Transcribed EMG Sample Reports For Medical Transcriptionists:
DATE OF STUDY:
This is an outpatient 56-year-old female with history of numbness in both lower extremities and both upper extremities, mostly tips of the fingers. She also has history of LS spine disc surgery with continued low back pain.
She was referred for electrodiagnostic testing to rule out bilateral carpal tunnel syndrome and also bilateral lumbar radiculopathy.
In both upper extremities, median and ulnar nerves were tested for motor and sensory responses with F-wave latencies, and in both lower extremities, tibial and peroneal nerves were tested for motor responses with F-wave latencies. Sural sensory nerves were also tested bilaterally. Left H reflex latency was also obtained.
FINDINGS:
Left median nerve motor distal latency 4.42, borderline delayed. Amplitude 15.5, normal. Conduction velocity 47.2, normal.
Right median nerve motor distal latency 4.62, mildly delayed. Amplitude 13.4, normal. Conduction velocity 52.5, normal.
Ulnar nerve findings on both sides are normal.
Left tibial nerve motor distal latency 3.8, normal. Amplitude 21.8, normal. Conduction velocity 35.9, mildly slow.
Right tibial nerve motor distal latency 4.5 and amplitude 19.3, both normal. Conduction velocity 40.2, mildly slow.
Both peroneal nerve findings were within normal limits.
Left median nerve sensory peak distal latency 4.52, mildly delayed. Conduction velocity 31.0, mildly slow. Right median nerve sensory peak distal latency 4.26, borderline delayed. Conduction velocity 32.9, mildly slow.
Ulnar nerve sensory findings were within normal limits.
Sural sensory nerve findings on both sides were normal.
F-wave latencies for all the tested nerves were all within normal limits.
Left H reflex latency is 32, borderline delayed for her height.
IMPRESSION:
1. Mild bilateral carpal tunnel syndrome, right more than the left.
2. Possible early peripheral neuropathy in both lower extremities.
Clinical correlation is recommended.
SAMPLE # 2:
DATE OF STUDY:
This is an outpatient 50-year-old male with history of pain and paresthesia in both upper extremities. He was referred for electrodiagnostic testing to rule out bilateral carpal tunnel syndrome versus cervical radiculopathy.
Median and ulnar nerves were tested for motor and sensory responses with F-wave latencies both sides.
FINDINGS:
Right median nerve motor distal latency is 5.28, mildly delayed. Amplitude 3.68, normal. Conduction velocity 54.1, normal.
Left median nerve motor distal latency is 5.96, mild to moderately delayed. Amplitude 3.97, within normal limits. Conduction velocity 71.0, normal.
Ulnar nerve motor findings, both sides, were normal. Left ulnar nerve sensory peak distal latency 4.1, mildly delayed. Conduction velocity 34.1, mildly slow. Right ulnar nerve sensory peak distal latency 4.98, mildly delayed. Conduction velocity 28.1, mildly slow.
F-wave latencies for all the tested nerves were within normal limits.
IMPRESSION:
1. Bilateral carpal tunnel syndrome, left more than the right.
2. Possible early bilateral ulnar sensory neuropathy.
Clinical correlation is recommended.
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