EMG Report - Really confused and scared now

[physerv24]

Was referred to the Cleveland Clinic by my PCP due to my BFS diagnosis in June 2013. I think he did this because he had never heard of BFS. Anyway, my first appointment was Sept. 30th for a clinical evaluation. Passed all strength tests and only showed brisk reflexes bilaterally. Left hand showed some atrophy in the thenar muscle, without weakness. Because of periodic numbness in the pinky and ring fingers, they suspected possible C-spine disc problems. October 1st, I had a very extensive EMG/NCS. They tested 22 muscles on the left side. The neurologist called me a couple days later and said that the EMG was negative for any signs of MND. They sent me for an MRI which showed mild disc bulges in C2 through C6 with stenosis in C5-C6 disc. Neurologist indicated this was not serious enough for surgery, however.

Today, I got a copy of the EMG report and am feeling very nervous. I will post what the report said and would appreciate anyone's opinion. I don't want to keep chasing a diagnosis but this has me worried. It states:

1. Fasciculation potentials in 19 of 22 muscles examined
2. Reduced recruitment patterns and chronic neurogenic motor unit potential changes in the C8-T1 myotomes. The recruitment patterns are characterized by motor unit potentials firing rapidly during attempted maximum voluntary contraction. There is no evidence of active motor fiber loss. These findings are nonspecific but are consistent with a lesion of the cervical instraspinal canal affecting the roots/segments at these levels. (BUT THE MRI DID NOT SUPPORT THIS????)
3. Normal sensory and motor nerve conduction studies including normal motor responses of the median and ulnar nerves with proximal points of stimulation (axilla and Erb's point). There is no definite evidence of a conduction block or differential slowing at any of these points of stimulation.

"This constellation of findings is suggestive of an intraspinal canal lesion affecting the C8/T1 myotomes. The normal motor amplitudes recording from the abductor pollicis brevis and adductor digiti minimi occuring in the setting of reduced recruitment patterns recorded from these muscles raises the possibility of a proximally situated conduction block, proximal to Erb's point. The chronic motor fiber loss changes in these muslces clearly indicates an axon loss process but there is no evidence of active or ongoing motor fiber loss at this time. These findings are insufficient for a diagnosis of widespread disorder of motor fibers like that seen in motor neuron disease."

Those last two sentences scare the hell out of me and confuse me at the same time, especially since the MRI did not show problems with the C8 disk. I would greatly appreciate anyone's opinion on this.

[LKP1231]

You had a very detailed emg which stated you have no mnd. Anything shown had to do with discs in neck. No motor loss. It's all good. Relax.

[LKP1231]

Insufficient finding for mnd. Why would you be upset?

[physerv24]

From your lips to God's ears!

[Dual_CoRed]

I have the exact same problem/EMG results as you. We have bad necks,no mnd.

[Yuliasir]

MRI findings depend on nature of your lesion and on the characteristics of scanner. Also, EMG had demonstrated that ou may have certain troubles not only in C2-C6 but in the lower part of spice (C8-T1). T is for thoracal spine so it is very low neck which might be not scanned.

Finally the two last phrases state you do not have MND but certain compression or other traumatic issue.

[Bibi]

I Think it is A Big mistake that You get your EMG report to Read for your selves . I makes You so scared because You cant understand The report , offcourse . I Think it Would be better only to have The result explained by A neuro.

[LKP1231]

I agree with Bibi. Interpreting the results is the drs job. We can't possibly truly understand it. I wish I'd never seen mine.

[dolphin8808]

I won't get mind, things that are very minor and have nothing to do with our fears trigger worse. You don't know what it means, trust your doc,

[LKP1231]

I wish my emg stated no findings of mnd. It just stated the findings and then on the doctors report stated their analysis. Makes me wonder why.

[Pascal35]

Hi physerv,

Was your whole spine checked with the MRI or just up to the C5-C6 level?
Since there are so many issues with your spine then the EMG findings seem to be relevant.
Was the thenar atrophy consistent in the EMG? Was the recruitment pattern full or not? I am asking this because what you call atrophy might have been there for many years and you could have just noticed it because of your fears...
At any case since the neuro said no MND then listen to him and move on...

[physerv24]

Pascal,

As stated in my post, the recruitment patterns were reduced. Thenar atrophy was linked to possible spinal lesion of the C8-T1 level. My MRI was only of my thoracic and cervical spine. No lumbar. The MRI showed disc protrusions from the C2 level all the way to the C6-C7 level, which also showed stenosis and canal narrowing. No mention of C8 so I'm not sure. The atrophy may have been there but for a long time since the neuro noted "chronic neurogenic changes" but no "active motor fiber loss".

I was actually hoping the MRI would be significant enough for surgery as that would give me some hope of reducing these twitches but it wasn't. Regarding constant twitching, my upper body has been going constant for 6 months. Don't be too worried about your bicep twitching for weeks. As I said, mine has been going non-stop for 6 months. I believe bobojojo's have been going for much longer.

[Pascal35]

[quote="physerv24"]Pascal,

Thenar atrophy was linked to possible spinal lesion of the C8-T1 level. My MRI was only of my thoracic and cervical spine. No lumbar. The MRI showed disc protrusions from the C2 level all the way to the C6-C7 level, which also showed stenosis and canal narrowing. No mention of C8 so I'm not sure. The atrophy may have been there but for a long time since the neuro noted "chronic neurogenic changes" but no "active motor fiber loss".

Hi physerv,

I believe that the C8-T1 level is lower than the cervical spine. I guess you need a new MRI but since you see that there are issues higher in your spine there is a good possibility that there are also issues lower too... Chronic neurogenic changes is also good news!