United Brachial Plexus Network, Inc.

DH's neurologist recently had him start on the electronic muscle stimulation (can't remember the right term at the moment) to prevent further muscle atrophy, especially in his shoulder area where he has the least movement. The pysical therapist had to really crank some of the electronic signals to get all of the muscles to fire, but eventually all of the muscles did engage. The PT told him this was a good sign because if the nerves were not intact, then the muscles would not fire. Is this true? He had his MRI last week which also showed no avulsion. He's scheduled for his second EMG in 2 weeks, so I guess we will know more then. What the PT said is further encouragement, but since I'm still so new to this and not sure he's correct, I don't want to get too excited. Thanks in advance for the help!

What the PT told you doesn't exactly make sense to me. At least for John, the point of estim was to keep the muscles from atrophying while we waited for the transferred nerves to grow out & "innervate" the muscle. Only then was John's muscle being fired by the nerve itself. Since nerves only grow about 1" / month, this can take awhile (around six months for John).

As we waited for that to happen, the estim would send a current or charge to the muscle, which caused the muscle to contract.

It's great news that the neurologist doesn't think the nerves are avulsed! Keep us posted what you learn from the 2nd EMG. The first EMG will provide a baseline that later ones can be compared to. And ask your neurologist for further explanation if what I wrote above doesn't make sense to you.

Take care,

Ellen

Thanks Ellen- that's exactly what I was wondering. Since I don't know exactly how the estim works, at first I thought it made sense, that the current had to have a place to travel (an intact nerve) to get the muscle to fire. But then I remembered people here saying they did estim to prevent atrophy while waiting for surgery/healing from surgery- so that's what made me doubt it. So the current from estim doesn't run along the nerve path, is that correct? Thanks again!

John placed the estim unit directly over the muscle he wanted to contract, then "zapped" it by hitting a button. It didn't require a nerve pathway to work. Hope that helps!

Ellen

How does NMES work?

The device produces a mild electrical current that is transmitted via leads to electrodes placed on the skin over the motor point of the targeted muscle.
Stimulation of motor end plates cause nerve depolarization and activation of muscle fibers which results in a muscle contraction.

So it still uses the nerves, but not from the root (spine).

Marieke (31, LOBPI)

Thanks for your response Marieke!

So if an MRI shows no avulsions and the NMES is firing the muscles then that would be a further indiciation that his nerves are likely intact and stretched? I know nothing is for sure, but that's what we've heard from the neurosurgeon. ortho and neurologist is the likely the extent of the injury. Every little bit of evidence that supports that is encouraging.

Most likely yes, his nerves are intact. You can have some pretty bad nerve damage and still have some movement/sensation.
Good luck to him!
Marieke (31, LOBPI)