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Electro diagnostic imaging and ncv was normal beside fasciculations. Does this rule out anti hu encephalomyelitis?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Dr. XXXXXXX

I had my electro diagnostic imaging ang ncv and XXXXXXX was normal beside fasciculations. Does this rule out anti hu encephalomyelitis. Additionally. I had a paraneoplastic auto antibody panel and am awaiting results. Is it possible could be cv2/crmp5 as I have retinal symptoms. Again I am 29 with 5 pack year history and worry of sclc causing neurologic syndrome.
Posted Wed, 9 Oct 2013 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 3 hours later
Brief Answer:
Normal reports are good news

Detailed Answer:
Hi,

Thank you for getting back.

I remember your case well.

Normal imaging, NCV and XXXXXXX are good news, and favor absence of encepahlomyelitis, and sensory neuropathy.

Regarding anti CV2/CRMP5, it is unlikely, as it is the combination of symptoms that favor or does not favor a paraneoplastic syndrome. In this case, cerebellar ataxia (imbalance of hands and feet, and walking disorder) are commonly seen, which you do not have.

In any case, we are awaiting antibody panel, which would further clarify the issue.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
 
Follow-up: Electro diagnostic imaging and ncv was normal beside fasciculations. Does this rule out anti hu encephalomyelitis? 1 hour later
If paraneoplastic panel is normal. And with my extensive blood work metabolic panel HIV test CBC cd4 to cd8 ratio etc. and normal ct 11 months ago normal cxr this month should I forget about any chance of paraneoplastic syndrome. Also emg and ncv normal with fasciculation. And normal neurologic exam 3 times over the last year.
 
 
Answered by Dr. Sudhir Kumar 6 hours later
Brief Answer:
I would think so

Detailed Answer:
Yes, I would think that you can stop worrying about paraneoplastic syndrome, if antibody panel also comes as normal. Moreover, as you mentioned, other investigations and neurological examination have also been normal.

As per definition, a malignancy can come within three years of onset of a paraneoplastic neurological syndrome. However, in practice, most appear within a year.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Electro diagnostic imaging and ncv was normal beside fasciculations. Does this rule out anti hu encephalomyelitis? 11 hours later
Thanks again for your extreme helpfulness. This question isn't soo much neurologic, but you seem very informative and makes this question worth asking you. I have had chest discomfort in the center of my chest along with limited coughing for the past three months. I have had repeat chest x XXXXXXX Would symptomatic lung cancer show up after 2 sets of xray 3 months apart. While symptoms are there?
 
 
Answered by Dr. Sudhir Kumar 4 hours later
Brief Answer:
Lung cancer is almost ruled out

Detailed Answer:
Thank you for getting back.

Having two normal X rays three months apart, in the presence of symptoms, would rule out the possibility of cancer lung by about 80-90%. However, if you want to exclude 100%, then a non contrast CT of the chest may be done.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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