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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Why does the cubital tunnel syndrome show inaccurate EMG results?

I have been frustrated with cubital tunnel syndrome for the past three years. I have had five surgeries, each time to put the nerve deeper and to remove scarring on the nerve. It keeps coming back. Surgery always removes the symptoms. Although my emgs always show mild involvement of the nerve, the condition shows up wth the typical clumsiness, weakness, and most obviously a wartenberg sign. This in itself defies logic--severe signs and mild emgs, doesn t make sense. But I am wondering about something. I had an ekg as a pre op procedure. It said I had LVH. But I don t. On an echocardiogram, the doctor said that the test was reading the signals from bottom up instead of top down. So, it was giving a false positive. I am wondering if this is happening with emgs. Somehow, could it be reading the signals in an opposite direction thereby missing the most damaged neurons? They are based on electrical signals, too. I have been very frustrated by all this. I need to know. But please don t respond based on what statistics say should happen. I have had this thing on both sides, and have had three recurrences--due to scarring of the nerve. Surgery is always successful, but why doesn t the emg seem to read accurately? could it because it is picking up signals differently. I have had many other tests to rule out everything else under the sun. It is cubital tunnel. It is the ulnar nerve. But please help me with this frustration.
Thu, 28 Mar 2019
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Neurologist, Surgical 's  Response

Since there is a poor correlation between EMG and clinical data, I think that second opinion and a second EMG elsewhere should be done.

This way two different EMG-s may be compared and this way you could be clearer.

Discuss with your treating Doctor for these issues.

Hope I have answered your query. Let me know if I can assist you further.

Dr. Erion Spaho, Neurologist, Surgical
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