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DR. EMAN RAMADAN

EMG EXAMINATION DATE : 5/6/2024 11:26:16 AM DATE OF REPORT: 5/6/2024 11:44:18 AM

PATIENT: ROKIA MOHAMED MOHAMED ADDRESS STREET:

DATE OF BIRTH: 12/12/1948 CITY:
AGE: 75 INSURANCE:
DIAGNOSIS :
ELECTROPHYSIOLOGICAL FINDINGS:
 POOR RESPONSES OF THE SURAL SENSORY RESPONSES.

 REDUCED AMPLITUDE OF THE TIBILAL AND PERONEAL MOTOR RESPONSES.

 SEVERE REDUCED AMPLITUDE OF THE FEMORAL MOTOR RESPONSE BILATERALLY.

 DELAYED BILATERAL TIBIAL F WAVE RESPONSE.

 DELAYED BILATERAL TIBIAL H REFLEX.

 REDUCED AMPLITUDE MEDIAN AND ULNAR MOTOR RESPONSES.

 REDUCED AMPLITUDE OF THE RADIAL SENSORY RESPONSES.

 REDUCED AMPLITUDE OF THE RIGHT AXILLARY MOTOR RESPONSES.

 EMG OF THE VASTUS MEDIALIS AND TIBIALIS ANTERIOR AND BICEPS MUSCLES REVEALED MIX

OF SMALL SHORT POLYPHASIC MYOPATHIC MUAPS AND DISTAL LARGE NEUROPATHIC MUAPS,

WITH FEW ACTIVE DENERVATION POTENTIALS.

 SSEP IS NOT APPLICABLE DUE TO POOR PERIPHERAL CONDUCTION.

CONCLUSION

ELELCTROPHYSIOLOGICAL EVIDENCE OF ACUTE ON TOP OF

CHRONIC THYROID RELATED SENSORY MOTOR (PREDOMINANT
MOTOR) AXONAL POLYNEUROPATHY AFFECTING DISTAL MORE
THAN PROXIMAL IN SYMMETRICAL PATTERN ASSOCIATED WITH
PROXIMAL NEUROGENIC AMYTROPHY, MORE EVIDENT IN BOTH
LOWER LIMB.

NO EVIDENCE OF GUILIAN BAREE SYNDROME.

NO EVIDENCE OF ANTERIOR HORN CELL DISEASE.

DR. EMAN RAMADAN

CONSULTANT IN PHYSICAL MEDICINE, RHEUMATOLOGY AND
REHABILITATION

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MOTOR NERVES STIM - REC LAT AMP CV AMP % DIST

[ms] [mV] [m/s] [%] [mm]
Femoral-Vastus A.Lng.Canal -- -- -- -- --
Medialis-Right B.Lng.Canal - A.Lng.Canal -- -- -- -- --
Notes:
Median-APB-Right Wrist - APB 4.2 1.4 -- -- --
Elbow - Wrist 7.5 0.7 61 -51.6 200
Notes:
Tibial-AH(Knee)-Left Ankle - AH 29.8 0.7 -- -- --
Notes:
Tibial-AH(Knee)-Right Ankle - AH 6.9 0.9 -- -- --
Knee - Ankle 14.9 0.6 44 -33.8 350
Notes:
Tibialis-Left Ankle - AH 7.3 0.7 -- -- --
Knee - Ankle 17.0 0.1 36 -87.1 350
Notes:

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SENSORY NERVES STIM - REC LAT AMP CV DIST

[ms] [µV] [m/s] [mm]
Median-Digit II-Right Wrist - Digit II -- -- -- --
Notes:
Sural-Lat Malleolus-Right Calf - Lat malleous -- -- -- --
Notes:

F-WAVE NERVES M-LATENCY M-AMPLITUDE FMIN F-M F/M

[ms] [mV] [ms] [ms] [%]

Medianus-Right 1.9 0.0 28.5 26.6 25.0

Notes:
Tibialis-Left -- -- 48.7 -- --
Notes:
Tibialis-Right 1.9 4.9 54.2 52.2 75.0
Notes:

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H-REFLEX NERVES M-LATENCY M-AMPLITUDE H-LATENCY H-AMPLITUDE

[ms] [mV] [ms] [mV]
Tibial(Knee)-Soleus-Left -- -- 33.8 --
Notes:
Tibial(Knee)-Soleus-Right 1.8 0.85 33.4 0.14
Notes:

MUSCLE EXAM NOTES

Biceps-Left --
General-Right --
Soleus.-Left --
Soleus.-Right --
Sternocleidomastoid.-Left --
Tibialis Anterior-Left --
Tibialis Anterior-Right --
Vastus Lateralis-Right --

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EMG SCORING
INSERT. SPONTANEOUS ACTIVITY VOLUNTARY ACTIVITY INTERPRETATION
ACTIVITY
FIBRIL. PSW FASCIC. MYOT. MYOK. CRD AMPLIT. DURAT. POLYPH. STABILE IP RECRUIR. EFFORT
Tibialis Anterior - Right
none none none none none none none none none none none none none none
Tibialis Anterior - Left
none none none none none none none none none none none none none none
Sternocleidomastoid. - Left
none none none none none none none none none none none none none none
Soleus. - Left
none none none none none none none none none none none none none none
Soleus. - Right
none none none none none none none none none none none none none none
Vastus Lateralis - Right
none none none none none none none none none none none none none none
Biceps - Left
none none none none none none none none none none none none none none

EXAM FINDINGS AND DIAGNOSTIC IMPRESSION:

SIGNATURE:

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