Confused

[Lovebridge]

I’m a 35-year-old black woman. In September, I had an EMG due to perceived weakness. The weakness was in my right arm. I was told it was normal. My neurologist never did a physical assessment, but my primary found hyper-reflexes in all extremities.
My current symptoms are:
Weakness in upper extremities. Can’t hold my cell phone or any object too long without having shaking. My leg muscles shake when I bend down.
Muscle twitches all over body
Tremors in my hands and what might feel like internal vibrations. Muscle fatigue tremors
Pulsating tinnitus
Visual changes (weak eye muscles as per ophthalmologist)
Occasionally tight neck muscles
Sore throat (sometimes hoarse after speaking too much)
The electrical component of the test was completed on all extremities. The needle testing was completed on the right side. Is the nerve testing sufficient to rule out ALS?
Does EMG rule out atypical forms of ALS? I believe visual changes that are muscle-related and tremors might be indicative of an atypical form.
My neurologist has yet to assess me for clinical weakness and says “I don’t look like I have ALS.” My primary did not believe I was clinically weak.
Would appreciate any input. Thank you!

 

[ShiftKicker]

Your neurologist knows their stuff. And, yes, the EMG is used to detect a variety of issues, not just for ALS. Your clean EMG has ruled out ALS as a cause for your symptoms. Also, what you report is not the pattern of symptoms that indicates ALS/MND. The variety of symptoms you're experiencing, which are affecting different systems, points away from ALS.

Please make sure to read here as well: Read Before Posting. for more information and guidance on what neurologists look for when concerning ALS.

Take care

 

[lgelb]

I certainly think a neuro exam, if only to refer appropriately, would be appropriate in the setting of hyperreflexia, tinnitus and clinically-verified ocular muscle compromise. That does not mean I think you have ALS, because I don't, but there are other conditions that should be ruled out.

In that vein, I would ask for the EMG report. Feel free to post it here with your name crossed out. Always remember that you are entitled to all lab results and reports on imaging and other tests. Often this is accomplished through signing up for an online portal.

If the neuro isn't interested in following up with you, I would find one who is.