Negative EMG

[cristinam]

I was wondering if any of y'all have had this injury, and had negative EMGs? Yet symptoms, presentation, and impairment appear to be a BPI but diagnostic tests don't match up.

Thanks for your input!
Cristina

[gimpyfireman2010]

No. My EMG matched bang on with my impairment.

[wazza]

Hi there, sucks to hear about you (anyones!) injury of course. I had "mixed" reactions from the injury with the results of a few NCS' (Nerve conduction study). My initial one was 'zero' as well as my arm was zero movement. Had surgery in my neck to see how the brachial plexus was, the neurosurgeon said it was 'ok but a bit messy there' but he had electrical stimulus happening around the injured section so nothing else was done except for some "tidying up". A couple weeks after the surgery I had another NCS and I had slight sound/reaction then a few weeks later [the neurologist doing it was saying I was a regular as most people had one at most every 6 months due to the slloooww recovery of nerves as we all probably know of] I had another NCS and I was almost 'perfect' with my sound/reaction to trying to move my injured arm/shoulder.

Still my symptoms were 100% impaired arm (hand was ok, just couldn't move or bend my arm in any controlled manner) but my NCS was almost the same as a 'normal' person. Yet it just didn't translate to me being able to move my arm for about 2 years then I had a late recovery. It's "good enough" for me for day to day living, probably 50%ish of movement in ways but the main thing, I can 'hold my own' when I'm out, people don't immediately see 'fault' in my injured shoulder + arm which is good for my confidence of being out amongst "critical society" *wink wink*. Hopefully this can at least give some help with regards to motivation for recovery? I had 'good' results with regards to tests but my injury was pretty severe, pain wise + lack of movement but it did eventually recover of sorts. I still get some pain but compared to the worst 2-3 years (it's been 4 1/2 years now) I'm on easy street with it. I don't need daily oxycontin, usually winters are bad for pain so just coming off winter now in Australia, I was needing oxycontin most days, we had a cold + wet winter compared to past 10 years down here but the past 2-3 weeks warmer weather has been a godsend.

I wish you well and hope even if you have symptoms/result of the injury, tests are positive may just take time for the actual results to translate to 'life', don't give up, I think that's the worst thing for us, the mental aspect. So I give a huge for you!

[cristinam]

Thanks so much for your responses! Wazza, So glad to hear you got a bit better. Any improvement is good, social awkwardness can be... well, awkward. May have to pass your story on to my docs to show them that we may be just a few, but not everything shows up on EMGs.
I seem to have a lot in common with you, Wazza. I have had 9 EMG/NSC since feb 2008- almost indifferent to them now! haha Some have shown minor deals here and there but overall nothing too far from normal and yet present with pretty severe symptoms.

A bit of a background on my injury, since I have been on here but haven't really shared my story. This all started after a car accident in 2008 (nearing 3 years, (2yrs 8months), in which I was rear-ended. This has led a good number of doctors to tell me it's a psychological. This in fact may be the most 'loss-for-words' moment for me. As someone recently asked what's it feel like to be told that, my response was " it is certainly frustrating, but I feel that those who tell me that don't know where I have been, where I'm at, or where I am going-- so if they want to make a judgment call as such because they don't know, then I guess I will just have to take it and move on." I find it to be an understandable question to ask but not a reasonable attribution or diagnosis.
One downfall is also that my arm has actually gotten worse in the last few years rather than better. My arm now sits incredibly internally rotated, sticks out and shoulder is far forward. So "faults" are immediately noticed.
I have some use of my hand, but with very little strength. 0 active motion in the shoulder and elbow. I can't pronate or supinate the forearm. In Nov 2009 I had my ulnar nerve transposed- I had severe clawing of my ring and pinky fingers w/no movement, they are not normal but significantly better then they were at that point. The bazaar thing about that is until the EMG right before surgery, nothing showed wrong, then it showed some minor slowing and we said it can't stay this way so lets go ahead and do the surgery. When my surgeon got in there he said it should have shown on the EMG a lot sooner and a lot more, my nerve was moderately compressed in two areas around the elbow and had some scar tissue. I guess some things just can't quite yet be given an explanation, nor can they be looked at as simply as black and white.
I am blessed to be able to say that I have found peace in my life and embrace the new perspective that has been given to, as well as just happy to be around which I guess is a big part of what keeps me going and living my life as "normally" as possible. Thankfully haven't come down. Though we all know the ramifications including the typically unnoticed, and pain that come with this. Personally, I am very sensitive to medication so I reached a point where I said I will simply find a way to put up with it (ice packs, heating pads, tens unit). So that's my overview. Not sure what's in store for me in the near future. I pray to God for to show me the way for He has a plan for my life bigger than my own.

