Old 05-19-2013, 02:06 AM #1 (permalink)
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Default Still hopeful it's something else, but what....

My husband (41) was referred by GP for suspected Carpel tunnel, then trapped ulnar nerve, then brachial plexopathy it now seems from the EMG results

MRI clear for spine and shoulder.

He went to see GP as he was struggling gripping lifting things and had noticed twitching getting worse in shoulder/ arm, and his muscle had visibly shrunk in that arm. I was sure I could see twitching in other arm but was hoping I was being a bit paranoid!

First neurologist he saw couple of days ago said he was 'concerned he was showing signs of MND'

Apparently he has, twitching in all four limbs visible when resting, brisk reflexes in initial arm, visible wastage/weakness in initial arm/ shoulder

Now waiting for another EMG for all limbs and brain MRI

My question is this, I keep reading that MND is hard to diagnose, and lots of other conditions mimic it, but what are these? I am desperately searching for other possible causes online and going round in circles.

My husband went to see GP again for help sleeping. she said 'it could still be lots of their things' but then refused the say what! When I asked the neurologist what else it could be he didn't really answer the question and said 'we can check the brain'

I have his initial EMG copied below, does this mean anything to anyone. Would anything suggest another condition?

I am sure many of you can understand when I say I just need to know either way so we can start to move on with it and deal with whatever he has. I am a very worried wife and mother of a 4 year old son and a 1 year old daughter.

Thank you so much for looking x

EMG findings copied below:


Clinically there is wasting over left upper limb

EMG/NSC findings
Sensory responses over left upper limb were normal and comparable to right asymptomatic side however his left dorsal ulnar sensory response is reduced compared to the right
Motor studies over left ulnar nerve showed mild and borderline slowing across the elbow
Median motor studies were normal
Concenctric needle EMG examination (see attached) ....which I don't have sorry!

Conclusion
The study provides electrophysiological support for very mild borderline left ulnar nerve entrapment at the elbow. However, these changes are minimal and cannot account for this patient symptoms. The electrophysiological finding of diffuse active denervation changes on concentric needle EMG examination strongly suggestive brachial plexopathy

I feel further investigation including neuro-imaging of the plexus as well as cervical, and upper thoracic spines should be considered as matter of urgency

? Neuro imaging was not revealing, repeat study in 2 to 3 months time would be useful. Please keep me posted
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Old 05-19-2013, 07:50 AM #2 (permalink)
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Default Re: Still hopeful it's something else, but what....

I can't comment on the emg but we have a very smart man by the name of "Wright" who can shed light on it. My neuro told me up front not to ask what he thought could be wrong with me until he had done all the tests he wanted done and looked at the results. He was the 3rd neuro I was sent to. All these neuro diseases mimic each other and it is a process of elimination. It takes time, It took me 5 years to get an answer, others it took months, some are still waiting.

It is very frustrating to wait and test after test. Some will have to be repeated. There is a very long list of diseases it could be, and my advice to you would be stop with the internet searches. All you will do is scare yourself and cause more stress. Try to just enjoy your family and let the drs do their job. I am wishing you peace and strength. You will get through this and we are here to listen any time you need.
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Old 05-19-2013, 07:51 AM #3 (permalink)
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Default Re: Still hopeful it's something else, but what....

Hi,you must understand we are not doctors so can only try to understand whats wrong with information given.

I understand the mri of his spine was ok and they are now doing a brain mri.......obviously the spine mri rules out anything there that could be causing your husbands problems.
sensory responses was normal in part except for ulnar nerve/elbow.....i say this is what they look for in neuropathy,it seems to indicate a trapped ulner nerve to me. I have a disabled left arm with deformity of elbow due to a childhood accident,i get problems with the ulnar nerve and have slight atrophy of left hand which is due to this.
emg shows active denerviation which means simply damage to the muscles/nerves is ongoing.

I know its hard but at this stage nothing is clear....if it was mnd its not a typical presentation.
The findings so far look like it is confined to the left arm which is hopeful......did they test his legs with emg?
Did they test his leg reflexes? sorry can't remember if you said.

Untill further tests are done and these may need to be repeated its a case of just waiting and watching progression.
Its hard i know but it does take time unfortunatly.
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Old 05-19-2013, 09:13 AM #4 (permalink)
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Default Re: Still hopeful it's something else, but what....

ok,had to go back and read your other thread to refresh memory.

You said the emg evidence did not support trapped ulnar nerve....if its not trapped then i'm not sure how the ulnar nerve is being effected.
You say he is having emg of other limbs,when that is done hopefully it will give more indication as to the problem being isolated or not.

We have a member here called brooksea,i think her husband began with it in his arms.
I dont think she comes on here much anymore,will check as she may be able to answer any questions you have.
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