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DrBrain
DrBrain, Neurologist
Category: Neurology
Satisfied Customers: 3262
Experience:  Diplomate, American Board of Psychiatry & Neurology
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Constant muscle fasciculations

Resolved Question:

I have spasms in my calves; what can a higher than average Fmin/ms on an F wave and H lat/ms on H reflex indicate on a nerve conduction study?
Submitted: 3 years ago.
Category: Neurology
Expert:  DrBrain replied 3 years ago.

Dr. Amit M. Shelat : Longer than average f-wave latency indicates that the nerve root has some evidence of damage. This can occur because of a pinched nerve or a process that injures the nerves. Prolonged H reflex latency suggests that there is sort of compression of nerve root. Pinched nerve can occur because of disc herniation in lower back. In your case it can occur because of an herniated disc at L5-S1 level.
Customer:

Would a pinched nerve cause constant fasciculation in my calves? I went to the ER and all of my protein levels, hydration, etc were normal but they have been fasciculating constantly for 3 weeks. . .also the tests there noted myoglobin in my urine, between levels 8-9. Will this continue to rise if my muscle continue spasming?

Customer:

on the motor NCS there is a large discrepency between the Amp % between my ankles and knee/fibhead; is this normal? Ankles are 100% while knees are 4.5 and 7.08 and my my Lat ms on my ankles are between 4-5 but on my knees is 15-16 and peroneal is 16-17; what would that indicate?

Dr. Amit M. Shelat : This depends on the severity of the nerve compression. If there is severe compression, it can affect the nerve and subsequently the muscle. Therefore the short answer to your question is yes. You should obtain an MRI of lumbar spine. Low amplitudes and increased further support the idea of a nerve compression.
Customer:

They did an MRI of the lumbar spine in the ER and all it said was L3 on L4 spondylolisthesis and mild arthritis. . .they indicated it doesnt cause lower leg muscle spasms. Also, there was a small area of hyper uptake on my brain MRI near my right spine? They said its not affecting anything yet. . .is my only option more tests?

Customer:

I also have Marfan Syndrome; would that indicate I should expect further deterioration on my spine?

Dr. Amit M. Shelat : Marfan syndrome makes you more susceptible to local nerve compression. The lack of strong connective tissue makes you more susceptible to dislocations and compression injuries.
Dr. Amit M. Shelat : Degenerative joint disease and arthritis is a major problem for patients with Marfan syndrome
Customer:

With all of the tests I have already gotten on my own, would you recommend any others? I will follow up with a neurologist for repeat MRIs of the lumbar spine and brain.

Customer:

In the meantime I have muscle relaxer meds for my legs but want a permanent solution; any recommendations on stopping the fasciculations? they turn into charley horses

Dr. Amit M. Shelat : I think that you should repeat the EMG in one month to see if there is any progression. If there is evidence of muscles getting affected such that they showing spontaneous activity, you should consult an orthopedic spine surgeon.
Customer:

Thank you :)

Dr. Amit M. Shelat : You're welcome. Please click accept if you are finished with all your questions. Thanks!
DrBrain, Neurologist
Category: Neurology
Satisfied Customers: 3262
Experience: Diplomate, American Board of Psychiatry & Neurology
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