abnormal EMG/NCS, normal MRI/NFL

[Cheezzypoof]

Hi all, 37/M had a sudden feeling of slight weakness in my lower right leg a month ago that hasn't resolved. Tougher to lift toes/big toe/dorsiflexion. Cramping, Fatiguing very quickly.

Passed clinical exam, but then abnormal EMG with results attached confirming slight muscle weakness in lower leg.

This study is abnormal. There is electrophysiological evidence for a mild right L5 radiculopathy. There is no electrophysiological evidence for large-fiber neuropathy, motor neuron disease, or lumbosacral plexopathy in the right leg.

MRI findings...
FINDINGS:Alignment: The vertebral alignment is maintained. Vertebrae/Intervertebral Discs: The vertebral bodies demonstrate expected height. The marrow signal is within normal limits. A smallfocus of STIR hyperintensity is noted involving the the intervertebral discs also demonstrate normal signal and morphology. There is no significant central canal or neural foraminal stenosis. Tiny synovial cyst arising from the lateral aspect of bilateral facetjoints at L5-S1 and L2-L3 levels. There is no encroachment upon the central canal or neural foramina.

MRI seems clear?

I also did an NFL (Neurofilament light chain) test that had me in normal range.

Report says no evidence motor neuron. Internet suggests my results are problematic... NCS decreased amplitude Peroneal nerve, Increased Distal Latency, Slightly decreased Conduction Velocity. 3 different muscles on my leg were slightly weak on the EMG.

Being the leg symptom started 4 weeks ago is this just all way too soon? My NFL test would read high if I had an active neurodegenerative issue correct? Should I put this to bed and move on or is it worth pursuing a second opinion?

 

[Nikki J]

There appears to be a forum glitch. Was this a file? Try a screenshot and upload from your photo library

However if you search this subforum for radiculopathy you will find many with your emg and mri who did not have als

Mr google is a quack and the suggestion is wrong.

 

[Cheezzypoof]

Sorry, let's see if this works

 

[Nikki J]

Thanks for reposting. See my comment above

 

[lgelb]

Leaving the duplicate content to test if others can see the EMG now in the initial post, that I simply inserted the existing images as I did with Al's post the other day.

I would ask the neuro or your PCP about a PT evaluation order. Often your difficulty with movement in this context is a neuromuscular mismatch that can be improved with targeted exercises.

 

[Cheezzypoof]

I start PT for my issue next week. My follow up with the neurologist he said the MRI was clear. He gave me a strong steroid for 5 days and muscle relaxers. No difference (except tennis elbow pain went away temporarily)

The whole thing is odd, and we'll see where the next couple weeks take me.

About 6 months ago I started experiencing a bit of a tennis elbow feeling, and I've had perceived weakness in my left forearm/wrist/thumb for about the same time as my leg. Just a little bit harder to do things with left than right... weight lifting my arm is tiring when it should be my chest, or back etc... just odd. I've also had twitching that began the same time as the sudden weakness in my leg. Mainly that leg, some in my other leg, some in my "weak" arm/thumb muscle. Some other random pops.

I have a cervical MRI next week, and an EMG end of next week arm/leg being done by the Cleveland Clinic as a second opinion. One way or another I'll have two professional opinions to roll with.

 

[Cheezzypoof]

Normal NCS/EMG today. Fasciculation in calf but he wasn't concerned. Even though my leg doesn't feel much different must be healing up some.

 

[Nikki J]

Thanks for letting us know. Congratulations and best wishes for a long healthy life

 

[Cheezzypoof]

Thank you Nikki, sent a donation to the forum. Best wishes