My EMG exam report, good surprise

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Kiliantkt
Posts: 35
Joined: Mon Jul 27, 2020 10:19 am
Location: Geneva, Switzerland
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My EMG exam report, good surprise

Unread post by Kiliantkt »

Hi guys,

I rarely post here even though I've been reading since July 2019. Like a mad guy the 1st year, a bit less now coz I'm more active on the 2 FB groups. Have PSSD + Anhedonia + Blunted emotions (among other stuff but that's the main issues)

Anyway, for those who are interested, I'm coming back to you with the report from my neurologist in regards to the EMG on the pudendal nerve.

I've translated it as it's initially in french (sorry if not perfect in english). I will also attach the initial PDF*. There's nothing much to point out. However, he mentions PSSD two times on an official report, and this alone is amazing in my opinion. I didn't expect that.

He sent an email with the attachement and briefly said this beforehand (in the email):

"Dear colleague, please find attached, in electronic PDF format, the report of the ENMG examination carried out at your request on Tuesday 10.11.2020 with your patient, Mr. Kilian Redard, 23.11.1989.
Electrophysiological exploration targeting the perineal region does not show any abnormalities, which is what one would expect to find in this type of sexual dysfunction, of a priori central cause (deregulation at the level of neurotransmitters of pharmacological cause) "

Now the report itself:

"Mr. and dear colleague,

Thank you for referring this patient to me. The results of the electrophysiological examination are as follows:

CLINICAL INFORMATION

Loss of sensations in the genitals, decrease in libido, erections and sexual pleasure, ejaculatory pain in the context of post-SSRI sexual dysfunction syndrome. The patient also mentions anhedonia and an increase in the frequency of urination with the need to "force" during urination, but no explanation was found during an urology consultation at the HUG a few months ago. These symptoms appeared 18 months ago, following withdrawal from antidepressant treatment with serotonin reuptake inhibitors.

- Question: verification of the integrity of the peripheral nervous system: ad ENMG perineal.

- Clinically: normal neurological status. Locally: no hypoesthesia in the saddle, no abnormalities of cremasteric and bulbo-anal reflexes, no decrease in sphincter tone.

ABSTRACT

Neurography

- sensitive: normal (left sural nerve).

- motor: normal (left tibial, right pudendal and left pudendal nerves). Note: possible amplitude asymmetry to the detriment of the line of M responses of the pudendal nerves (collected by St-Marks electrode), but notable difficulties in determining the latencies and precise amplitudes of the responses due to the stimulation artifact.

- Sympathetic cutaneous response: normal, with strong habituation to the lower limbs and a low amplitude of responses at the perineal level (compared to those collected from the 4 limbs). Electromyography: See attached table.

CONCLUSIONS

Perineal electrophysiological investigation devoid of significant abnormalities: these negative results therefore tend to confirm the central origin of this sexual dysfunction (with possibly a decrease in the perineal orthosympathetic neurovegetative reaction suggested by the small amplitude of the sympathetic cutaneous response recorded at the scrotal level) .

If anyone qualified can also interpret this, happy to hear your feedback. Even though I'm sure the neurologist knows his sh** 🙂
What do you guys think ?

*HOW DO WE ATTACH A PDF?
PE, ED, Dead Libido, Loss of erogenous sensation, Ejaculatory anhedonia, Burning at ejaculation
General Anhedonia
Severe Blunted Emotions
SSRI & SNRI: 2011-2019
cdraham
Posts: 448
Joined: Thu Jul 04, 2019 10:39 am
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Re: My EMG exam report, good surprise

Unread post by cdraham »

Good news. Looks like down stream neurotransmitter issues are causing the sexual problems. Unlike in PFS where they have pudendus nerve damage by high Allopregnanolone
JP1985
Posts: 201
Joined: Thu May 21, 2020 3:11 am
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Re: My EMG exam report, good surprise

Unread post by JP1985 »

I had one of these too. Here’s mine...

I am referring to your appointment with me in Spire Manchester Hospital on the 10 June 2019. You saw me because of the decreased sensory in your penis.

I then did an MR head which was normal. The MR of your lumbar spine just sowed some wear and wear. I discussed the scans again with my colleagues and the mild compression of the left S1 root would actually not explain your symptoms.

You have now had your pudendal EMG and nerve conduction studies. This was done in Manchester Royal infirmary on the 21 August 2019 and I am really very sorry that this all took so long, but as you probably noticed quite a complex and difficult examination which has to be planned long term and actually only Dr MacDonagh is the consultant who can do this.

