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  Cervical Myelopathy  
  It has been a while since I have left a message. They think that I have cervical myelopathy. Six months later, and 4 doc's. The most recent doc I visited talked with me for 10 mins. Watched me walk and said this is what he thinks I have. 98% sure! Anyone out there ever heard of it??? Am taking Baclofen 10mgs at night for the first 15 days then twice a day after that. Any comments?
  Answer Cervical myelopathy is due to pressure on the spinal cord at the level of the neck. Baclofen should help to ease the spasticity. All the best.
  Brachial plexus injury  
  If damage occurred to a nerve during shoulder surgery, will nerve conduction studies show the damage to that nerve? Symptoms include decreased range of motion, atrophy of muscles in arm and severe pain. Also have history of some carpal tunnel syndrome. Will the test shoe which injury is causing the problems listed above? Also, is the needle test really necessary if you have already had the other part of the test and it showed nerve damage?  
  Answer Yes, nerve conduction studies are very helpful in your case. It should help to tell where is the lesion and is it one or more than one nerve involved. Also, I would think that needle examination in important in your case.
  Best treatment for C3/4 disc protrusion  
  With C 3/4 disc protrusions and radiculopathies what's the best course of treatment?  
  Answer You're asking a very general question which is impossible to answer without a great deal more info on the subject, age, lab findings, symptoms etc.. There may be a variety of approaches which are suitable for some cases but not for others.
  EMG/neurological tests in multiple level disc and upper and lower limb complains  
  I suffer from extreme low back pain and neck pain and weakness in my arms pains in my shoulders...and more. I had surgery on my back 10 years ago. I had an MRI and it shows multiple levels of bulging. I have numbness in hands and feet, sciatica, etc...My question is why do I have to go to a neurosurgeon or get EMG test?? I am going tomorrow for the neurology tests. However I already met with a neck surgeon who said he would be happy to operate on my neck...He didn't need Nero tests???? It seems to me I should see a orthopedic surgeon not a neurosurgeon...I heard that neck surgery may stabilize a back...Is that true??? The multiple levels of bulging are in my neck...  
  Answer Various doctors rely on different tests to establish a diagnosis and it may well be that in cases like yours, there are too many doctors involved in the care who might not know what the others are thinking. It is always best to narrow down the number of doctors you're dealing with to avoid such situations.  
  Just Wondering about cervical myelopathy  
  Has anyone ever heard of cervical myelopathy? Prognosis? Treatment? etc. After all I have been through I am very skeptical. Any feedback would be great!  
  Answer Cervical myelopathy means that you have a tight spinal canal in the neck area. The spinal cord is inside that canal of course and it comes under pressure because of the lack of space. This is what is referred to as a myelopathy (myelo refers to the spinal cord and pathy is used to indicate disease). Diagnosis is made by CT or MRI and or myelogram. The symptoms may involve root symptoms and also some weakness and increased reflexes in the legs if the canal is too tight. Treatment, when the disease is advanced, involves surgery to relieve pressure on the spinal cord.
  Comment Thank you! You have told me more than anyone else I have asked. When searching the internet for cervical myelopathy, there isn't much. I have started Baclofen 10 mgs twice daily, been taking for about 2 1/2 weeks, have noticed some increased weakness, but less cramping, a little more pain. No talk of surgery. Today I go for my first PT, hopefully something helps, and this has been the most frustrating 8 months of my life. Without your web site I would still be out in the dark!  
  Answer Would like to hear of your symptoms and history. I have been thru a very frustrating time also. I have weakness in my legs and ankles and increased reflexes. I also have tripped and fallen several times and suffered one broken bone already. I have a small spur in the cervical area (arthritic) PT has helped somewhat but certainly has not eliminated the problem. I do not have a lot of pain, just leg muscle cramping and stiffness and what I mentioned above. Baclofen has not been working for me. Doctors do not seem to be too anxious for surgical intervention. Would like to hear from you.  
  Myelogram results for cervical disc  
  I just got my myelogram back reads: Extradural defects located at the C 5/6 level of disc. What does this mean?  
