neuropathy/vasculitis with normal EMG/NCS?

[kellymdempewolf]

I had and EMG/NCS today which were "normal" but yet I still have very concerning neuropathy/fine motor skill loss/weakness concerns (you can read the details in my blog entry *neuropathy-testing-emg-ncs-a-very-frustrating-experience-with-a-doctor/* that I wrote today)

Anyone have normal EMG/NCS but go on to have biopsy and find vasculitis?

[litliwlowa]

My EMGs and NCS are always normal. I think only once came back with mild cubital tunnel syndrome. I think they only test the major nerves. However, as you know from personal experience, norm on those doesn't explain the symptoms you're experiencing. I've lost a lot of my fine motor skills over the years. Yet EMGs and NCS come back normal. I can't do a simple walk like one foot in front of the other on a line for years. Yet EMGs and NCS lower limbs also come back normal

I read your blog post on this experience. Sounds like the doctor/specialist who performed the studies has his own "issues". Some docs are like that unfortunately. Like we woke up that morning stupid or something, so they talk down to you as though you're a child. Those are the doctors I shake the dust off my feet when I leave and find another one.

As for vasculitis? My gastro is convinced I have vasculitis, which can be another "friend" sjogrens brings to the party. She's seen how the veins swell up really huge for no reason and my skin changes colour at the same time. When I advised her that rheumy poopoo'd that as no way, since I don't have the rash that usually accompanies it, she said vascular doc is the one to bring that up with - not rheumy. So I see my vascular doc in December.

Keep pounding the pavement for answers. It's not your imagination that something is going on with your body.

[sarahjane]

I had a nerve conduction study in January which confirmed my neuropathy. According to the neuro the cause was vasculitis and not sjogren's. Rheumy initially poo poo'd that idea but has changed that since I developed subcutaneous nodules which are being biopsied next week. Have you considered a biopsy of the affected areas? They can do this on the nerves involved.

[Chris]

I had a skin biopsy which confirmed small fiber neuropathy along with a sweat test. My EMG was normal....
My muscle biopsy just confirmed neurogenic atrophy which means the nerves going to the muscles are damaged.

[lighthouse33]

I found this during my research yesterday.  Neuros perform this test to diagnose small fiber neuropathy when the nerve condition test results are normal.  This is something I had not heard about.  Read below:

Quantitative Sudomotor Autonomic Reflex Testing (QSART)

QSART is used to diagnose:

Painful small fiber neuropathy when nerve conduction test results are normal

Disturbances of the autonomic nervous system, which controls the sweat glands, heart, gastrointestinal tract, other organs, and blood pressure

Complex regional pain syndrome or reflex sympathetic dystrophy.

The focus of QSART is the small nerve fibers which go to the sweat glands. The test site is usually on the patient?s foot, leg, or forearm. A capsule is placed over the skin on the test site. The technologist stimulates a nearby sweat gland by delivering a chemical through the skin, electrically. The patient feels warmth, but no electric shock. The effect of the chemical lasts for approximately five minutes. During the test, the amount of sweat under the capsule is measured at various times. A computer analyzes the results, determining how well the sweat gland functions and how well the nerves functioned to help the gland release sweat at a ?normal? time.

http://www.neurology.upmc.edu/neuromuscular/patient_info/testing.html