11/13/2020 5:24:09 PM
52 yo female s/p chemo for breast ca 2017. Bilateral LE markedly absent PP, vibration, LT distal to her shins bilaterally. High arches and hammer toes, thin ankles, calfs not atrophied. MMT 5/5 bilateral LE, but weak heel raise bilaterally.
Bilateral LE tibial and fibular motor responses were normal, but elicited only upon increasing the PW to 200-700 us, and 100 mA (patient insensate so not painful). Bilateral superficial peroneal and sural responses were absent, H-reflexes absent, fibular F wave absent. Tibial F waves normal.
Needle EMG was normal.
What is the significance, if any, of the requirement of strong stimulation to elicite a normal motor response in this setting?