  Answer The result of the myelogram would indicate that there is a sort of pinched nerve at that level (C5/6), which is the upper cervical level. This result should be taken into consideration in your further management after your doctor has looked at the myelogram films.
  Having neck and UL pain. What specialty might be of help?!  
  Hello. I have been fighting headaches, neck, shoulder, arm, and back pain for about five years, and I'm wondering if someone can help me decide where to go next. I have been doctoring in a small town--have seen doctor, chiropractor, physical therapist, and anesthesiologist. So far physical therapy has helped the most. Right before Christmas, the last two fingers on my right hand went numb. I couldn't start my car, had trouble opening doors, holding anything with a handle. The pain was worst right between (and under the right) my shoulder blades, but I'm also having pain across the top of my right shoulder and behind my right arm pit. In the past, I've had extreme tension-type headaches, stiff neck, cold and hot sensations down my right arm (usually feeling like water pouring down, heaviness in my upper arm, stiffness and pain under my shoulder blade, and a quivering across my upper back. My arm seems weak, but I can do things if I concentrate. The symptoms started while I was pregnant with my second child, but I can't think of any injury that could have started them. I saw an orthopedic surgeon in a larger city last week and had an MRI that showed a bulging disc (C6-C7), but he feels that the disc isn't significant enough to cause all this trouble. Wednesday I am having local anesthetic injected into the nerve root there as a "diagnostic procedure." My question is this--am I seeing the right kind of doctor? I am completely frustrated by the pain and the amount of time I've wasted so far. Can anyone give me any idea of what I might be dealing with?  
  Answer 1 I gathered that you have 2 problems that could explain your symptoms. The first one is the neck, this has been investigated by MRI and was not significant, and you are undergoing some further evaluation for that. But the second problem is the symptoms in the hands, that could be the cause of good deal of your symptoms, I believe a pressure or entrapment of nerve at wrist (carpal tunnel syndrome) should be excluded by doing (EMG). Seeing a neurologist would help you evaluate all your symptoms, including the headaches.
  Answer 2 I saw your post and also the reply by another doctor telling you to go see another doctor of course. I deal with clients everyday with your types of symptoms and it could very well be a situation involving your nerves somewhere between your head and your fingers. Since you have tried just about every type of doctor, I would suggest that you find a massage therapist to work with and start working with the muscles in your neck, upper back, rhomboids, pectoralis major and minor and all the way down your arm. Of course, don't neglect the rest of your body either. Tight muscles can impinge nerves and cut off circulation to any part of your body. Releasing the tension in these muscles and getting the blood flow circulating properly again can do wonders. I know I had a serious injury, which involved symptoms that you are describing and studied to become a massage therapist while healing from my injuries. I believe massage therapy sped up my healing process and gave me lasting relief. And I still have doctors running around trying to figure it all out with all their tests. Massage therapists get right to the source and take care of it. Let me know if it helped or if you have any more questions.  
  Answer 3 OR, you could burn incense and chant.....for God's sake see a competent neurologist.  
  Need For EMG due to multiple sensory & motor complains  
  I was referred to a neurologist who has ordered an EMG but I am reluctant to schedule it. Briefly, symptoms for several years have included episodes of numbness in face, arms, and or legs (uni- and bi-lateral), extreme fatigue/weakness in primarily legs, arms secondary (episodes where extremely difficult to get up stairs), "heaviness" in legs, hand tremors, constantly dropping things, loss of balance and coordination. An MRI brain scan showed 1 lesion in deep right frontal lobe with differential of demyelination (no trauma history). I have an ongoing history of recurrent positive EBV. MS has been mentioned by my PCP. The Neurologist mentioned peripheral nerve disease but I don't see how it fits with some of the symptoms. I haven't seen EMGs noted as a primary diagnostic tool for MS. Would an EMG really be of any benefit? Any input would be greatly appreciated - Thanks!  
  Answer The EMG is not helpful in the evaluation of chronic fatigue syndromes (unless it is due to a neuromuscular transmission disorder such as myasthenia gravis). It would be useful however in detecting any nerve disease causing the numbness you describe and or the presence of muscle disease, which is causing the weakness and heaviness in the legs.

