EMG and nerve conduction study

[ebrownkirkland]

Hello. I had a nerve conduction study and EMG done yesterday. Still waiting for the results, but basically, I had these tests done because I have been having numbness and tingling along with spasms in (especially) my right leg. (I also get it in my left leg, but it's not as severe in my left leg as it is in my right.) In addition to this, an MRI recently found a 9 mm enhancing lesion "immediately adjacent to the right lateral ventricular atrium." Two different MS specialists believe what I have is early MS (one diagnosed me with clinically isolated syndrome), and I was sent for three days of Solu-Medrol infusions to address the active lesion. My question is why I was sent for the EMG and nerve conduction study. From my understanding, spasticity, according to Wikipedia, "mostly occurs in disorders of the central nervous system affecting the upper motor neurons in the form of a lesion, such as spastic diplegia, or upper motor neuron syndrome, and can also present in various types of multiple sclerosis..." So why, if I'm having muscle spasms AND I have an active lesion, did the neurologist send me to have an EMG and nerve conduction study? Not upset about having had these tests done (although they were somewhat uncomfortable), but I am a bit perplexed. I was told they were checking for a nerve impingement or something of that nature, but wouldn't the lesion on the MRI have ruled that out?? (I have other lesions, too, but the rest are 3 mm or smaller and not in locations that would scream "MS.")

[Snoopy]

Hi ebrownkirkland,

The diagnostic criteria requires all other possibilities be ruled out. It is reasonable for your Neurologist to order other testing to rule in/out those other possibilities. This doesn't mean your Dr. is changing his mind, but is being diligent in making the correct diagnosis. That really is the important thing...making the correct diagnosis.

The EMG isn't diagnostic for MS but if positive can point your Dr. in a different direction. MS is a disease of the Central Nervous System(CNS). The EMG looks at the Peripheral Nervous System(PNS).

This link might help you to understand the Nervous System:
http://www.news-medical.net/health/What ... ystem.aspx

[Zyklon]

My first neurologist did some basic tests during my first relapse. I was babinski reflex positive so there was something going. Since relapse was right after a severe flu, they suspected Guillain-Barre Syndrome. They did an EMG test and ruled it out.

Snoopy is right. They must rule out other options.

[ebrownkirkland]

Thanks, Zyklon and Snoopy. The test results were normal... Guessing this will confirm their suspicion of early MS??

[Snoopy]

The test results were normal... Guessing this will confirm their suspicion of early MS??

A normal EMG certainly rules out some other possibilities When do you see your Neurologist again?

[ebrownkirkland]

Aug. 11

[ebrownkirkland]

My neurologist called me today. I've been diagnosed with relapsing remitting multiple sclerosis and he's going to put me on Tecfidera. Said the results of the EMG and nerve conduction study along with my symptoms and MRI results, which show older lesions and a new one (he's saying now that a couple of older lesions are in locations common for MS) sealed the deal for me. Sigh. At least now I know what I'm dealing with, I guess.