Nerve Conduction Study - Help With Results.

[Retired77]

Awhile back I had a nerve conduction study done for Carpal Tunnel and did not get an answer to my question as the severity of it. I was hoping that by posting part of the results someone with knowledge might be able to give me a guestimate on what I might be expecting. Thanks...

--Delayed left median sensory latencies to the thumb, ring finger and

transcarpal sensory latencies.

--Normal left radial sensory latency.

--Absent left ulnar sensory latency to the ring finger.

--Normal left ulnar sensory to the small finger and normal transcarpal latency.

--Normal left median (to APB) and ulnar (to ADM and FDI) motor latencies with

normal amplitudes and conduction velocities.

--There is significant delay in median sensory conductions in comparison

with ulnar and radial sensory conductions- this is evidenced by an abnormal

Combined Sensory Index (CSI) of 1.2 on the right and unable to calculate on the

left due to the absent ulnar response to the ring finger (normal <1.0). The CSI

is a composite sum score defined as the difference between median vs. ulnar and

median vs. radial sensory or mixed nerve latencies, where a normal score is

<1.0.

Abnormal study.

1. There is electrodiagnostic evidence of a demyelinating right median sensory

mononeuropathy at the wrist (carpal tunnel syndrome). There is no evidence of

axonal loss on needle EMG.

2. There is electrodiagnostic evidence of a demyelinating left median

sensory mononeuropathy at the wrist (carpal tunnel syndrome).

3. There are electrodiagnostic findings which might suggest a possible left

sensory neuropathy either at the wrist or elbow.

4. There is no electrodiagnostic evidence of right ulnar neuropathy at the elbow

or wrist.

4. There is no electrodiagnostic evidence of right cervical motor radiculopathy.

Electrodiagnostic testing is insensitive for the detection of purely sensory

radiculopathy.

[Vync]

Basically, they are saying there is something wrong in your hand and elbow. I wish I could provide a guestimate on what it might rate %-wise, but I am not an expert. The "might's" in there could be interpreted as "possibly's" by the VA, which might not be good. If this was for a C&P and you can get the doc's write up, it might shed more light on it.

I can tell you that if it shows up on the EMG, it is more likely to be taken seriously. I had EMG's that showed nothing, but pressure sensitivity tests showed otherwise. I ended up having surgery that helped to a degree, but now it is giving me problems again...

[jbasser]

Carpal tunnel.

Get a second opinion if it is for a cervical spine claim..

Basser

[TALON II FE]

It is pointing to no issues radiating from the spinal column, but there is localized issues at your wrist (carpal tunnel as jbasser stated). I have this as well as cubic tunnel syndrome on my right arm, which is basically the same as carpal tunnel, but it is at the nerve sheath in the elbow instead of wrist. For me, with both as well as cervical problems, it was a bird's nest of problems and took a few years and a lot of testing to untangle. I wouldn't wish that on my worst enemy. The "good news" is that It looks like they are saying that you have specific, localized loss of median nerve function. It looks like they were able to mostly isolate to your wrist/carpal tunnel.

Where I believe they could "screw you" is if they did not do a full EMG on both arms for a "baseline' comparison. This can be an issue since everyone is neurologically a little different and age also plays a part in what is thought to be "acceptable degradation. With these tests there is a fairly broad range that is considered normal. essentially, there is nothing to compare what is "normal for you" to the abnormal results on your other arm. I could definitely see them trying to "debunk" the EMG by saying that the Doc "missed the mark" and requiring another EMG, since there was "Absent left ulnar sensory latency to the ring finger". I know with my issues, every time it came back as absent, I ended up getting hit up for another EMG a few months down the line.

Have you had a carpal tunnel release yet or are they suggesting one? I had one about 5 years ago on my right wrist. There was other damage there, but I believe the release helped some. The real positive is that it looks like the Doc was able to isolate median nerve issues. If you have not had a carpal tunnel release, I would recommend considering it and do the research to decide if it is right for you. For me, my surgeon and I decided the cubic tunnel release, which is a more delicate procedure than a carpal tunnel release, was not worth the risks involved, so I opted out. Nerves are funny things, they are very slow to regrow and sometimes do not at all. The longer that you wait with a restriction/ entrapment, the more likely that the damage will become permanent.

With them basically eliminating cervical issues playing a part, that could be good or bad news, depending on what your expectations are. Did they EMG your whole arm, bicep, tricep and shoulder area? Without the upper arm being tested, they really have not fully checked for cervical complications. If they did not, and there is any suspicion of spinal involvement, I would push for another study (sorry, I know how bad these can suck! When they start shoving those dull needles into the palm of your hand, telling you to relax muscles you can't even control, etc). For carpal tunnel, there are also some physical therapy options, braces, meds, etc that can give you some relief as well, depending on how long you have had the issues and how intense the symptoms are. I would keep in mind that these drugs all have side effects and affect everyone differently. For example, most can cause weight gain and libido problems. Sometimes "the cure is worse than the disease".

I am no expert, but I have had a lot of EMGs and I have some issues that correlate with yours, so I "feel your pain". I used to just want to slam my hand into something to get rid of the random, unpredictable pain spikes that still come and go today, but somewhat less frequently. I wish they had figured mine out sooner to avoid permanent damage. I hope you are able to get some relief from your symptoms. If you have any other questions that I may be able to answer from my experience, I will do my best.

Edited June 7, 2015 by TALON II FE

[Fat]

"NEVER GIVE UP"

Seems favorable though........