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Questions for Dr's regarding requested neurologic report

Posted by Shane on 2/28/02 at 15:22 (075306)

Here's some comments from my neurologic consultation.

Tinel's sign over the rt. medial heel (distal to the tarsal tunnel)

Bilateral fallen arches.

Decreased pin prick over bilateral planter surface of the footin the distribution of the lateral planter, but not the medial plantar nerve.

Nerve conduction performed w/ recording over the bilateral tarsal tunnels.

Rt. - no response over the calcaneal branch
LT. - response @ 2.7 msec and 10 millivolts

Branch point of the plantar nerves
Rt. 2.9 msec and 5.6milivolts
Lt. absent

Lateral plantar response
RT. 4.1 msec w/ 2.5 milivolts
Lt. no response

Medial plantar
Rt. latency 4.3msec amplitude of 3.5 milivolts
Lt. no response.

Impression:
Carpal Tunnel syndrome bilaterally, more severe on the Right w/ respect to the calcaneal branch. on the left, the lateral and medial plantar responses are worse (absent). There is evidence of chronic denervation/reinnervation, more in the abductor hallucis.

Then he remarked:
The patient will see you in the follow up to further address the differential diagnosis of his tarsal tunnel syndromes and his calcaneal osteophytes.
(end of letter)

Now this is prior to my Left TTS release. The surgery seemed to relieve some of my numbness in my outer toes, but now I have numbness in my heel. I still have presence of heel spurs, bilaterally and continue to have chronic heel pain, some of which is aleviated w/ cortisone injections. So my question for the Doctors is what do you make of my diagonosis? Any help to explain in plain english would greatly be appreciated! Thanks.

Re: Questions for Dr's regarding requested neurologic report

DR Zuckerman on 3/03/02 at 14:42 (075558)

It means your plantar fascia could be the problem. You could have a micro-tearing at the insertion. Examination will confirm this. You are a very good candidate for ESWT if the physical examination confirms chronic insertinoal plantar fasciitis

Re: Questions for Dr's regarding requested neurologic report

DR Zuckerman on 3/03/02 at 14:42 (075558)

It means your plantar fascia could be the problem. You could have a micro-tearing at the insertion. Examination will confirm this. You are a very good candidate for ESWT if the physical examination confirms chronic insertinoal plantar fasciitis