Slow Nerve Conduction: Beyond Bone Spurs and MRI Follow-ups

Nerve conduction is slower - follow-up question?

Continuing to ask Dr.
Gao: The nerve conduction on the side of my waist is slower.
Besides bone spurs, what other possibilities could there be? My doctor does not have any other X-rays for reference, so I am unsure how he concluded it is a bone spur.
Additionally, last year I experienced tremors in my right foot and hand, and I paid out of pocket for a brain MRI, which unexpectedly revealed a venous aneurysm in my right brain.
I would like to ask the doctor if I need to have an MRI for follow-up every year.
Thank you, Miss Lin.

Miss Lin, 40~49 year old female. Ask Date: 2015/12/22

Dr. Gao Chunde reply Neurology

Slowed nerve conduction indicates that there may be an issue with that part of the nerve, prompting further investigation into potential underlying causes.
For cerebral vascular malformations, regular monitoring is recommended, including assessment of clinical symptoms and imaging studies.

Reply Date: 2015/12/22

More Info

Understanding slow nerve conduction can be complex, especially when considering the various underlying causes beyond just bone spurs. In your case, the slow conduction in the lumbar region could be attributed to several factors, and it’s essential to explore these possibilities to gain a comprehensive understanding of your condition.

Potential Causes of Slow Nerve Conduction
1. Nerve Compression: While bone spurs (osteophytes) are a common cause of nerve compression, other factors can contribute as well. Herniated discs, for instance, can protrude and press against nerve roots, leading to symptoms such as pain, numbness, and weakness. In your case, the MRI findings of disc protrusions at L5-S1 and other levels suggest that this could be a significant factor.

2. Peripheral Neuropathy: Conditions such as diabetes, vitamin deficiencies (especially B vitamins), and autoimmune diseases can lead to peripheral neuropathy, which may manifest as slow nerve conduction velocities. If you have any underlying conditions that could affect nerve health, these should be evaluated.

3. Demyelination: As indicated in your previous nerve conduction studies, demyelinating conditions such as Multiple Sclerosis (MS) or Guillain-Barré Syndrome can lead to slowed conduction velocities. These conditions affect the myelin sheath surrounding nerves, impairing their ability to transmit signals efficiently.

4. Inflammation: Inflammatory conditions affecting the nerves, such as vasculitis or infections, can also result in slowed conduction. If there is any suspicion of an inflammatory process, further evaluation may be warranted.

5. Structural Abnormalities: Other structural issues, such as tumors or cysts, can also compress nerves and lead to altered conduction velocities. Although less common, these should not be ruled out, especially if symptoms persist.

MRI Follow-ups for the Aneurysm
Regarding your right cerebral aneurysm discovered during the MRI, regular follow-up imaging is generally recommended. The frequency of these follow-ups can depend on several factors, including:
- Size of the Aneurysm: Larger aneurysms may require more frequent monitoring.

- Location: Certain locations in the brain may be more prone to complications.

- Symptoms: If you experience new neurological symptoms, more immediate imaging may be necessary.

- Family History: A family history of aneurysms or other vascular issues may also influence the need for regular monitoring.

Typically, if the aneurysm is small and asymptomatic, follow-up MRIs might be recommended every 1-2 years. However, if there are any changes in your symptoms or if the aneurysm shows signs of growth, your healthcare provider may suggest more frequent imaging.

Conclusion
In summary, while bone spurs are a common cause of nerve conduction issues, other factors such as herniated discs, peripheral neuropathy, demyelination, inflammation, and structural abnormalities should also be considered. It’s crucial to have a thorough evaluation by a neurologist or a specialist who can correlate your symptoms with the findings from your imaging studies.
As for your cerebral aneurysm, regular follow-up imaging is advisable to monitor its status. Always discuss your specific case with your healthcare provider to determine the best course of action tailored to your needs. If you have any new or worsening symptoms, do not hesitate to seek immediate medical attention. Your health and well-being are paramount, and proactive management is key to addressing these complex issues.

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