Forum

Nerve conduction test

Hello, just wanted to ask a question. I’ve had brain mri (negative) and lots of blood tests all clear. Last neuro appointment I had ECG and sent for ct scan thorax and chest also clear. I was supposed to see neuro again weeks ago but not got an appointment through yet, no surprise there! Today I received an appointment for a nerve conduction test and EMG. No idea what these are for and wasn’t told I would need these. My neuro said my problems are not neurological so I don’t know what these tests are for. Can anyone advise please? Many thanks. Andy

I guess he is being thorough before he sees you again which is no bad thing. They are part of a typical range of tests that might help to pinpoint or rule out causes of neurological symptoms. The nerve conduction test I assume to be to test the nerve conduction speed of a specific nerve pathway within the Central nervous system for evidence of damage possibly from demyelination, as this slows the speed. However, many nerves exit the CNS and may be damaged after that point (peripheral neuropathy), requiring a different type of test called an EMG. A nerve conduction test could actually refer to either type but since it has been distinguished from an EMG, this is my presumption. These other types of tests for possible indications of demyelination in the CNS can include SSEP tests, where a limb is possibly being affected, or VEP test where the optic nerve might be affected. Peripheral neuropathy has several potential causes, MS is not one of them.

Hello again, sorry to be a nuisance. I had the nerve tests yesterday and was told it was negative. The nerves in my legs did what they were supposed to. Is this good news? I asked what they were testing for and was told there is no nerve damage in my legs. So I’m wondering now why I’m getting so much weakness, pain etc in them. Does this negative result finally rule out ms? Thanks in advance for your help. Andy

Would assume so, unless your result was only just within the normal limit, by just one point say.

Thank you for the reply, it makes you wonder why this test isn’t done earlier if it can rule out ms so quickly. Surely its a lot cheaper than the brain mri!

That test doesn’t rule out MS, it rules out peripheral neuropathy. It is not a test relating to the central nervous system of which MS is a disease of. In fact, the reason i was referred to an MS specialist is because peripheral neuropathy has been ruled out as nerve conduction tests and EMG test came back normal.

So instead of ruling out ms this test makes it more likely? Had you had any other tests done prior to the nerve test? I’ve had a negative brain mri and a ct scan as well as lots of blood tests. I was going to ask my gp if I could be referred to ams specialist so hopefully that’s what will happen now.

It doesn’t mean MS is more likely. It just means that the neuro issues are not caused by damage to the peripheral nerves. When I had my first mri and it came back clear the neurologist said ‘well that’s MS ruled out, I will refer you for tests that identify peripheral neuropathy. If you go on the nhs website and type in peripheral neuropathy it explains everything really well. I also asked the chap that did my nerve conduction tests and EMG whether they relate to the diagnosis of MS. He said no. After those tests came back clear I requested a referral to an MS specialist as I was seeing a general neurologist and thought he had been a bit flimsy in disregarding MS based on one mri. I have now seen an MS specialist and had several MRI tests, lumbar puncture and Vep test and they at present are not shedding any light on my symptoms either…the mystery continues!

What i I will say is just because one thing is ruled out doesn’t mean that it HAS to be the other thing. The way my neuro put it was, not everyone with sickness and vomiting has food poisoning. There are so many things that cause our bodies to act out of sorts.

My neuro told me my problems are not neurological based on one brain mri and a datscan. At present I haven’t had a spine mri or lumbar puncture and it doesn’t look likely I’ll be getting those judging by his comments when I saw him last. I’m wondering what will happen next. Hope you get some answers soon.

I think you have to remember that a neurologist is not precisely testing to see if you have MS. S/he is conducting a panel of tests to try to figure out whether the symptoms you are describing have a neurological cause. So the exact tests, like nerve conduction, MRI, etc go together with your neurological examination and your history for the neurologist to work out a) do you have a neurological problem, and b) what that neurological problem is.

What we, as patients, often do, is look at the symptoms we have (often with help from the Internet), think we fit the pattern of a given diagnosis and then expect that our doctors are testing to see if we fit that diagnosis.

So, we are looking at the problem from the wrong perspective. Your doctor might initially think your exam and history fit a given diagnosis, but then the MRI changes matters, so they continue testing. Or they don’t think you fit a typical pattern of any specific disorder, so are testing from all angles to see if something ‘fits’.

If your neurologist is certain that your symptoms have been shown to not have a neurological cause, then that’s pretty much all they can say, they can’t diagnose something else that’s not their speciality. So you might find you are referred back to your GP, or to a rheumatologist, or to another specialist.

Best of luck finding some answers. It’s a horrible place to be, limbo land.

Sue

Thanks sue, yes limbo land is a horrible place. Doesn’t help when you’re supposed to see the neuro in 4 months which turns out to be 13 months… I understand that they have to be sure before they give a diagnosis but it just seems to be going on and on. I’m still not sure which conditions have been ruled out by the tests I’ve had done so far. All very frustrating!