Topic: Who has had Nerve Conduction Velocity Test (NCV)
springshowers
Frequent Contributor (1K+ posts)
Member # 19863
posted
How was it? Did they do the electromyogram (EMG) along with it too ? I read the EMG is normally done with the NCV test and that the EMG Is painful?
Anyone with experiences here on Either or both?
Posts: 2747 | From Unites States Of America | Registered: Apr 2009
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posted
I had am emg many years ago and didnt know they were gonna shove needles in my elbows and hands etc. The jolts from the prod were enough then the needles came out.
They want me to do another since my hands and feet are tingling but no thanks....
-------------------- Diagnosed with chronic neuro lyme 12/10 after 30 years of vertigo.2 tick bites in 3 yrs from upstate NY. Was on omincef for nine mths..zith and rifampin stopped.Remission~ All the pain and symptoms are back and I am not treating now with biaxin. Posts: 788 | From New york..queens | Registered: Nov 2010
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springshowers
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Member # 19863
posted
I am not sure I am going to let them do the tests at this point..
Thinking it over
Posts: 2747 | From Unites States Of America | Registered: Apr 2009
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IckyTicky
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I did, back in December. It really wasn't so bad. I was bracing for something horrendous but it was very do-able. Not fun..but not excruciating or anything.
-------------------- IGM: 18+, 23+, 30+, 31+++, 34+, 39IND, 41++, 58+++, 66+, 83-93IND IGG: 31+, 39IND, 41+ Also positive for Mycoplasma Pneumoniae and RMSF. Whole family of 5 dx with Lyme. Posts: 1014 | From Texas | Registered: Jul 2009
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posted
I had both of them done in march before I was officially diagnosed with Lyme.
For me, they were ruling out ALS, as well as looking for MG. (Before I was diagnosed with lyme they looked at MG, MS, ALS, Cancer, and Pseudo-Tumor Cerebri all very seriously. Plus lots of others they considered for a short while.
Also in a way, I know that they were looking to see if they could medically prove that the symptoms I was experiencing were true... that they were actually happening. Sad but true.
I had intermittent severe muscle weakness, tingling, and numbness. Started on my left side and then went to my right side. was both arms and legs. But they only tested my arms.
My results were all normal.
It wasn't a pleasant expierience, but I've been through MUCH worse. I expected it to be much worse than what it was.
I would be asking your doctor what knowledge they are hoping to gain from the test? What are they suspecting? What are they trying to rule out?
-------------------- 10/10 EIA 1.4+, 41 (IGG), 23 (IGM) Bitten over 20 years ago. Currently not treating, looking for a Dr who will work with my insurance lol.
More muscular, cognitive, nerve issues than joints. Facial droop and blurred vision. Posts: 323 | From Michigan | Registered: Apr 2011
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posted
I think it depends on the practitioner. I had one done and it wasn't too bad since I knew what was going to be done. Then later another one done by a workman's comp dr who was unnecessarily rough.
Posts: 857 | From northern california | Registered: Dec 2009
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posted
yes, emg hurt, NCS aint so bad. Mine was normal too despite my right arm and hand being really atrophied. Those are just for large fiber nerves, small fiber neuropathy can still be happeneing. I think they need a biopsy for that.
Posts: 105 | From Ca | Registered: Mar 2011
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scorpiogirl
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Member # 31907
posted
I had both done last May, they were ok... no big deal and that's coming from a big wuss!!
I think they did the tests to try to figure out my peripheral neuropathy. That was before I knew I had Lyme and Cos.
My tests were all normal! Go figure!
-------------------- Posts: 1391 | From Lyme Land | Registered: May 2011
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springshowers
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Member # 19863
posted
So. Oh. Now has everyone who has done the tests come up negative? Who had neuropathy due to lyme?
Maybe when it comes from Lyme for whatever reason it shows up negative. Even though we have symptoms.
So it could be not from damage but from either blood flow or nutrient deficiencies or from parasites etc..
SO if you have the symptoms from these sorts of things is is not really "damaged" And though it feels the same ?
Does that make sense?
Has anyone had a real positive test. i am told this doctor I am seeing is supportive and knowledgable of lyme disease etc.
There must be some lyme people who have had progression of the disease or the disease that has gone into the nerves causing real damage. Right?
If nobody here has had a pos test I a suspect and i wonder if the test is even useful at all.
My understanding of the test is to rule out nerve damage as opposed to the symptom coming from other causes such as I listed and maybe others..
Posts: 2747 | From Unites States Of America | Registered: Apr 2009
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springshowers
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Member # 19863
posted
SO On the test description I find this funny
"A normal body temperature must be maintained for the nerve conduction velocity test test, because low body temperatures slow nerve conduction."
Lots of lyme patients suffer from low body temp. The sicker I am the lower my temp is and as I feel better and improve it normalizes. Always still waxing and waning but I found this comment to be interesting..
And I am surprised there are not a lot of positive results for this test from those who have the symptoms.. But then again. I guess not. Its odd.
I assume everyone is assuming their symptoms will improve as they treat the disease.?
Posts: 2747 | From Unites States Of America | Registered: Apr 2009
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posted
I've had several EMGs done because of my severe carpal tunnel. During the last one I had done, the technician kept tapping the wires because he thought something must be wrong. He kept giving me more and more juice, apologizing profusely for the discomfort he was causing me. Each increment hurt more than the last.
Finally, he discovered the problem. My disease was so bad that he had to use a ton of current just to get a reading. He said it was the worse case he'd ever seen, about a 9.5 out of 10.