MS cannot be evaluated by EMG because MS is caused by a demeyelination at the Central Nervous System level which is not investigated by EMG.

  Comment Thank you SO MUCH for your quick and thorough response! You provide a great service to the public and are a rare person in the field of medicine. In spite of my experience as a medical research writer, determining how to handle your personal health care can be quite challenging! Based on your response, I guess I should probably go ahead with the EMG. You mentioned CFS, and because of my background, I was able to locate one of the leading specialists at National Jewish after researching CFS and noting similarities to my problems. Of course, I've been on the merry-go-round of tests in order to rule out any other cause. If you think the test is worth a shot, I'll go ahead! But, if you think otherwise, let me know. I'm quite tired of diagnostic tests!  
  Answer You're welcome. At the bottom least, a negative EMG will rule out any "peripheral" cause of your symptoms. A positive one may help in addressing those, which can be treated.  
  Tingling and numbness in both hands, is EMG important?  
  I have recently had tingling and numbness in both of my hands. It gets extremely painful at night. I woke up one morning and my left hand was totally numb and it took over an hour for feeling to return. Blood tests that I have had in the past (unrelated to this) have had some form of indication of possible lupus or other disease as the doctors ask to do another test that will rule out these things. When the tests are run, the results are OK. I am being scheduled for an EMG for the hands and the information in your forum has been very helpful in knowing what that is all about. I'm just wondering if these blood tests are telling us something and we're just missing what it is? There is also extreme cramping in the hands and feet. Thanking you in advance for any reply.  
  Answer I believe that your doctor is working in the right direction to reach a diagnosis. The EMG study, however, should be very valuable to rule out any nerve entrapment at the wrist (carpal tunnel syndrome), as your symptoms do really suggest that.
  Persistent neck and back pain despite normal radiography  
  I was in a car accident about 2 years ago and have been in a lot of pain since then. I've had e-rays and a MRI done but they seem to be normal and I can't understand if I'm normal why am I still hurting? Is there another test that would show more than what I've already had done? Symptoms are lower back pain, neck pain, and pains that go throughout my right side. Can you give me any advice?????  
  Answer You need to see neurologist or orthopedic doctor to have good evaluation, then he would decide if further tests are needed or not, including EMG.
  Comment Thanks for replying to me. I seen I think an orthopedic Dr but he was I guess you can say a insurance Dr and made me bend over and looked at my MRI results and said "nothing" was wrong with me. I made a mistake in seeing this Dr and now insurance company is giving me a hard time. But if nothing is wrong with me I shouldn’t be hurting. Can you have nothing wrong and still hurt?? Thank you  
  Answer It seems to me that "nothing" i.e. no weakness and no other abnormalities were found on clinical examination and MRI. This is reassuring. Symptoms of pain may persist after car accidents. However, physiotherapy frequently helps.  
  Can biceps injury be due to CTS or disc bulge? Time of wearing splint in CTS?  
  Hello, I had an EMG done yesterday and have bilateral carpal tunnel. My question is this: the Doctor said that I have muscle damage in my bicep muscle, would this be a possible result of the CTS or maybe the result of a disc bulge in my neck? Also should I wear the splints during the day, if possible or only at night? Thanks  
  Answer The muscle damage in the biceps muscle is not a result of CTS, but may be a result of disc bulge in the neck. CTS does not cause damage of any muscle except the thenar muscle in severe cases. Regarding the wrist splint, you should wear it at night and day times.
  CTS and Thoracic outlet syndrome?  
  I am concerned that my CTS might indeed be TSO, I have heard they can be confused, would an EMG be a tool to arrive at a definitive distinction? If not in your opinion what would be a useful diagnostic tool?  
  Answer Thank you. Careful history, symptoms and signs can often differentiate between them. Also, the electromyographer can quite easily tell between CTS or thoracic outlet syndrome (TOS) by nerve conduction tests and EMG. It is the best diagnostic tool to diagnose either. However, you may need other investigations (radiology) to see if there is extra rib (cervical rib) that could be the cause of TOS. Practically, CTS is very very common while TOS is very rare.
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