First outcome muscle biopsy

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First outcome muscle biopsy

Postby German2 on September 28th, 2015, 11:48 am

Hi there,

this is a question to the well informed which I really ask for opinion.
I wasn't here for a while...but it went worse with my arms (pain, muscle loss). My neuro confirmed this atrophy and was even not sure about my back..Today I received the report of my muscle biopsy which I did have 2 weeks ago. My neurosurgeon who did the biopsy told me before, he will just give me a phone call about the outcome. But as I was in his office today I was told that I have to come to talk to him personally (in two weeks!!).

The report is 2 and a half pages long and I just will tell you the gist:
slight caliber deviation with single fiber atrophie and hypertrophy of both fiber types and slight grouping as sign of reenervation of before ongoing denervation. No signs of an advanced chronigcal neurogenic Muscle atrophy.
Classification: largely compensated, slight neurogenic damage. No florid inflammation.
They have found one red-ragged-fiber, and several COX negativ fibers, which would not be enough for a differenctial diagnostic.

Has anyone an idea what this means? All other indicators like enzymes and so on where ok. I am very alarmed about that report....I think it does not exclude MND. Hopefully it includes other options like PNP or herniated disc and relative spine stenosis?? ..
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Re: First outcome muscle biopsy

Postby Xina535 on September 28th, 2015, 6:27 pm

I have never seen or read results of a muscle biopsy before. That is mostly over my head.

But this sentence stands out to me: "No signs of an advanced chronigcal neurogenic Muscle atrophy."

as being positive. I wonder if there is a "muscle biopsy forum" or place to post the results and see what they say. I cannot imagine waiting 2 weeks for getting the results read! What if you call and tell them you'll go and sit all day in the office and wait for any time the doctor can see you?
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Re: First outcome muscle biopsy

Postby Yuliasir on September 28th, 2015, 10:56 pm

German,
as a medical translator (not a doctor) I can see that you have a few atrophied fibers in the biopsy with the SLIGHT decrease in fiber diameter. Other fibers had grown instead (hypertrophy) to compensate that. NO SIGNS OF CHRONIC NEUROGENIC ATROPHY - which means you do not have ongoing denervation process, it was in the past, and you got re-innervation, which would not be a case should you have malignant denervation process. So seems like you had a pathological process once (a case could not be cleared by the biopsy as it deals only with the consequences - it might be inflammation, mechanical trauma etc.) which now stopped and is practically LARGELY compensated.

so this should be taken as practically excluding MND of malignant type, like ALS.
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Re: First outcome muscle biopsy

Postby German2 on September 29th, 2015, 12:17 am

Oh you saved my day!! Thank you soo much....Yes, indeed it says single atrophied fibers and hypetrophied ones...reinnervation after denervation BEFORE...After my first reading I got to the same interpretation as you wrote, but after reading and googling, reading and googling and the fact that doctor wants now to discuss with me personally, I got very unsecure.

As I really have confirmed atrophy in lower arms which is proceeding, accompanied from pain when I use my arms to swim or other workouts (and I went through all special forms of hell anyway...;-)) I only can explain this to me by plexus brachialgie..I have a lot manual therapy hoping to get that in place again...Although my nerve conduction speed was ok and does not support the plexus theory.
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