We had a look at the results here and the EMG actually showed some chronic neurogenic changes. Therefore, this gave us some evidence that a peripheral nerve problem would cause your problems.
Dr MacDonagh thought that the cause is probably a partial lesion of the lower sacral nerve roots on both sides. However, this is also mild and also could very well recover. I am aware that these have being going on for 2years. Dr MacDonagh and I both agreed that there was definitely no serious nerve or muscle problem causing your symptoms and hopefully this peripheral nerve problem will resolve. There is unfortunately no surgery or another curative treatment which I can think of at the moment.

I am happy to see you at any time again, but I have not arranged another review appointment. If you wish to discuss this further or would like to add further information to your symptoms then please contact my secretary, Jill.

I send you my very best wishes.
Last pill March 2019 - Citalopram for 7 years
Numbed penis and weak orgasm
Fatigue
Slightly blunted
Dizziness (this has improved a lot in the last 6 months)
BruteForce
Posts: 13
Joined: Fri Nov 13, 2020 10:55 am
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Re: My EMG exam report, good surprise

Unread post by BruteForce »

cdraham wrote: Fri Nov 13, 2020 12:23 pm Good news. Looks like down stream neurotransmitter issues are causing the sexual problems. Unlike in PFS where they have pudendus nerve damage by high Allopregnanolone
Where did you find information about pudendus nerve damage by high Allopregnanolone? Can you give any references?
Kiliantkt
Posts: 35
Joined: Mon Jul 27, 2020 10:19 am
Location: Geneva, Switzerland
Contact:

Re: My EMG exam report, good surprise

Unread post by Kiliantkt »

cdraham wrote: Fri Nov 13, 2020 12:23 pm Good news. Looks like down stream neurotransmitter issues are causing the sexual problems. Unlike in PFS where they have pudendus nerve damage by high Allopregnanolone
Yeah or at least something involving the brain, nothing new. Just good to exclude other potential issues.
PE, ED, Dead Libido, Loss of erogenous sensation, Ejaculatory anhedonia, Burning at ejaculation
General Anhedonia
Severe Blunted Emotions
SSRI & SNRI: 2011-2019
Kiliantkt
Posts: 35
Joined: Mon Jul 27, 2020 10:19 am
Location: Geneva, Switzerland
Contact:

Re: My EMG exam report, good surprise

Unread post by Kiliantkt »

JP1985 wrote: Fri Nov 13, 2020 4:17 pm I had one of these too. Here’s mine...

I am referring to your appointment with me in Spire Manchester Hospital on the 10 June 2019. You saw me because of the decreased sensory in your penis.

I then did an MR head which was normal. The MR of your lumbar spine just sowed some wear and wear. I discussed the scans again with my colleagues and the mild compression of the left S1 root would actually not explain your symptoms.

You have now had your pudendal EMG and nerve conduction studies. This was done in Manchester Royal infirmary on the 21 August 2019 and I am really very sorry that this all took so long, but as you probably noticed quite a complex and difficult examination which has to be planned long term and actually only Dr MacDonagh is the consultant who can do this.

We had a look at the results here and the EMG actually showed some chronic neurogenic changes. Therefore, this gave us some evidence that a peripheral nerve problem would cause your problems.
Dr MacDonagh thought that the cause is probably a partial lesion of the lower sacral nerve roots on both sides. However, this is also mild and also could very well recover. I am aware that these have being going on for 2years. Dr MacDonagh and I both agreed that there was definitely no serious nerve or muscle problem causing your symptoms and hopefully this peripheral nerve problem will resolve. There is unfortunately no surgery or another curative treatment which I can think of at the moment.

I am happy to see you at any time again, but I have not arranged another review appointment. If you wish to discuss this further or would like to add further information to your symptoms then please contact my secretary, Jill.

I send you my very best wishes.
Thanks for your answer. I remember reading your story.......in your case it's like good news but at the same time bad news. I really hope time will help you!! Most of PSSD sufferers have negative EMG though.......in all case our symptoms aren't changing at the moment, so same-same no matter what. Stay strong!
PE, ED, Dead Libido, Loss of erogenous sensation, Ejaculatory anhedonia, Burning at ejaculation
General Anhedonia
Severe Blunted Emotions
SSRI & SNRI: 2011-2019
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