rypz79

Hello Dr. Corenman,

I’ve read in this blog
https://www.huffpost.com/entry/nerve-injury-types-and-re_b_13008678
That fibrillation is only seen when there is an axonal injury. Thus when there is no indication of fibrillation on the EMG test it’s likely to be damage to the myelin sheath only.

1) Is that correct? Couldn’t find any reference for that in your article
https://neckandback.com/treatments/ emgncv-electromyograms-and-nerve-conduction-studies/

2) Is Neurapraxia essentially an interruption in the conduction of the impulse down the nerve fiber due to myelin sheath damage only with no axonal damage involved?

3) Can / is it common for Neurapraxia to occur due to a compression from disc herniation with symptoms of radiculopathy?

4) With almost no motor loss do you recommend me doing an EMG/NCV test (the surgeon told me couple of days after the surgery that it’s irrelevant)?

Thank you very much Dr. Corenman

Hello Dr. Corenman,

Well since my month post-op visit this coming Wednesday have been canceled due to the covid-19 closure here and since EMG/NCV tests are not very useful for sensory/pain I did some testing on my own.

It turns out that my L5 dermatome area on my right foot (inner and outer surface) is not numb per say there is a little loss of sensation compared to my left foot so when I pinch it with a nail or when standing on a cold floor or with feeling of hot water in the shower they feel the same.

I also found out that when I sit on my knees “choking” the blood supply for both legs the left one takes 10-15 seconds to “wake up” with the normal sensation of an awakening limb while in my right feet there is no such sensation.

It feels like one foot is getting less electrical charge then the other and when both at rest feels a bit colder.

Can I conclude something from these findings about my nerve damage and my recovery chances from this radiculopathy?

Thank you very much Dr. Corenman

If the nerve root is inflamed, pushing and pulling it (walking and flexing the hip) will aggravate it.

In general taking strong NSAIDs (e.g Etodolac 400-800mg) as needed can slow / can increase / doesn’t affect the nerve healing process or in other words does inflammation can slow / can increase / doesn’t affect the nerve healing process?

When you mention dermatome, you are talking about pain and sensation (numbness). This is different that a “myotome” which indicates muscle strength…

So essentially every remote (more then 18 inch away from the disc herniation) motor loss, even partial (weakness) is unrecoverable even if the decompression surgery occurs at the time of the herniation?

I’m a little confused and probably don’t fully understand this. Assuming this in not Functional Compression Nerve Block does sensory loss (pain, numbness, burning sensation, pins and needls) falls into the Functional Myelin Injury Nerve Block which recovers between 4-12 weeks from the decompression surgery even if the sensory tissue is remote? or the 12 months recovery time applies also for remote sensory tissues?

(PS in the nerve damage & healing article
it’s named Injury to the Myelin Sheath Only with 8-14 weeks of recovery time not 4-12 weeks but again I might be mixing things)

Thank you very much Dr. Corenman