EMG/Nerve Conduction test results

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shane42

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Finally got the test today and here are my results.

NCT:
Peroneal.R
ankle 5.1 MS (latency) 7.5 mV amplitude
Fibula Head 11.2 MS (latency) 7.3 mV amplitude
Ankle-Fibula Head 6.1 ms (lat. Diff.), 47m/s Conduction volicity
Popliteal Fossa 14.9 MS (Latency) 2.0 mV amplitude 2.0
Fibula Head-Politeal Fossa 3.7ms, 30M/s conduction volcity

Tibial.R
Ankle 4.4 ms (latency) 11.6 mV amplitude
Popliteal Fossa 12.2 ms (latency) 13.0 mV
Ankle- Popliteal Fossa 7.8ms 47m/s conduction velocity

Peroneal.Left
Ankle 5.7 MS (latency) 5.4 Mv
Fibula (head) 12.0 (latency) 5.2 Mv
Popliteal Fossa 15.0 ms (latency) 1.5 Mv
Ankle-Fibula (head) 6.3 MS (lat. Diff.) 46 m/s conduction velocity
Fibula (head)- Popliteal Fossa 3.0 Ms (lat. Diff.), 27 m/s conduction velocity

Sensory Nerve Conduction
Sural.R
Lower Leg 3.9 ms (peak Lat) 10uV amplitude
Ankle-Fibula (head) 6.3 ms (lat. Diff.) 4uV amplitude
Ankle-Lower Leg 3.9 ms (lat. Diff), 45 m/s conduction velocity
ANkle Lower leg 3.9 ms (lat. diff), 42 m/s conduction velocity

Needle EMG results Insertional Spontaneous Acitivy
Tibralis anteror L Normal 2+ Fib, 1+ wave, Fasc (none)

Volitional Muaps
Mild Incr (amplitude) Mild Incr (duration), Config (Poly), +1 Poly

Max Volitional Acitivity
Pattern: -3 Red (Effort Full)

Gastrocnemius (medial head) L Insertional Spontaneous Activity
Normal None (Fibs) None(+wave) None(fasc)

Volitional Muaps
normal (amplitude), Normal (duration) Normal (config), None (poly), Normal (pattern)
Max Volational effort= normal

TIbralis Anterior R Insertional Spontaneous Activity
Normal +2 Fibs, +2 Waves, Fasc (none)

Volitional Muaps
Mild Incr (amp), Mild Incr (duration), Poly (config), +2 Poly

Max Volitional Acitivty
-3 red pattern (full effort)

Peroneal nerve conduction studies shows severe slowing and moderate amplitude reduction across the fibula head bilaterally. EMG exam shows evidence of denervation in the porneal-innervated muscles bilaterally.

Bilateral peroneal compression neropaties at the fibula head with evidence of both demyelination and axonal damage.

Doctor told me that if only myelin was damaged it would have healed faster but because there was denervation that there is nerve fiber damage as well and this will take a long time to heal. He said on average nerve fibers can grow back at a rate of about an inch a month. He said it should take close to a year to heal but suspects it should heal on its own. I am somewhat perplexed on how i did so much damage to myself just by sitting with my legs crossed. He did say at the end that he was happy to give me the good news so i assume this means that i dont have any serious nerve disease. I posted these results for others who may not understand what the stuff means. He told me with ALS you have axonal damage (fail the EMG) but would pass the nerve conduction test. I failed both which i guess is good news. I would really like to thank everyone on this site for contributing information, and my prayers go out to all of you who are in a situation of not knowing exactly what is happening or those who have already been diagnosed with some degree of assurance.
 

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Thanks for sharing, Shane. Congrats on the good news!
 

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Hi Shane, when i did my EMG the doctors knew exactly where i crossed my legs! My right over left. My EMG had extremely mild NCV slowing and my third one was normal. So your nerves can heal.. On my first EMG my muscles however had lots of PSW's, Facics, and Fibs throughout. I hope everything goes well for you.... Sam
 

shane42

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I have noticed that i now have some random muscle twitching. The strange thing is my EMG did not pick up any fascilations even though they started a few weeks ago (after the test). Could these be brought on by the stress and anxiety i had the past few months over this condition or the fact that i have not been able to exercise much because of my feet problem? They are very annoying, the last like 1 second, but its hard to sleep because thats when they seem to be the worst. There is no pattern to the twitches.. sometimes they will be in my calf, others in my bicept, or forearm, feet, hand (mainly thumb), or abdomen. I find it strange that eeg didnt pick them up, and when i told my doctor he sort of dismissed them as nothing (i guess cause the test was negative for fasc). Is it possible for an EMG to not detect twitches? or are these different types of twitches? they feel just like one nerve fiber firing on its own, Its hard for me to see them because they happen so quick by the time i look they are gone. The only one i have actually seen is one in my thumb. I was never known to be a twitcher so this all to curious. They feel almost like something is crawling under my skin inside my muscle. Very strange to say the least. Any feedback would be cool.. Samantha i noticed you said u had twitching as well, and you were diagnosed with the same sort of condition? Did u have alot of stresss and anxiety over this, and were u able to exercise like normal? What did doctor say they were from?
 

shane42

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just wanted to add, that they dont seem to happen if i am moving around, but usually when i am sitting or lying down
 

shane42

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i just notice that i had a type instead of (after the test) it should say (before the test)
 

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Hey Shane- I read that that is a sure sign of BFS: if the twithces go away when you move around then the fasciculations are benign. That what I read.
 

