Discussions By Condition: I cannot get a diagnosis.

What does this mean?

Posted In: I cannot get a diagnosis. 2 Replies
  • Posted By: jilliankma
  • December 26, 2008
  • 09:03 PM

I went to the neurologist and got an emg and eeg testing done, i had the results faxed over and the eeg said my lower extremities came back mildly abnormal but the neurologist chose to ignore it and assured me there's nothing wrong.Then why would it come back mildly abnormal?:confused:

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  • Realize that many factors can influence the readings of tests like EEG and EMG, everything from the amount of subcutaneous tissue that exists under the electrodes, temperature of the surrounding tissues, changes that occur in electrode spacing during movement, as well as changes in muscle length during movement among other things can all affect the outcome of the test. Specifically addressing the EEG, the test you're likely referring to is the somatosensory evoked potential (SEP), measuring signals between the tibial nerve and the sensory cortex. Again, many factors can provide variations in readings and the diagnostic equipment will typically offer a translation based upon normative ranges programmed into its database. Realize, however, that the equipment is not capable of discerning whether confounds exist within various patients that can affect the result but yet not represent a problem. The equipment only measures the signals against norms and reports it as normal or abnormal. My long-standing personal opinion regarding circumstances wherein physicians tell you the test is abnormal but nothing is wrong, tends to establish the need to directly explain why in order to provide reassurance for the patient. So my personal practice is that if the test reading is abnormal but due to circumstances which do not exist within the realm of any pathology, then the patient is told that the test outcome is negative or normal. Why would anyone wish to invoke apprehension or anxiety when there is no need? In other words, if the test is only technically abnormal because of typical confounds which can skew the result, then it's in all reality a normal test and your doctor should have stated so. Neurological symptoms that are associated with pathology are recognized by the company they keep. In other words, even an abnormal EMG or EEG would need to be supported by other clinical signs and diagnostic test data in order to represent actual neuropathology. If this supportive evidence is absent, then an technical abnormal result on EEG is considered to be of little value. Having said that, I would now ask why you were originally referred to a neurologist? What are your symptoms, when did they first begin and how have they changed over time? Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • December 26, 2008
    • 10:28 PM
    • 0
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  • Realize that many factors can influence the readings of tests like EEG and EMG, everything from the amount of subcutaneous tissue that exists under the electrodes, temperature of the surrounding tissues, changes that occur in electrode spacing during movement, as well as changes in muscle length during movement among other things can all affect the outcome of the test. Specifically addressing the EEG, the test you're likely referring to is the somatosensory evoked potential (SEP), measuring signals between the tibial nerve and the sensory cortex. Again, many factors can provide variations in readings and the diagnostic equipment will typically offer a translation based upon normative ranges programmed into its database. Realize, however, that the equipment is not capable of discerning whether confounds exist within various patients that can affect the result but yet not represent a problem. The equipment only measures the signals against norms and reports it as normal or abnormal. My long-standing personal opinion regarding circumstances wherein physicians tell you the test is abnormal but nothing is wrong, tends to establish the need to directly explain why in order to provide reassurance for the patient. So my personal practice is that if the test reading is abnormal but due to circumstances which do not exist within the realm of any pathology, then the patient is told that the test outcome is negative or normal. Why would anyone wish to invoke apprehension or anxiety when there is no need? In other words, if the test is only technically abnormal because of typical confounds which can skew the result, then it's in all reality a normal test and your doctor should have stated so. Neurological symptoms that are associated with pathology are recognized by the company they keep. In other words, even an abnormal EMG or EEG would need to be supported by other clinical signs and diagnostic test data in order to represent actual neuropathology. If this supportive evidence is absent, then an technical abnormal result on EEG is considered to be of little value. Having said that, I would now ask why you were originally referred to a neurologist? What are your symptoms, when did they first begin and how have they changed over time? Best regards, J Cottle, MDThank you so much for your response, i do have here a previous post that i had posted a couple weeks ago that i still didn't get a good response.I'm 23 years old this all started only when i smoked, i'd smoke a cig the first couple drags i would what it seemed like lost control of every muscle even my breathing muscles so it felt as if i wasn't breathing for that moment. It is very scary cause your mind is aware of what is going on but have no control of your body, i have developed a lot of depression and anxiety because of this because i have found no answers to why this happened. This all happened to me several years ago i quit about 3 years ago and just recently i've experienced it even without smoking! It happened in stressful situations, for example there was a bat in my house hovering over me and i felt like i could not protect myself because i lost that control, when i my body snaps out of it i am very shaky and scared. People keep telling me its anxiety, well ive seen 3 therapists 2 psychiatrists i have taken zoloft, paxil, xanax, prozac, colonapin over the past years.Nothing is helping, a few months back i started developing heart palpitations after a month they disappeared.This past month i started developing muscle spasms in my feet,hands,face, mouth,stomach throat,thighs.. basically everywhere they are happening as we speak and they are very annoying. Sometimes i have the feeling like it is going to happen.. the losing control all day long whether i am at home relaxing to helping pt's at work. I am currently seeing a neurologist and taking colonapen which isn't doing anything. I had a emg and nerve conduction test, i called for the results and the ma said my lower extremities came back abnormal..? what does that mean i'm scared.I have an appt for him to explain results but i know hes gonna says everything is fine because he has his mind set on anxiety after only speaking to him for 5 mins the first appt. I've tried everything i still have these feelings i feel like i am running out of time and my muscles are just wasting away. I just feel so hopeless the pain and feelings are so strong. I cannot go on living life like this. My other symptoms are aches in upper arms and both thighs, buzzing in the back of my head crackling noises when i turn my head, weakness inside the back of my throat and chest, stiff joints, extreme difficulty breathing like i need to make myself breath and forget to breath, my brain feels as if it is weak or being lazy and my throat, i also have memory problems and trouble talking. Sometimes the light in the room would get dim and slowly it would adjust back to normal lighting.I've told the neurologist all of this and it still did not strike him as abnormal. i just went to the hospital a couple days ago my blood results came back normal they did a ct scan and that came back normal.I'm not sure what else to do i thought of everything and seen so many dr's about this and nothing. I would just like to know what other people with the same problem have be diagnosed with and some insight on what else more i can do.Thank you so much for your time in reading this. :(
    jilliankma 9 Replies
    • December 27, 2008
    • 11:21 PM
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