Need EMG/NCG diagnostics for CIDP
AnonymousJanuary 11, 2009 at 9:27 pm
Just found my old EMG/NCV peripheral neuropthy report the neuro first did. Wondering what all the numbers mean: Right 6.8 msec and left 7.2 msec and tibial right 7.2 and left 7 msec, secondary axonal loss and peroneal and tibial F-waves were absent bilaterally as were compound muscle action potentials.
Please let me know where I may get info to interpret the results from FORUM/websites.
AnonymousJanuary 21, 2009 at 12:02 am
I didn’t seem to find the info I wanted to be able to understand my NCS results on the “www.TELEEMG”. Tried several times to Google for info and that didn’t help.
There had been a few older posts on what numbers meant I thought.
Maybe when I go back to the neuro in March he can explain it. I wanted to find/compare my results with others to see how I fared. Doesn’t sound good to read absence of reflexes, ect.
Thank you and if anyone knows sites I may find of use please post them
AnonymousJanuary 21, 2009 at 8:15 am
I wish I had more answers for you, too. And for myself. I never understand exactly what my results mean but i know they are bad.
I recently had my right hand done and this is what mine says:
rt median recording thenar at elbow-wrist= distal latency is 10.8 ,conduction velocity m/sec is 29 and it says normal m/sec is 48-70.
The hypothenar muscle was the same but distal latency msec was 7.3.
that was the motor part.
sensory part for the same place and also at my little finger, palm and index finger all shows NRR….meaning no response recorded.
My summary says that ‘the median and ulnar compound muscle action potentials are markedly prolonged in latency and slowed in conduction velocity. Sensory nerve action potentials could not be obtained from either nerve. Needle exam shows fibrillations in the first dorsal interosseus but not the abductor pollicis brevis muscle. Both muscles show severe neuropathic motor unit changes.’
The impression reads: ‘Abnormal study of the right upper extremity. The electrophysiologic evidence is most consistent with a longstanding length dependent neuropathic process with demyelinating features. There is evidence of axonal loss which may be secondary to a primarily demyelinating process. Clinical correlation is needed.’
I had this done bc of severe burning in my hand that was happening only at night. I thought maybe I had carpel tunnel. He ruled that out and said it’s active CIDP.
I have the emg results that were done on my legs…basically the same thing…alot of NRR’s.
I have looked up what these muscles are and such…but, I dont know exactly what it all realllllllly means other than …bad. I looked everywhere for answers, too, and unless you know what all these nerves and muscles are..it’s not easy to figure out. Maybe your doctor will explain ?
good luck with your answers. I wish I could help.
AnonymousJanuary 21, 2009 at 3:25 pm
Hi Limekat, the old posts are from either Jethro, Gene or DocDavid. I can’t remember who posted it or when, but I do remember it was posted at one time. I’ll try to do some hunting in my notes too, sometimes I print those things out just for times like this. Take care.
AnonymousJanuary 29, 2009 at 4:34 am
Isn’t it just a jumbley up mess sometimes. Not to worry too awful bad. You can work your way through these things. I just had another one done last August, I couldn’t find it, but I did find one from 2004. The numbers were only a little different for me this time.
The form for mine seemed to be very similar, First a section on clinical impressions done by the EMG Dr/tech. Then came the actual results on the first column it listed the nerve that was tested. In my case they did my feet first, so the peroneal nerve results were there, then ulnar, then mixed sensory/ulnar. The ulnar nerve was my hand/arm. The next column was where the actual electrodes were placed. If you remember, they had one electrode stationary, and moved the other one around, shocking you all the way. That is the second column.
like fib-ankle, or knee amp, or fib -ant. tib, or in the hand I had elbow to wrist and wrist to fingertips. Those measurements arein seconds and the next column was the actual result and the last column was “normal”.
