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What does the EMG results indicate? Could it cause problems with fine motor skills in hands?

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Posted on Mon, 3 Sep 2012
Question: What does the following EMG results indicate? And could it cause problems with fine motor skills in hands?
1) findings of acute denervation on needle examination of the deltoid and biceps
2)the patient was having a fairly significant amount of paraspinal muscle spasm that precluded an adequate evaluation of the paraspinal musculature in either position.
3)electriciandiagnostic findings consistent with a right c5-c6 radioculopathy
a. mild to moderate
b. C5>C6
c. There are findings of acute denervation on needle examination of the biceps.
d. No evidence of any chronic innervation changes or significant axon loss.
doctor
Answered by Dr. Sudhir Kumar (6 hours later)
Hi,

Thank you for writing in.

EMG findings have been done on upper limbs (hand muscles). These findings are suggestive of C5-6 radiculopathy. C refers to cervical. This means the fifth and sixth cervical nerves are affected. These nerves begin in the cervical spinal cord (neck region) and supply various muscles of the hands such as biceps, forearm muscles, deltoid, etc.

The common problems faced by a person suffering from C5-6 radiculopathy could be:

1. Pain in arm and hands, which seem to start in the neck and radiate down,
2. Weakness of arm muscles,
3. Numbness in the arm.

Further evaluation of this condition requires:

1.MRI scan of the cervical spine (this could show a disc prolapse compressing the C5 and C6 nerves in the neck,
2. Opinion from a Neurologist/neurosurgeon.

Treatment options may include:

1.     Medications to relieve the pain (pregabalin, gabapentin, etc),
2. Physiotherapy (neck extension exercise, IFT, etc). In rare cases, where the nerve compression is severe, surgery may be required.

Please get back if you have any more queries.

Dr Sudhir Kumar MD (Medicine) DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Health City,Hyderabad

Above answer was peer-reviewed by : Dr. Shanthi.E
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Follow up: Dr. Sudhir Kumar (1 hour later)
Thank you for your response. I just got the stand up open results. Please give me your thoughts on prognosis and whether this could be the cause of fine motor skills loss in my hand. MRI results:
C4-5: There is a 5.0 mm disc herniation identified with right para entrap extension with contact of the right C4-5 nerve root. The right neural foramen is compromised secondary to the encroachment by the fragmented disc. Edema and hemorrhage are identified within the disc suggesting recent trauma. The spinal cord at this level appears compromised secondary to the large disc defect displacing the spinal cord from anterior to posterior. There is an abnormal cord signal identified suggesting contusion of the spinal cord at this level.

Impression: large central disc herniation at C4-5 with right para entrap extension producing contact of the right C4-5 nerve root. Additionally, there is edema and hemorrhage involving the C4-5 disc in conjunction with abnormal signal within the spinal cord suggesting spinal cord contusion.
doctor
Answered by Dr. Sudhir Kumar (39 minutes later)
Hi,

Thank you very much for sending in your MRI cervical spine results.

These results show that there is a large disc prolapse at C4-5 level with compression of the nerve and spinal cord at that level.

Loss of fine motor movements could be related to the findings on the MRI.

Regarding prognosis, most people gradually improve over time. Treatment requires use of cervical collar, physiotherapy and medications.

Use of collar prevents any sudden movement of neck, thereby ensuring that there is no further damage to the nerve or spinal cord.

Physiotherapy serves two purposes:
1. Reducing the pain in the neck and arms,
2. Increasing the muscle strength of hand muscles.

Medications are given to relieve nerve pain (if any) and for nerve regeneration (neurovitamins).
A small proportion of patients (10% cases) may require surgery. A neurosurgeon would be able to advice on that after examining you.

Dr Sudhir Kumar MD DM XXXXXXX Consultant Neurologist
Apollo Health City, Hyderabad.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sudhir Kumar (45 minutes later)
Thank you very much for your response. Regarding this matter, I have one more request. Because I am not familiar with neurovitamins but would love to know more about them, please provide more information about them (i.e., name, brands, effectiveness, availability).
doctor
Answered by Dr. Sudhir Kumar (34 minutes later)
Thank you for getting back.

Neurovitamins commonly used for nerve regeneration are:
1. Mecobalamin (vitamin B12)
2. Thiamine and benfothiamine (vitamin B1)
3. Pyridoxine (vitamin B6)
4. Alpha lipoic acid

In most places, these are sold as food supplements and do not require a doctor's prescription. Common brands in India are NUROKIND PLUS, NUROKIND NEXT, GLA-M, METNEUROBION, MATILDA FORTE, etc.

I am sure these combinations are available in your place too (brand names may be different and the local pharmacist/chemist should be able to guide you more).

Hope this suffices. If all your queries are answered, please close this discussion.

Best wishes,
Dr Sudhir Kumar MD DM XXXXXXX Consultant Neurologist
Apollo Health City, Hyderabad

Above answer was peer-reviewed by : Dr. Prasad
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What does the EMG results indicate? Could it cause problems with fine motor skills in hands?

Hi,

Thank you for writing in.

EMG findings have been done on upper limbs (hand muscles). These findings are suggestive of C5-6 radiculopathy. C refers to cervical. This means the fifth and sixth cervical nerves are affected. These nerves begin in the cervical spinal cord (neck region) and supply various muscles of the hands such as biceps, forearm muscles, deltoid, etc.

The common problems faced by a person suffering from C5-6 radiculopathy could be:

1. Pain in arm and hands, which seem to start in the neck and radiate down,
2. Weakness of arm muscles,
3. Numbness in the arm.

Further evaluation of this condition requires:

1.MRI scan of the cervical spine (this could show a disc prolapse compressing the C5 and C6 nerves in the neck,
2. Opinion from a Neurologist/neurosurgeon.

Treatment options may include:

1.     Medications to relieve the pain (pregabalin, gabapentin, etc),
2. Physiotherapy (neck extension exercise, IFT, etc). In rare cases, where the nerve compression is severe, surgery may be required.

Please get back if you have any more queries.

Dr Sudhir Kumar MD (Medicine) DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Health City,Hyderabad