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What Do These EMG And MRI Reports Indicate?
Question: HI I have a question on my EMG results and diagnosis + questions about future followups. I attached the EMG and also here is the MRI results:
FIRST REPORT read: L5-S1 The disc is subtly desiccated with bulge and annular fissure. No central or foraminal stenosis seen, minimal spurring toward the foramina. No evidence of impingement upon the L5 nerve roots 1. Disc Bulges at the L4-L5 and L5-S1 with annular fissure but no significant neural compressive effect. 2. No evidence of XXXXXXX disc herniation seen 3. No abnormal enhancing lesion identified. No evidence of abnormal nerve root enhancement
SECOND REPORT: Disc space narrowing at L5-S1 Loss of the normal lumbar lordosis L5-S1 - Shallow 1-2 mm posterior central protrusion. On post contrast images there is a small focus of enhancement involving annual tear at L4-L5 and the protrusion at L5-S1
FIRST REPORT read: L5-S1 The disc is subtly desiccated with bulge and annular fissure. No central or foraminal stenosis seen, minimal spurring toward the foramina. No evidence of impingement upon the L5 nerve roots 1. Disc Bulges at the L4-L5 and L5-S1 with annular fissure but no significant neural compressive effect. 2. No evidence of XXXXXXX disc herniation seen 3. No abnormal enhancing lesion identified. No evidence of abnormal nerve root enhancement
SECOND REPORT: Disc space narrowing at L5-S1 Loss of the normal lumbar lordosis L5-S1 - Shallow 1-2 mm posterior central protrusion. On post contrast images there is a small focus of enhancement involving annual tear at L4-L5 and the protrusion at L5-S1
Brief Answer:
There is mild compression of left S1 (sacral) nerve in the back.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.
I have noted your clinical details and also seen MRI/EMG reports. Based on this, there is mild compression of left S1 (sacral) nerve in the lower back. The compression is due to bulging of discs in the lower back.
As of now, you require physiotherapy for the back.
If there is nerve pain in the back/leg, you can take pregabalin capsules.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
There is mild compression of left S1 (sacral) nerve in the back.
Detailed Answer:
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist, and I would try my best to help you.
I have noted your clinical details and also seen MRI/EMG reports. Based on this, there is mild compression of left S1 (sacral) nerve in the lower back. The compression is due to bulging of discs in the lower back.
As of now, you require physiotherapy for the back.
If there is nerve pain in the back/leg, you can take pregabalin capsules.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi...I was told by Dr. 99.5% chance that it is NOT even a very early sign of ALS on EMG. I have a 1 inch pelvic tilt on left side and hip weakness there they claim this is likely causing the mild radiculopathy. Also, my CK levels were normal at 113. What can I do to rule out this being an early sign of ALS? Another EMG in a few months or is this so clearly not even an early sign of ALS (I have zero clinical signs except twitching) that I shouldn't worry? I have twitching mostly in both calves and foot arches but also in areas examined by EMG namely to the left and right of knee cap, quad, hamstring, and glutes on both sides though calves more frequent. Also very occasional twitches in both shoulders, back, and crainal. Twitching in both calves going on at least 1 month other body areas I have had in past over the years.
If I go to PT and am able to strenghten/grow calf muscle on left side would that rule out ALS process in lieu of doing another emg?
If I go to PT and am able to strenghten/grow calf muscle on left side would that rule out ALS process in lieu of doing another emg?
Brief Answer:
Another EMG is not needed now.
Detailed Answer:
Thank you for getting back with more information.
I agree that your symptoms and EMG have excluded ALS. You do not require another EMG or any other test at this point in time. As of now, you should focus on physiotherapy. I agree that if muscle strength increases/size grows, then, it would be against a diagnosis of ALS.
Best wishes,
Dr Sudhir Kumar MD DM
Another EMG is not needed now.
Detailed Answer:
Thank you for getting back with more information.
I agree that your symptoms and EMG have excluded ALS. You do not require another EMG or any other test at this point in time. As of now, you should focus on physiotherapy. I agree that if muscle strength increases/size grows, then, it would be against a diagnosis of ALS.
Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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