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A 57-year-old female asked:

Can you have peripheral neuropathy with negative nerve. conduction tests? tested positive for bilateral carpal tunnel

4 doctor answers8 doctors weighed in
Dr. Romanth Waghmarae
Pain Management 40 years experience
Neuropathy: Yes its quite possible that it will not be picked up on EMG. Peripheral neuropathy is a small fiber disease - EMG's are not very specific with small fiber disease. The best is to do a non-invasive Nerve Conduction Velocity (NCV) study which is a more specific test for small fiber function. - keep in mind that there is a great deal of controversy on the application of EMG's
Dr. Bennett Machanic
Neurology 53 years experience
Yes: You could possess a small fibre neuropathy, where EMG test would uncover only minimal and subtle variations. The carpal tunnel syndrome could emerge independently due to repetitive wrist/hand flexion extension such as keyboarding, and might not relate at all to a more widespread neuropathy.
Dr. Jeffrey Wint
Hand Surgery 36 years experience
Peripheral neuropath: If severe enough, will be evident on the standard nerve studies, but the examiner must also at times test for the neuropathy by testing other muscles away from the hands. This is known as a neuropathy profile and some tests don't do this. If one has an early neuropathy that affect the toes, it may not have been significant in the hands yet while still in some ways contributing to the overall exam
Dr. Olav Jaren
Neurology 20 years experience
Carpal tunnel or PN: If your nerve conduction test showed you have carpal tunnel syndrome, that is your diagnosis. Your nerve conduction test is not normal or negative if this is the diagnosis. This is a good test for distinguishing these two conditions. It is possible to have rare kinds of neuropathy with a normal nerve conduction test- this is why it is important to have an interview and exam with the test minder

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Last updated Feb 27, 2019

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