Your story Wazza, has given me some more hope and good insight, as well as the other inspiring stories other of you have posted previously. So thank you all . Many blessings to all and a reminder to keep on keeping on !! <3

Wazza I do have a few a questions for you, if you don't mind.
-Would you be inclined to say that your operation had an influence in you getting better?
-When you say 50% better, can I reason that you have control of your arm enough to bend you elbow and say lift your should maybe 90 degrees and keep it unnoticed at your side, ect?
-With the negative EMGs, were you still considered as having a TBPI?

Thanks again! If any of you have any more insights please post them!

[wazza]

Wazza I do have a few a questions for you, if you don't mind.
-Would you be inclined to say that your operation had an influence in you getting better?
-When you say 50% better, can I reason that you have control of your arm enough to bend you elbow and say lift your should maybe 90 degrees and keep it unnoticed at your side, ect?
-With the negative EMGs, were you still considered as having a TBPI?

Hi, glad my post had some (good) effect and hope etc. At moment I'm in the middle of a "runs" episode, not feeling good at all, off to the toilet way too often when culminated in severe vomiting last night. So I won't be doing a detailed post for the time being, feeling too crap (though, getting better today I think! Been off for 2-3 days, hopefully it's a bug and not symptoms of ongoing stomach probs due to the medication).

I'd be inclined to say the operation most likely had negative effect, mentally + physically. Pretty much soon as I had the op, I started getting severe sublaxation of my shoulder/arm, it was visibly "drooped" an inch or two. Plus speaking to a doctor of chinese medicine at a centre I was going to for acupuncture + massage [GREAT for pain relief overall!] had a talk to me and spoke out loud his concerns about what was cut to look at my injury during the surgery. Such as 'just' the skin and stuff was a somewhat major invasive search inside my shoulder, still with this type of injury, exams/tests can't really show any of the medical people what's going on inside until they actually go inside. Still, it was a relief at that time to get surgery and hear the authority in the voices of the medical staff about the problem rather than somewhat educated guesswork/hope on what was going on inside the shoulder.

Around 50% recovery is really hard to define. I've 'lost' my bicep (for time being or long term, no idea of course) so I can't bend/flex my arm in any real controlled manner with regards to bicep, I can do it "the cheats" way but that isn't too beneficial to me in the long run besides the temorary psychological aspect So I can bend my arm but the hand/palm cannot be twisted and must always be facing the sameway, downwards either during the bending or straight arm. I've lost a window of moving which is the upper right hand side of the arm yet if I lie down, I can move it to the 'lost window' side of things. My shoulder still 'sits' wrong, I either have to elevate it by holding on a backpack shoulder strap usually when walking or keep my hand in pants/jeans or jumper pocket as I still don't have that "strength" to keep it holding up against gravity 'nicely'

All since post injury in 2006, I've always been considered TBPI, either the lack of movement and/or atrophy gave the medical people instant 'recognition' something was wrong with the BP due to the immediate history of me and the injury. I still have "half my upper arm" gone, mainly the bicep, I've regained size in it, it's not the 'thin piece of rope' it once was plus you could see the shoulder bones quite easily for a while, I've gained enough size/muscle to give my shoulder something more than 'skin + bone', still not 100% normal for size compared to left but enough to make it not instantly noticeable that something is "wrong". Mainly when I move about or try to use my arm that people then notice something is wrong due to the "wrong" type of way my arm moves, not the controlled manner but the 'straight from point A to B' jerky movements.

Ok, enough typing for me, I'm glad I was a 100+ WPM computer user in the day, wasn't too long to type this post but I'm heading back to the comfy couch until my parents get here so they can babysit our 11 1/2 month old bub whilst my wife goes off to gym for a little. Gotta love the help that my parents have been since we moved back to be near them recently, driving 50-100 kms so they can be help to me/us And they get to see their only grand child is a factor as well. Wishing you the best!

[cristinam]

Oh no! I hope you are feeling better now! I do appreciate your response, though you didn't have to reply immediately. Thank God for parents and family, I would be lost without mine! I'm sure it's great to have them so close now.

Again thanks for your insight. I now more or less understand what you mean by 50% recovery. Hoping you will continue to improve, at least you have seen improvements!
I am the same way in diagnosis- majority have told me you have something wrong with you BP- then there are the one's that look at the EMG and say no (as mentioned in my last post). It certainly tests aside, appears to be.

Well, I need to head off to school now, so I am off for now. Thanks again