Page 1 of 2

peripherel nerve excitability

PostPosted: December 30th, 2014, 10:19 am
by joycecaroll
What is it and would my emg have showed it?

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 1:09 pm
by misterjuanperalta
It's an umbrella term for overactive nerves affecting muscles. Neuromyotonia is a form of it. RNS will confirm it. RNS is Repetitive Nerve Stimulation. There is blood work to help identify it as well.

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 1:40 pm
by Ghayes420
As Juan states, PNH (peripheral Nerve Hyperexcitability) is a specific diagnosis that is confirmed by a specific type of Nerve Conduction Study (NVC). Since 2007, this test called the RNS (a type of NCV) is used to try and elicit a cramp from the muscles. At the Mayo Clinic they refer to it as the 'CFS protocol' .When it is positive you are said to have PNH.

It must be noted that PNH is also a benign condition and PNH is found alone or with other disorders like Neuromyotonia or Isaac's. It is not a prelude to anything bad, especially when it has been present for an extended time.

Also to note that you can twitch everywhere like mad (as I do) and test negative for PNH (like I did in March 2013).

To answer your question, no, your EMG alone would not confirm this diagnosis.

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 2:28 pm
by joycecaroll
Would the nct have showed anything pointing to hyperexcitability if it was present? I'm so scared of bulbar due to my tongue twitches.

Now I haven't had them for two days. Good sign? Or could they stop for several days in the hyperexcitability phase?

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 3:24 pm
by bobajojo
peripheral nerve hyper excitability is a benign condition. I tested positive for it by the RNS test as others have mentioned. I have tongue twitches everyday all over my tongue. Not sure why you are worrying about it, most of us have hyper excited nerves.

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 3:51 pm
by leaflea
PNH is typically benign, but not a lot is known about it. And most of us who have sought out this site have it - anyone who twitches or cramps more than the average person - enough to make them seek out this site (although there are possibly some hypochondriacs here who have just normal twitching). Matt, I have been wondering what they said to you about looking for any benign tumor? The latest study out of Mayo (published March 2014) found 1/3 of those who have PNH had a benign tumor. I don't claim to understand everything about it, but the fact that ALL of the 1/3 subjects stopped twitching and cramping after the benign tumor was removed makes me very interested in finding out more about it. Joyceroll I think you can relax about bulbar. Worrying about it won't change anything. At least half of us with PNH seem to have tongue or mouth issues at some point.

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 7:21 pm
by veryworried123
did they say where the begnin tumor was in the study?

where they all over if different people

i always wondered this and was scared of this as well

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 7:46 pm
by veryworried123
And can someone please explain exactly what peripheral nerve hyperexcitability is I've read about it on the Internet however there's a lot of generic information on there

Is BFS considered peripheral nerve hyperexcitability?

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 8:47 pm
by leaflea
it is very difficult to explain. I have asked many times myself. Just found this wikipedia article was updated FOUR DAYS ago. It will give you a place to start your investigations if you so desire or haven't already exhausted all resources :-)

http://en.wikipedia.org/wiki/Neuromyotonia

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 9:06 pm
by Ghayes420
This is just my understanding as was explained to me by the Mayo Clinic...

PNH used to be a blanket term encompassing almost all conditions of hyperexcited nerves.
In 2007 a study was released that showed that they can actually diagnose PNH with a specific type of nerve conduction study called RNS. Many top hospitals now have this protocol as part of their procedure when a patient presents with twitching and cramps. The Mayo clinic refers to this as the "CFS protocol testing".

The exact language on my final report was "...the CFS protocol testing on the nerve conduction study showed no after discharges. Therefore no sign of Peripheral Nerve Hyperexcitability."

Note I did show fasciculations in the muscles tested as well, but because I didn't have the after discharges when they did the CFS protocol (known as RNS) the final diagnosis was idiopathic benign fasciculations.

This, to my understanding, is the current method used to diagnose PNH.

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 9:09 pm
by veryworried123
If you test negative for ESR and ANA auto immune does that mean that you do not have peripheral nerve hyperexcitabilit

Thanks

Re: peripherel nerve excitability

PostPosted: December 30th, 2014, 9:20 pm
by Ghayes420
No, ESR and ANA are not used for the diagnosis of PNH to my knowledge. Those tests are used to detect autoimmune conditions that may cause fascicualtions.
-Greg

Re: peripherel nerve excitability

PostPosted: December 31st, 2014, 2:38 am
by TwitchyDoc
PNH is as benign as headache. It depends on the cause. Great article about PNH can be found here: http://brain.oxfordjournals.org/content/125/8/1887. Table 6 presents causes of PNH...

Re: peripherel nerve excitability

PostPosted: December 31st, 2014, 2:53 pm
by leaflea
So Twitchydoc, the table 6 in this study does not make PNH sound so benign as a headache. Why o why do those things not play out here on this board? We have a few Hashimotos, one thyroid cancer, a Raynaud's or two and that is about all. Not even one thymoma. Are those they studied only those with positve VGKC or AChr? The sample size is small, is it not? And then there is the new Mayo study published in March 2014 finding 1/3 of those with PNH had a BENIGN tumor, with completely resolved symptoms once the tumor was removed. How do these studies reconcile with one another? Sample size was similar. Have you looked into this? I cannot make sense of it and would love you or Helen or Buzznerd to give us some interpretation of it: http://www.ncbi.nlm.nih.gov/pubmed/23836298 If there is any credence to this, many of us could resolve our symptoms if we could find the benign tumor. My doctor said it could be as simple as a lipoma - very common.

Re: peripherel nerve excitability

PostPosted: January 7th, 2015, 6:38 am
by joycecaroll
Question about jaw reflex: sometimes my jaw jerks. Not from any stimulation - I'll just sit in my couch and my jaw will open up a bit, kind of fast. Is this anything bad?