Here are the results of my emg/nerve study. Thoughts?
Technical limitations:
SUMMARY:
1. Right median nerve motor conduction study is normal, including F-wave minimal latency.
2. Right ulnar nerve motor conduction study is normal, including F-wave minimal latency.
3. Right peroneal nerve motor conduction study is normal, including F-wave minimal latency.
4. Right tibial nerve motor conduction study is normal, including F-wave minimal latency.
5. Right median, ulnar, radial, sural, and superficial peroneal nerve sensory studies are normal.
6. Right transcarpal comparison study is normal.
7. EMG examinations of the right tibialis anterior and medial gastrocnemius show increased insertional activity with a few fibrillation potentials; there are normal-appearing motor unit action potentials though at submaximal effort. The EMG examinations of the right vastus lateralis and vastus medialis show no abnormal spontaneous activity; there are normal-appearing motor unit action potentials though at submaximal effort. The EMG examination of the right peroneus longus shows no clear abnormal spontaneous activity; there are motor unit action potentials seen while "at rest" due to patient's inability to completely relax this muscle due to discomfort. There are normal-appearing motor unit action potentials at submaximal effort.
Please see EMG data sheet scanned into the electronic medical record for quantitative data.
IMPRESSION:
This electrodiagnostic study shows:
There are normal nerve conduction studies in the right upper extremity and right lower extremity. There is no evidence of a diffuse large fiber polyneuropathy or focal mononeuropathy in the nerves examined.
On EMG examination of the right lower extremity there is no evidence of an irritative myopathy.
There are subtle denervation changes seen in the right tibialis anterior and medial gastrocnemius muscles on EMG which are of unclear clinical significance, but could represent early or mild active radiculopathy at these levels. Clinical correlation is recommended.
Alison L Walsh, MD
Unless otherwise indicated temperatures of the limbs were studied and monitored during nerve conduction studies and were maintained at above 30°C in the lower extremities and 32°C in the upper extremities during the study as per guidelines.
Reference Values
Lehigh Valley EMG Laboratory Nerve Conduction Studies: Normal Adult Values
Bold: Based on AANEM Sept 2016 Practice Guideline
Italic: Based on Preston and Shapiro Electromyography and Neuromuscular Disorders
Motor
| Nerve | Amplitude (mV) | CV (m/s) | Distal Latency (ms) | F response (ms) | Distance (cm) |
| Median | ≥ 4.1 | ≥ 49 | ≤ 4.5 | ≤ 31 | 7 |
| Ulnar (ADM) | ≥ 7.9 | ≥ 52 | ≤ 3.7 | ≤ 32 | 7 |
| Ulnar (FDI) | ≥7.0 | ≥50 | ≤ 4.5 | | 15 |
| Radial (EIP) | ≥2.0 | ≥50 | ≤2.9 | | 4-6 |
| Peroneal (EDB) | ≥1.3 | ≥38 | ≤ 6.5 | ≤56 | 8 |
| Peroneal (TA) | ≥5.0 | ≥44 | ≤ 6.7 | ≤56 | 5-10 |
| Tibial (AH) | ≥4.4 | ≥39 | ≤6.1 | ≤56 | 8 |
| Tibial (ADQP) | ≥3.0 | ≥41 | ≤ 6.3 | ≤56 | 10 (w/calipers) |
Sensory
| Nerve | Age | Amplitude (uV) | CV (m/s) | Peak Distal Latency (ms) | Distance |
| Median | ≤49 | ≥17 | ≥50 | ≤4 | 13 |
| | > 50-79 | >10 | >50 | ≤4 | |
| Ulnar | ≤49 | ≥14 | ≥50 | ≤4 | 11 |
| | 50-79 | ≥10 | ≥50 | ≤4 | 11 |
| Radial | * | ≥7 | ≥50 | ≤2.8 | 10 |
| Lateral antebrachial cutaneous | * | ≥5 | ≥50 | ≤2.5 | 10 |
| Medial antebrachial cutaneous | * | ≥4 | ≥50 | ≤2.6 | 10 |
| Sural | ≤59 | ≥6 | ≥40 | <4.5 | 14 |
| | ≥60 | ≥3 | ≥40 | <4.5 | 12 |
| Superficial Peroneal | * | ≥6 | ≥40 | <4.4 | 12 |
| Saphenous | * | ≥4 | ≥40 | <4.4 | 12 |
| Medial Plantar | * | ≥2 | ≥35 | ≤3.7 | 14 |
| Lateral Plantar | * | ≥1 | ≥35 | ≤3.7 | 14 |
| | | | | | |
| Median-Ulnar Comparison | Significant Distal latency difference |
| Mixed (palm-wrist) | 0.4 |
| Motor (Median: wrist to second lumbrical and Ulnar: wrist to interossi) | 0.5 |
| Sensory (digit 4) | 0.5 |
