MRI, Nerve Conduction Study, and EMG
MRI, Nerve Conduction Study, and EMG Update
Update: This article was originally posted late 2008 - so advancements may have taken place to make the mentioned tests less invasive. I am not a doctor and I do not recommend taking my advice or anyone else's in the comment section on any medical issue. If your personal doctor feels you should have any test you should follow his or her advice. The purpose of this article is to offer my experience and opinion of the procedures.
A few years ago I began exhibiting numerous odd symptoms. My doctor and I both thought the symptoms to be neurological in nature. I underwent numerous tests to determine exactly what was going on with me physically. I had two MRI's, a nerve conduction study, and an EMG. I would like to share those experiences with you to help you better prepare for similar procedures.
An MRI is performed to differentiate between pathological tissues and normal tissues within the body. It is also used to monitor the neurological, cardiovascular, and musculoskeletal systems of patients. I had an MRI (magnet resonance imaging) performed about a year ago. As a matter of fact, I had two of them. I had an MRI of my brain and an MRI of my cervical spine. Both times, I had to lay on my back on a very narrow table that slid into a thin tube. The MRI procedure is completely painless but may cause mental distress to those who are unable to be in small, tight spaces for an extended amount of time. If you are one of the many people who is unable to tolerate small, closed spaces you can ask your primary care physician to give you something to help with anxiety during the MRI. For the MRI of my brain a small plastic "cage" that looked like a miniature milk crate was placed over my head. It did not cause any discomfort and I did not even realize it was in place once I closed my eyes. (My technician told me to close my eyes before she slid me into the tube to reduce anxiety and told me to keep them closed for the entire time I was in the tube.) I was in the MRI machine for an hour and a half for the brain scan. The machine made all kinds of strange noises in surround sound. Some sounded like a xylophone, others sounded like chartoon-ish aliens arguing, and others sound like the soft, rhythmic beat of a distant drum. The repetitive sounds actually put me in a semi-conscious state of mind when I focused on them too intently. The radiologist told me to stay completely still so I would not blur or mess up any of the images. Sometimes the noises in the MRI were so strange it was difficult not to smile or laugh, which made it even more difficult not to move. Don't confuse the previous statement to sound like I enjoyed the experience. Rather, I am one of those people who needed anxiety medication due to the small, cramped tube. I am also fidgety and it was difficult to hold still for so long. My second MRI for my cervical spine only took about 30 minutes and the machine made the same odd noises and I had to hold still again. I did not require medication the second time because I knew it would be for a much shorter duration.
Note: I do not have experience with these types of MRI's, but there are open MRI's for those people who do not fit into a MRI tube or who cannot tolerate being in the MRI tube.
The Nerve Conduction Study
The nerve conduction study has an ominous sound to me, like an evil scientist's experiment. The test name also makes me think of human torture techniques that must have been used on criminals in the dark ages. However, getting shocks of electricity sent through your nerves is not nearly as painful as one may think. A nerve conduction study is often performed to help diagnose issues with the nervous system. Electrical currents are used to measure the electrical activity traveling between your brain and your nerves. The current used is much less than what powers your home and the study only produces mild discomfort in my opinion. The feeling is akin to hitting your "funny bone" again and again in different areas of your body, depending on where the technician is placing the device that transmits the current. While indeed an incredibly annoying feeling, I was not in any pain during the procedure.
I had the nerve conduction study performed a year ago for peripheral neuropathy and I was terrified before I got to the appointment. However, the test was not nearly as bad as I had feared. The technician gave me a gown to wear and I had to lay flat on an examination table. The room was dimly lit and very quiet to ease my nerves, please pardon the pun. The technician rolled a cart over to the table and showed me the device she would use to stimulate my nerves and to measure the activity taking place between each nerve and my brain. The test was performed on both sides of my body along my arms and legs. The first series of currents were a mild tingle. As the test went on, the technician increased the current until my extremities were twitching with each shock. As stated earlier, the shocks did not hurt, not even at their strongest point. The feeling was weird indeed, but not painful. While having the test performed, I envisioned someone plucking each of my nerves like one plucks the strings of a guitar. After the test I did not have any lasting effects and I spent the rest of the day as usual, playing with my kids.
An EMG (electromyography) is used to measure the electrical activity of muscles. The test is used to diagnose maladies that affect the proper function and/or strength of muscles. A neurologist performs the test and inserts a fine, wire electrode through the skin and into the muscle using a long needle. If you have ever had a shot that hit the muscle, you know that it hurts like crazy. An EMG is no different.
I had an EMG a year ago, and before I went for the appointment I researched the topic on the Internet. I found medical information and procedures for the test all over the place. What I did not find, and what I was looking for, was a personal account of the test to help me prepare for it. After my test, I understood why I did not find a personal account. Surely all the neurologists spend their evenings finding such accounts and erasing them from the face of the Earth. Otherwise, nobody would ever have the test performed. Before I go further I want to say that if you are going to have the test and you are not prepared for the truth, do not continue reading this. An EMG does provide the neurologist with invaluable information if you do indeed have decreased muscle function and it can be an important part of your care.
Following is my personal account of having an EMG done. It is not nice, I am going to be brutally honest, and it may scare you away from the test if you are about to have one. Scaring people is not my intention at all. I simply want to provide information for people who truly want it. I was not prepared for my EMG because I could not find similar information. That said, even if I had found the information, I still would have gone for my test, because the information provided at the appointment was extremely important to my health.
The EMG I had was performed on the entire left side of my body from shoulder to foot, including my hand and arm. For the test, I had to change into a hospital gown and rest on my side, facing away from my neurologist. The first needle went into my calf. I could hear what sounded like an out of tune radio trying to come in clear. The neurologist turned the needle inside my muscle and it was very painful, but tolerable. The pain only lasted a moment before the neurologist pulled the needle out of my muscle. The second needle went into the outer arch of my foot and I barely felt it go in. I was later told the more muscle you have, the worse the EMG hurts. Evidently I don't have any muscle in that part of my foot. I don't remember where all the rest of the needles went, but I do remember getting one in my left hand and one in my lower back on my left side. If you are going because you think you may have carpal tunnel syndrome, don't worry too much about the EMG. The needle in my hand was placed into the meaty area between my pointer finger and thumb - and it didn't hurt much at all. While I do not have carpal tunnel syndrome, I have read that it causes the muscles in your hand to deteriorate. Keeping in mind the statement that the EMG needle hurts more when you have more muscle, it only makes sense that an EMG for carpal tunnel syndrome would not be very painful. However, the needle that went into my lower back is a completely different story. The actual insertion of the needle into the skin is not what truly hurt; it was every turn of the needle the neurologist made while inside my muscle that threw me into a panic. After what seemed like hours, but was really only seconds, my body reacted instinctively to the intense pain and my fist shot out at my neurologist. Luckily, I only made contact with the cart because my neurologist saw me coming and had time to roll his seat back. At that time, I decided I was finished with the test and my neurologist agreed with me. The test results came back within normal range, so I feel as though I went through the test for no reason and I hope to never have to go through the test again because it was the most painful experience I have ever been through. On the other hand, I am glad I had the test to rule out what was originally suspected.
It is my hope that this information gets to patients who feel the need to prepare for similar tests. I often ease my anxiety of something by learning as much as possible about that thing. Since I was unable to find honest and accurate information about the above procedures, it is my desire to offer that information to others.