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What does this EMG test result indicate?

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Orthopaedic Surgeon, Joint Replacement
Practicing since : 1997
Answered : 1619 Questions
Question
I have an EMG done and want help understainding the results: My condition is trouble walking with numbness tingling in the feet.

Summary:
NCS: The right tibial F wave complex demonstrated a mildly prolonged latency. The remaining bilateral tibial and peroneal sensorimoror studies and F wave complexes were normal. The bilateral tibial H reflexes were within normal limits.

EMG: A disposable monopolor needle was used to explore selected muscles of the bilateral lower extremities. No other abnormal spontaneous activity consistent with acute or chronic denervation was discovered. Motor unit analysis revealed evidence of reinnervation in hte right tibialis posterior. Motor unit action potential analysis of the remaining muscles demonstrated a normal amplitude, configuration, duration and recruitment. Interference pattern was normal.

Conclusion:
1. There is electrodiagnostic evidence of chronic right L5 lumbar radiculopathy with reinnervation. No acute denvervation potentials were discovered.
2. There is no electrodiagnostic evidence of a peripheral neuropathy affecting the lower extremities.

Please note: in parallel to this was a Lumbar spine MRI which showed no disc herniation or bulges.

Curious what the interpretation of this can be?


Posted Sat, 30 Aug 2014 in Brain and Spine
 
 
Answered by Dr. Mukesh Chugh 1 hour later
Brief Answer:
EMG/NCV studies are normal

Detailed Answer:
Hello
Thanks for posting
I have gone through your query and understand your concern.The electrodiagnostic test (EMG/NCV) are grossly normal and whatever the finding (L5 radiculopathy on Right side) are on one side only that too showing recovery as shown by statement "No acute denvervation potentials were discovered".
Above all you have symptoms in both legs while EMG/NCV is suggestive of changes in right limb and that too not the whole limb only a single muscle. So in my view it has no significance.
Hence, one has to look for other cause for your suffering.

Hope your queries are answered and I shall be glad to answer any further query.
Take care


Above answer was peer-reviewed by
 
Follow-up: What does this EMG test result indicate? 2 minutes later
Would other causes be something like an MND? that is my concern?
 
 
Answered by Dr. Mukesh Chugh 29 minutes later
Brief Answer:
Your feature are not suggestive of the MND

Detailed Answer:
Hi
It's good to see you.
After going through your reply, it does not look to be MND as it can be easily picked by EMG/NCV study.
Please tell me-1. The duration of your symptoms and are they increasing day by day?
2. Do you smoke and take alcohol?
3.What is the blood level for vitamin B12?
Looking forward to your reply.
Take care
Above answer was peer-reviewed by
 
Follow-up: What does this EMG test result indicate? 3 hours later
This has been going on for about a year. I feel
Off balance all the time on the lateral parts of my feet. I had normal vitamin levels including b12. I drink occasionally
But not frequently
 
 
Answered by Dr. Mukesh Chugh 18 hours later
Brief Answer:
As follows

Detailed Answer:
Hello
I have few more questions to ask-
1. Are you able to walk on your heels and toes?
2. Tell me the area of numbness and tingling in feet?
3. How strong is the external rotation of foot?
It is definitely a case of neuropathy that is disease of nerve supplying the muscles and skin of leg. But the cause needs to be finding out.
Be positive and do not lose hope.
Take care
Above answer was peer-reviewed by
 
Follow-up: What does this EMG test result indicate? 4 hours later
1. Are you able to walk on your heels and toes?
Yes I have done this several times at dr appts
2. Tell me the area of numbness and tingling in feet?
It's the outter part of the lower legs and outter parts of feet and heels
3. How strong is the external rotation of foot?
What do you mean by that?

What are some causes of neuropathy?
 
 
Answered by Dr. Mukesh Chugh 19 hours later
Brief Answer:
As follows

Detailed Answer:
Hello
I have gone through your reply carefully. When your foot goes away from the other foot is called external rotation. This movement is done by muscle which is supplied by the nerves responsible to carry sensation from outer part of the lower leg, feet and heels.
There are many causes of neuropathy. Approximately 30% of neuropathies are “idiopathic,” or of an unknown cause. In another 30% of cases, the cause is diabetes. Other neuropathy causes include autoimmune disorders, tumors, heredity, nutritional imbalances, infections or toxins.
You may discuss all the above causes with your treating doctor preferably an experienced Neurologist, to reach some conclusion.
All the best and wishing you good health.
Please do not lose hope and BE POSITIVE.
Above answer was peer-reviewed by
 
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