Type Report Title Here - CloudEMG



5943600-508000Memphis Urgent Care Specialists2200 Universal Drive, Memphis, TN 52134 Phone: 555-650-5216 Fax: 555-564-0336Report:Jane Seagull MERGEFIELD LastName \* MERGEFORMAT MERGEFIELD PatId \* MERGEFORMAT Physician: MERGEFIELD Doctor \* MERGEFORMAT Dr Frank CastellanoAge Range:45Ref Phys:Dr John RainierHeight Range cm:170Technician: Judy C.Gender: MERGEFIELD Sex \* MERGEFORMAT FemaleStudy Date: MERGEFIELD StudyDate \* MERGEFORMAT 2/16/2016LEGENDBorderlineModerately out of normal rangeSeverely out of normal rangeTechnical* SD (Standard Deviation) indicates how far the patient's conduction values vary from normal. Values below -2.5 are considered abnormal.NERVE CONDUCTION STUDYMotor NCSNerveSideStimulation SiteDist.,cmLat.,msLat.,SDAmp.,mVAmp.,SDVel., m/sVel., SDR Peroneal MotorRightankle73.651.819.182.54L Peroneal MotorLeftankle74.30.644.24-0.87R Tibial MotorRightankle145.9-0.692.13-2.39L Tibial MotorLeftankle146.5-1.52.23-2.36* Middle & proximal site distances vary by patient therefore normals data is not available for these parametersSensory NCSNerveSideStimulation SiteDist.,cmLat.,msLat.,SDPkLat.,msPkLat.,SDAmp.,?VAmp.,SDPkVel., m/sPkVel., SDR Sural SensoryRightcalf141.53.993.551.0926.541.7139.440.98L Sural SensoryLeftcalf141.03.993.80.3343.543.2636.840.21F-WavesNerveMin,m/sMin, SDMean, m/sMax,m/sR Peroneal Motor48.2-2.1953.4553.45L Peroneal Motor51.3-3.4460.8560.85R Tibial Motor52.65-2.2859.6559.65L Tibial Motor53.75-2.6358.4558.45HReflex NCSNerveSideStimulation SiteDist.,cmLat.,msLat.,SDAmp.,mVAmp.,SDR H-ReflexRightpopliteal33.15-3.991.96-1.05L H-ReflexLeftpoplitealNR-4.0NR-3.99Referral Diagnosis: Chronic low back pain for 5 years.Patient now complains of new left lower extremity weakness, numbness and tingling.No recent trauma.FindingsThe findings of this nerve conduction examination suggest the following. Clinical correlation with the patient's symptoms and examination is indicated to confirm these findings:Right and Left L5-S1 Radiculopathy 1) Prolonged Right H-Reflex Latency at 33.15 ms 2) Un-recordable Left H-Reflex Latency 3) Prolonged left Tibial and Peroneal F-wavesThe Electrodiagnostic results in this report are meant to supplement the patient examination and be reviewed by a qualified healthcare provider and are not a substitute for the professional judgment of the healthcare professional in diagnosing and treating patients. This impression was generated by a computer analysis and each potential finding identified should be clinically correlated by a qualified healthcare provider. This computer analysis does not imply that all listed findings are clinically relevant given that some recordings may be deemed a technical artifact and excluded from calculations. The clinical diagnosis can only be made by the treating physician in the context of the patient's other symptoms and findings. MERGEFIELD Doctor \* MERGEFORMAT Dr Frank CastellanoNERVE CONDUCTION ANALYSIS DETAILThe findings of this nerve conduction examination suggest the following. Clinical correlation with the patient's symptoms and examination is indicated to confirm these findings:1) Right and Left L5-S1 Radiculopathy Lumbo-sacral root lesions are most frequent in the L5-S1 distribution, the intervertebral space between the lumbar and sacral vertebrae. They are typically caused by compression of the nerve root as it exits the spinal canal and cause a great deal of low back pain with radiation to the affected limb(s) and loss of reflexes, and weakness. Their onset is usually acute, following an injury, or can come on as an aggravation of an old back injury. Treatment should address the cause, and in the beginning, consists of an anti-inflammatory drug regimen and analgesics, accompanied by traction if indicated. When symptoms do not subside within months or significantly interfere with function, and imaging shows a well defined lesion, surgery is indicated.The Electrodiagnostic results in this report are meant to supplement the patient examination and be reviewed by a qualified healthcare provider and are not a substitute for the professional judgment of the healthcare professional in diagnosing and treating patients. This impression was generated by a computer analysis and each potential finding identified should be clinically correlated by a qualified healthcare provider. This computer analysis does not imply that all listed findings are clinically relevant given that some recordings may be deemed a technical artifact and excluded from calculations. The clinical diagnosis can only be made by the treating physician in the context of the patient's other symptoms and findings.Dr Frank CastellanoMotor WaveformsL Peroneal MotorR Peroneal MotorLat., msAmp., mVVel, m/sDistal4.34.24Lat., msAmp, mVVel, m/sDistal3.659.18L