Help Interpreting EMG “Clean” or “Dirty”

[Abcd12345]

Hello All,

I am an early 30s male. Approximately 6 months ago I began experiencing clumsiness, twitching, and cramping in my non dominant hand. Symptoms largely improved, but some thenar discomfort remains. Initially presented to an ortho who had no findings. Ortho mentioned that if I continued to have unexplained issues, the cause could be MS or ALS. This caused a lot of anxiety, and I have had difficulty moving on. Referred to neurology, exam unremarkable other than 3/4 reflexes in lower extremities bilaterally. Neuro rated hand strength 4/5. MS ruled out via MRI. Referred to neuromuscular clinic as I explained I had significant anxiety following ortho’s comments.

Neuromuscular rated strength 5/5, exam again unremarkable other than brisk reflexes in lower extremities bilaterally + brisk jaw jerk. Concludes no definite UMN or LMN signs, but does mention it “cannot be completely excluded” that this is a very early stage disease, although they did not believe it to be likely. Neuromuscular clinic orders EMG of one side of body, with the attached set of results.

Is this considered a “clean” EMG? The neuromuscular doc said the conclusion was reassuring and no significant evidence of motor neuron disease, but looking at the table it appears that there were some abnormalities. Based off the conclusion communicated to me, I was surprised that the entire table was not “Norm”. Based off my doctor’s statement that it was not completely possible to exclude very early disease, is there anything concerning in this set of results?

 

[ShiftKicker]

Hello there-

So sorry you've found yourself with health worries. It sounds like you're getting great care. You have not included the summary/conclusion part of the EMG. If you wish to provide for further feedback, please feel free to do so.

Make sure to read the Read Before Posting link, as it does answer many of the questions that bring people here. It outlines why things like symptoms that improve, lack of clinical weakness and an EMG without the tell-tale pattern of LMN problems would point to some other reason for symptoms.

~F

 

[Abcd12345]

Thank you for replying - the read before posting is helpful and addressed my questions. Apologies for not reviewing beforehand. Can this thread be deleted or removed?

 

[KimT]

That EMG is definitely NOT ALS. You would see positive sharp waves, fibs, reduced recruitment and it would be widespread.
I'm happy for you.