinating polyradiculopathy. She thought it could be autoimmune. I need a good dr willing to dx. Thank you!
nemo1, you wisely keep insisting on a dx. Without the testing we investigate on our own and can't anything out. The doctor suggesting the spinal tap may have had a differential diagnosis of some type of demylineating process. If you are retrieving medical records, asking for the "doctor's notes" might reveal their thinking.
The MRI would show greatly thickened nerve roots with CIPD. A friend was diagnosed several years ago and has been helped by Hizentra. The link can locate the closest diagnostitian. There is also a video outlining the path to diagnosis. https://www.gbs-cidp.org/support/centers-of-excellence/?utm_source=google&utm_medium=cpc&gclid=Cj0KCQiAnrOtBhDIARIsAFsSe50ia-0YfTWHAZXpZbI3RifeGwrUHCC2k2CT9VeNPQhRKm_fUxIhgeEaAvG3EALw_wcB
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4 Reactions@nemo1 Yes it does, i have lots of pain growing from Hamstrinig to tibialis and peroneus, it even hurst with contact, surgeons have said no surgery but the pain just gets worst, started in one leg and now is on the other leg, same pain path and muscles, wish there was something clear they could do for us rather than all these test and PT and medicines that really do not help to heal us.
Thank you for replaying and hope it goes better for us
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