The tricky thing about “normal” is that we are all a little different. I am 6 ft 4 inches. If you are “5ft 2 with eyes of blue” your results should be faster, the signal has a shorter distance to travel. It would be hard to compare mine to yours. BUT, in every one I have read, they always put an asterisk beside the result that is outside te norm for your height, and maybe weight, I am not sure there. BUt anyway, the more abnormal readings, and the divergence from noprmal would indicate your severity of dysfunction.
It also would have the Dr. who did the test’s impression at the bottom. They will express their opinion. From there they always write something like, “Further clinical study is needed” meaning that you have to go back to the Dr. so he can read ias well and tell you what it means.
If you have more than one of them, you can check to see if your condition has either improved or deteriorated from time to time.
The numbers you posted at the beginning are hard to decipher. You gave me one point, tibia, but not the other point, like anterior fibula or something.
I’ll check back later on to see how you want to proceed. I’ll help if I can
AnonymousFebruary 1, 2009 at 2:09 am
My exam showed absent reflexes in lower extremities and trace in the upper extremities.
QUERY: Peripheral neuropathy vs. myopathy
Motor NCSs of the peroneal and tibial nerves bilaterally revealed prolonged distal latencies, slowed conduction velocities and small CMAP amplitudes.Femoral motor NCSs bilaterally revealed absent compound muscle action potentials.Right median, ulnar, and radial motor NCSs revealed mild prolongation of distal latencies, slowed conduction velocities and borderline to small CMAP amplitudes.
Peroneal and tibial F-waves were absent bilaterally.Right median and ulnar F-waves were prolonged (median 35.8 msec and ulnar 34.8 msec) and impersistent (greater than 40% dropout rate).
H-reflexes were absent bilaterally.
Sural and lateral femoral cutaneous sensory NCSs bilaterally revealed absent sensory nerve action potentials. Antidromic sensory NCSs of the right median, ulnar and radial nerves revealed prolongation of distal latencies, slowed conduction velocities and small SNAP amplitudes.
So glad I accidentally went to this neurologist to see if he could treat my diagnosis of Fibromyalgia. I wanted his opinion on the two back surgeries I was told I desperately needed so I could be “cured” of back pain/lameness.He knew instantly I had a neuro problem. Just by accident I dragged myself into his office that rainy day.I sent two other folks from my Fibro support group to this same neuro. Both ladies had progressive MS.
Thanks for any help. Will be seeing neuro sometime in March.
AnonymousFebruary 4, 2009 at 8:54 am
Sorry I am so slow. We are switching to a cable modem and higher speed internet connection. Actually saving money with the bundle and getting better service. Whee !!
Anyway, back to your report.
1.) Absent or severely diminished reflexes are part of the game. Some of us are more or less affected, but almost all have some diminished level of reflex action.
2.) Absent muscle action potentials. They test your muscles ability to first work, and then recruit other muscles to help. When you flex a muscle, there are many fibers that actually contract for the action to occur. When they stick that needle in there and root around, they are looking for ANY single nerve to muscle connection. After they find one they have you flex that muscle and then measure the action potentials. The more mucles “join in” the action, the gbetter the muscle functions. If there is little recruitment, then they can talk about a “muscle” component in your neuropathy. The goos news is that frequently muscle damage is the first to be reversed when recovery occurs. Sensory losses sometimes don’t come back, or they take longer to repair. I don’t know why.
3.) They talked about bilateral dysfunction. CIDP is bilatetral, it happens pretty much the same on both legs for instance, or both arms. When the damage is on one side or the other, but not both, they look for another diagnosis.
4.) When they talk about prolonged F-waves, that is a measure of conductivity and speed.
5.)Median, ulnar and radial nerves are in the arm. Femoral, sural are in the leg.
It looks like there is both sensory loss and muscle damage. Like I said before, the muscle damage is often correctible with either IVIG or other treatments. The sensory stuff takes a little longer. I don’t know why, but it always seems that way. I don’t know your diagnosis or treatment, but aggressive treatment should help your energy and strength.
I hope all goes well
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