Make Pain a Thing of the Past – EMG – Physician Partners of America

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Idiopathic intracranial hypotension, sometimes known as pseudotumor cerebri, is a condition that causes pressure inside a person’s head even though there is no brain tumor or other discernible reason for the pressure.

Though idiopathic intracranial hypotension is a rare condition, with fewer than 200,000 diagnoses in the U.S. each year, the people who do have it experience symptoms similar to a brain tumor, which can make life more difficult.

For example, idiopathic intracranial hypotension could cause painful headaches or problems with vision, including temporary blindness. These symptoms can cause a disruption in your life, making it difficult to drive, work or enjoy your usual activities.

The word “idiopathic” indicated that the cause of intracranial hypotension is not known. However, there are treatments that can help.

Symptoms of Idiopathic Intracranial Hypotension

As mentioned, idiopathic intracranial hypotension has symptoms that are similar to those you see in someone with a brain tumor. The pressure inside a person’s head increases with idiopathic intracranial hypotension. However, there is no tumor in place to cause these symptoms.

The symptoms may include blurry vision or double vision. Some people may experience temporary loss of sight. There may be periods of dizziness, nausea or episodes of vomiting.

You may also experience hearing a ringing in the ears, sometimes corresponding to your heartbeat. Some people may have a hard time concentrating or a stiff feeling in the neck.

Headaches are one of the most common symptoms in people with intracranial hypotension. The headache is usually behind the eyes. These headaches may be severe, especially when standing upright and are often are not as bad when the person is lying down.

Some people describe the pain as throbbing, others do not. The pressure can feel like a weight pressing down on the head or a feeling like something is pulling from the skull down through your neck.

Idiopathic intracranial hypotension is most commonly found in obese women, particularly those who are old enough to have children. Weight loss may help to relieve the symptoms of idiopathic intracranial hypotension.

Diagnosis and Treatment of Idiopathic Intracranial Hypotension

If you experience the symptoms of idiopathic intracranial hypotension, go to the doctor and talk through your symptoms. You will likely get lab tests done and possibly imaging to confirm that there is no tumor present in your brain and the condition is, in fact, idiopathic intracranial hypotension.

Once you have been diagnosed with idiopathic intracranial hypotension, your doctor will determine the best potential course of treatment. Medication is usually the preferred treatment, when possible.

Diuretics, medicine that makes you produce more urine to get rid of excess water and salt in your body, are typically the first option for treating idiopathic intracranial hypotension. Furosemide and acetazolamide are among the diuretics that you may be prescribed. The medicine helps you produce less spinal fluid and relieve your symptoms.

If medication does not help, you may need a surgical procedure to help relieve the pressure in your skull. Talk to your doctor to see if surgery is needed.

During the course of a patient’s treatment for chronic pain, their physician may suggest the need for additional testing.

The reasoning for needing more testing is to get a better handle on a patient’s specific pain management needs. Among the testing that a physician may recommend is a study of how a patient’s nerves and muscles are working.

Dr. Prasad, a pain specialist in Dallas-Fort Worth, performs this test on his patients during the course of treating their chronic pain. Below he answers a few basic questions about what an EMG and NCS test means.


Question: What is an EMG/NCS test?

Dr. Prasad: “EMG stands for Electromyogram and NCS stands for Nerve Conduction Study. These are diagnostic tests to check on how a patient’s muscles and nerves are functioning. The results from this test will help a pain specialist to diagnose the severity of a patient’s condition and accurately map put appropriate treatment options.”

Question: Why am I being referred by my doctor to get an EMG/NCS test done?

Dr. Prasad“You may be referred for this test if you experience numbness, tingling or a burning sensation; muscle weakness such as foot drop, wrist drop, difficulty opening jars; back pain shooting down your leg, or neck pain shooting down the arm.

Q: What will happen during the test?

Dr. Prasad:  “During nerve testing, small electrode patches are applied to the skin over certain muscles and/or nerves. Then the overlying skin is gently electrically stimulated to see the nerve response. During EMG testing a small, thin needle is used very briefly to test how well the nerve and muscle are working together. There is no electric stimulation involved during EMG testing.”

Q: Is there anything that I should do before having the test?

Dr. Prasad: “Avoid wearing skin lotions, oils or creams on the day of the test. Wear comfortable, loose-fitting clothing that allows access to muscles and nerves to be tested. Generally speaking, patients can take their usual medications for blood pressure, diabetes, thyroid, and others as prescribed by their physician. However, if you are taking a blood thinner, please notify the doctor in advance.”

Q: Are there any restrictions before or after completing the EMG/NCS test?

Dr. Prasad: “There are no restrictions on activity before or after the test, and there are no lasting after-effects.”

Q: When can I expect the results of this test?

Dr. Prasad: “After completing the EMG/NCS test, the doctor has to look at all the findings before making the interpretation. The test results will be sent to your doctor that referred you for the test. They will discuss the results during your follow up visit.”