That said, it's not excruciating pain or anything, just a very annoying shock that only lasts for a second or so. Nothing that anybody but a first class whiner would freak out about.
Posts: 50 | From Saratoga Springs, NY | Registered: Jun 2011
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posted
Springsshowers, I had a profound "buzzy" feeling come into my hands because of the Lyme. It feels very different than the Carpal Tunnel pain and numbness (which is always a sign of real nerve damage), in that it effects the entire hand rather than the thumb, index finger and inside of the middle finger of CTS (caused by compression of the median nerve). I imagine that the Lyme symptoms can be present without any actual damage to the nerve.
Now that my Lyme buzziness has resolved, my hands feel "normal" again (well, normal for me) - even though I am 100% positive that I still have severe nerve damage because of the long-term CTS (25 years now).
I suspect that some of the peripheral neuropathy from Lyme is occurring at the nerve root, near the spinal cord, and not along the nerve itself. Not sure how they could place the probes to measure that.
Posts: 50 | From Saratoga Springs, NY | Registered: Jun 2011
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posted
I had the tests as well, and as others have posted, I came out with normal results. What was good was to have things like ALS ruled out. The tests are not pleasant, but they are not long.
Posts: 447 | From Vermont | Registered: Jan 2011
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springshowers
Frequent Contributor (1K+ posts)
Member # 19863
posted
So far from my first evaluation doctor says i most likely have Small Fiber Peripheral Neuropathy.
And they want to do the two tests but say that those will most likely be negative and that will mean he is right with his diagnosis. So these tests will be negative with the small fiber diagnosis. Then will do a skin biopsy which should then show positive. ALso though my back has been bothering me and I have herniated disks and degenerative disk disease and have had multiple epiderals over the past 5 years that have saved me from lots of suffering. It seems to be coming back on strong and they want to test those areas too during the test related to other areas of the body.
I am not sure the tests are even necessary. Also though they want to do more testing around blood sugar as diabetes is in the family and I have had high glucose levels through the years but was told I am hypo glycemic and those never made sense to me. But they said these symptoms can be a pre curser to one of he types of diabetes and forgot now but I think type II.
OF course checking on Vitamin B levels blood test.
Sometimes I think tests are overkill. I went into a GI Doc once and all he did was order six tests and said to go do them all and then make an appt and come back. I mean it was upper lower and side ways and digestive monitoring and and and... They got more and more invasive and painful and hard to sit through and I was on the third and said Heck with this. I diagnosed myself and treated myself and did not have the repeated acute infections and hospitalizations ever again. I do not think we need all the tests all the time. I think it may help with medical coverage or continued disability.
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springshowers
Frequent Contributor (1K+ posts)
Member # 19863
posted
Small fiber peripheral neuropathy is a type of neuropathy. It is also called a small fiber neuropathy, small fiber sensory neuropathy (SFSN) and C fiber neuropathy.
Naming due to pathology
This type of neuropathy is named after the specific portion of the peripheral nervous system that is affected. Small nerve fibers are the nerve fibers near the skin's surface that carry sensation. They are unmyelinated (meaning they don't have a fatty layer of insulation), and conduct slowly. They carry mostly pain and temperature sensation. Nerves to muscles and other sense organs (like pressure touch) are usually myelinated, conducting faster.
Symptoms
The key symptoms are insensitivity to heat and/or cold. There may be other neuropathic symptoms which are common to all polyneuropathies, such as tingling, numbness, muscle weakness, cramps, pain and other symptoms. People describe the pain as an "ice pick being poked into bone", "like an electric shock", "or walking on broken glass". In some cases, the pain causes a loss in the ability to feel when injury occurs, so one may be bleeding or have a skin injury without even knowing it.
Topographic pattern
Like many polyneuropathies, the symptoms usually start in the longer nerves and progressively attack shorter nerves. This means that most often the symptoms start in the feet and progress upwards, and usually symptoms are more severe in the feet. However, patients with Fabry disease have isolated small fiber engagement, and can have a more widespread small fiber disruption.
Diagnosis
This neuropathy is considered a separate clinical entity from a regular large-fiber polyneuropathy. Small fibers are difficult to diagnose. The diagnosis of a large-fiber (common) polyneuropathy is much easier. Many large-fiber polyneuropathies have minor small-fiber engagement, and small-fiber engagements are often implied if the patient has minor small-fiber symptoms in addition to large-fiber symptoms. The clinical picture of an isolated small-fiber neuropathy is characteristic, but the diagnosis is not always easy.
It is often a disorder diagnosed by ruling out everything else. In fact, nerve conduction tests and electromyography (EMG tests), which are good in diagnosing other neuropathies, are usually bad in detecting small fiber neuropathies. Quantitative sensory testing (QST) can be used to measure more objective changes in the temperature sensation. An elevated heat-detection threshold, heat-pain threshold, a reduced cold detection threshold or cold pain threshold may indicate a small-fiber neuropathy. A conventional nerve biopsy is not useful, since in this procedure mostly large-fiber nerves are studied. A skin biopsy (with the measurement of intraepidermal nerve fiber density) can be used for a diagnosis, but is not commonly available. This test allows for direct visualization of the un-myelinated nerve fibers (the "small fibers") in the epidermal layer of the skin, and requires taking a small skin sample.
Causes
The classic example of a small fiber neuropathy is Fabry disease. Sometimes the disorder is caused by diabetes, HIV, Erythromelalgia, postherpetic neuralgia, CRPS, alcoholism, and many other nerve pain conditions; its cause is also commonly idiopathic. Since there are no known causes for most cases and most tests do not identify it, not much money is spent on curing idiopathic cases.
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