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Hi Shane, i agree with Cindy on this one. When i started having twitches they were in the exact places i later had muscle wasting. I can see them through my clothes. It looks just like something is poking your skin from the inside out, or sometimes it is really faint and you have to look close. BFS can cause muscle fatigue as well as twitches. My first EMG i felt no faciculations but the machine could read them and the doc could see them. My second EMG they told me nothing and at that time i had some in my stomach that looked like a heartbeat and they did not say anything. I have visible muscle wasting along with hypereflexia, and they still will only say i have a neuromuscular disease. They will not diagnose ALS unless they are 100% sure. I wish i could say dont worry about it but that would make me a hippocrate. I get used to the twitches so they dont cause me anxiety or worry, but when i get a new one like the ones in my (mouth area) i know that something is going to change and i get real down real fast... But then they just twitch twitch twich to the point you get used to that one too... Sam
 

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Excersize

Hey Shane, the excersize thing is not so good. I used to do pilates, and we would even drive an hour away to go ice skating in the winter. I stopped excersizing at the gym because my stomach muscles would shake so much and pilates works on your core. My left side was noticabley weaker so i would work that side more, but it never got strong. This was two years ago. Right now the only excersize i get is practicing baseball with my kids. The funny thing is, throwing the ball has made my ribs hurt like hell, instead of my arms! When all my ribs start aching it really is hard to deal with that pain. Anyways, i went on a walking field trip with my kids and learned two miles is too much. The next day my whole body felt like i weighed five hundred pounds and i could barely lift it, it put me out for a day and a half! I used to walk two miles every day of my life! You must excersize no matter what though, i have spasticity and if i do not stretch my joints lock up. My left knee area already is bent and i am unable to fully straighten it. I have found swimming to be the BEST thing ever. The water holds most of your weight and you move every muscle at the same time and it is fun!
 

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Sam,

How are you, did you ever find a pool in your area?
I am starting aqua therapy on Wednesday. Hope I get some relief from it.
I am expeirencing burning pain in my ribs. Is this the pain you are having.
 

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Hi Crystal, the nearest free pool access or Y is in New Bern which is about an hour from me. Now that it is getting warmer i can swim in the ocean, although i still have about two months before i can do that. My muscle pain feels like i pulled a muscle and i can still move but it is tender? Does that help? I do however have burning pain in my right rib stomach area but it is from my gallbladder! When i get insurance someday i will have it removed. After my endoscopy and the biopsies coming back normal, my gastro had me get my gallbladder checked again. It turns out he might know something after all ! Well, my insurance was cancelled and i unless i run an infection with a high WBC count the hospital is not about to take it out. It is okay, it is forcing me to stay away from greasy foods. I went way off the subject but this whole crazy thing makes me crazy.. It is like is this from my muscle condition or is this from my allergies or is this something else? (Now i get burning pain if i excersize, pretty quickly i might add..... Are you still being very physcial?)
 

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Can MS cause randomly failed EMGs in some cases?

I had positive sharp waves, membrane-something and other nasties in all 4 limbs. Tester suggested 6 months chronic denervation in hands, and new denervation in legs and upper-arms. Clean on the mouth/lip. The next day I passed on all 4 limbs with the same machine with a different tester.

Given the random nature of MS, can the results change from day-to-day (as in my case)?
 

crystalkk

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Jim,

Who did the 1st emg and who did the 2nd. Emg's are as good as the person doing them.
Did the 2nd emger do all the same muscles in as many spots. I would be totally confused as well.
Emg's are not used for MS. Ms does not cause denervation. MS is tested with brain MRI and spinal tap.
 

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You have to have MS for a long time for it to cause EMG abnormalities. It would however cause NCV abnormalities/nerve conduction study. Yes, the MS could attack your nerves and you could heal, then they get attacked and you heal.... This leaves scars on your myelin sheaths, that show on NCV tests and Evoked Potential tests, the scars also show on your brain with MRI. The spinal tap will tell if you have an autimmune antibody that is causing the MS. A lot of people with MS do not get diagnosed for many years because the body fights back trying to heal itself and it can go into remission.
 

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So basically my life depends on which of the two doctors that took my two EMG was a complete goon?

I can see how maybe one doc would find problems in 1 limb and another find 2 limbs, or 0 and 1 etc. But to find all 4 limbs, and then find zero limbs the next day?!

I cant help but wonder that, due to my age, the 2nd doc was hiding something. He refused to hand over the scan traces, saying "there was nothing worth printing out" on them. He also stopped after just 1 pin in each limb saying that there was "no need to do this anymore".

3rd EMG will be, lets say, 'nervy'. I think it best if I go to a fresh hospital and make no mention of the previous 2 tests.

Pass that one, and I'll be all over CFS and MS. Fail, and well, start praying for MD, PLS etc. (i.e. 'anything besides ALS').
 
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