Tibial MotorR Tibial MotorLat., msAmp., mVVel, m/sDistal6.52.23Lat., msAmp, mVVel, m/sDistal5.92.13Sensory WaveformsL Sural SensoryR Sural SensoryLat., msPkLat., msAmp., ?VVel, m/sDistal1.03.843.54Lat., msPkLat., msAmp, ?VVel, m/sDistal1.53.5526.54F-WaveformsL Peroneal MotorR Peroneal MotorFWMin, m/sFWMean, m/sFWMax, m/s51.355.2560.85FWMin, m/sFWMean, m/sFWMax, m/s48.250.5553.45L Tibial MotorR Tibial MotorFWMin, m/sFWMean, m/sFWMax, m/s53.7556.4258.45FWMin, m/sFWMean, m/sFWMax, m/s52.6555.859.65H-Reflex WaveformsL H-ReflexR H-ReflexNot RecordableLat., msAmp, mVVel, m/sDistal33.151.96Exam Results DetailsLower NervesFigure 3 – Lower RightPeripheral Neuropathy Score: 0.32 1. R Peroneal Motor F-Wave Latency appears to be borderline 2. R H-Reflex Latency appears to be severely outside of normal rangeFigure 4 – Lower LeftPeripheral Neuropathy Score: 0.53 1. L Peroneal Motor F-Wave Latency appears to be moderately outside of normal range 2. L Tibial Motor F-Wave Latency appears to be moderately outside of normal range 3. L Sural Sensory Peak Latency appears to be borderline 4. L Sural Sensory Peak Velocity appears to be borderline 5. L H-Reflex Amplitude appears to be severely outside of normal range 6. L H-Reflex Latency appears to be unrecordableGSR EXAMSideLat. Hd(s)Lat. Ft(s)Lat. Diff(s)Amp. Hd(mV)Amp. ft(mV)Amp. Diff(mV)Hand-FootLeft0.014.244.234.880.254.63GSR Results SummarySeveral abnormalities were found suggesting the presence of a small fiber neuropathy: 1. The left foot latency was prolonged (hand-foot test). 2. The left foot amplitude was decreased (hand-foot test). 3. The left hand-foot latency difference was prolonged (hand-foot test). The Electrodiagnostic results in this report are meant to supplement the patient examination and be reviewed by a qualified healthcare provider and are not a substitute for the professional judgment of the healthcare professional in diagnosing and treating patients. This impression was generated by a computer analysis and each potential finding identified should be clinically correlated by a qualified healthcare provider. This computer analysis does not imply that all listed findings are clinically relevant given that some recordings may be deemed a technical artifact and excluded from calculations. The clinical diagnosis can only be made by the treating physician in the context of the patient's other symptoms and findings.GSR Left Hand-FootFigure 1 - Left Hand-Foot Lat1. L hand latency appears to be normal. (0.01 seconds < 1.6 seconds)2. L foot latency appears to be abnormal. (4.24 seconds > 2.6 seconds)3. L hand-foot latency appears to be abnormal. (4.23 seconds > 1.4 seconds)Figure 2 - Left Hand-Foot Amp1. L hand amplitude appears to be normal. (4.88 mV > 1.8 mV)2. L foot amplitude appears to be abnormal. (0.25 mV < 0.8 mV)3. L hand-foot amplitude appears to be normal. (4.63 mV < 7.5 mV)NEEDLE EXAM SUMMARYMuscleSideSpont Act.MUP AmplitudeMUP DurationMUP PolyphasicsEDB Right - Extensor digitorum brevis, Ischiadicus, L4-S2RightNormalNormalNormalNormalL3-L4 Right - Lumbo-Sacral Paraspinals L3-L4RightNormalNormalNormalNormalL4-L5 Right - Lumbo-Sacral Paraspinals L4-L5RightNormalNormalNormalNormalL5-S1 Right - Lumbo-Sacral Paraspinals L5-S1RightNormalNormalNormalNormalLG Right - Gastrocnemius, Tibial S1-S2RightNormalNormalNormalNormalMG Right - Gastrocnemius, Tibial S1-S2RightNormalNormalNormalNormalTA Right - Tibialis anterior, Peroneal, L4 L5 s1RightNormalNormalNormalNormalVL Right - Vastus lateralis, Femoral, L2-L4RightNormalNormalNormalNormalEMG Impression Summary: The findings of this needle examination show the following:1. No abnormalities found.The Electrodiagnostic results in this report are meant to supplement the patient examination and be reviewed by a qualified healthcare provider and are not a substitute for the professional judgment of the healthcare professional in diagnosing and treating patients. This impression was generated by a computer analysis and each potential finding identified should be clinically correlated by a qualified healthcare provider. This computer analysis does not imply that all listed findings are clinically relevant given that some recordings may be deemed a technical artifact and excluded from calculations. The clinical diagnosis can only be made by the treating physician in the context of the patient's other symptoms and findings.Needle Exam MusclesExtensor digitorum brevis, Ischiadicus, L4-S2Lumbo-Sacral Paraspinals L3-L4; Lumbo-Sacral Paraspinals L4-L5; Lumbo-Sacral Paraspinals L5-S1Gastrocnemius, Tibial S1-S2Gastrocnemius, Tibial S1-S2Tibialis anterior, Peroneal, L4 L5 s1Vastus lateralis, Femoral, L2-L4 ................
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