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sabby

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Hi all the well wishers
I am from India , problem was started visible muscle twitching rotating to different limbs , Consulted 3-neuro all suggest Benign cause , done blood works, anxiety treat, Vitamin treatm , done EMG , EMG & NCV involving three muscles suggest fasciculation & high MUAPs with Impression of Chronic Denervation & Innervation , then consulted the best MND doctor of India

She ordered another EMG/NCV in his own center in a gap of 20 Days involving Muscles of Upper, Lower Limbs, Trunk, Neck & Cheek as per her impression it is normal in aspect of Neurophysiology
,but in 1st L Dorsal Intercoursa muscle a doubtful fasciculation comment was there , She noted DTR 2 to 3 + earlier all neuros mention that 2+ she planed next review after 3 months ordered Vitmain D3 test which comes out 33.5nmol/L taking Vita D suppliments now , As she downgraded my DTR reflex i consult another neuro he also noted general hyperreflexia and prescibe me Diazapam to control anxiety pls guide
 
Hi
The neuromuscular specialist's EMG summary was normal except for a possible fasciculation? That is considered a normal EMG.

The only finding on your clinical exam was borderline hyperreflexia? Again can often be seen in healthy people and is very common in anxiety.

Vitamin d deficiency can make you feel terrible so after it is replaced I think you will notice a positive difference.

Twitching is very very common and by itself means nothing ( see the sticky) and you have had an expert examine you and have had an EMG too . I would forget about MND, take my vitamin d, work on my anxiety and stop reading about MND!

Good luck and happy life!
 
Thanks a Lot Nikki J
Psychologically releasing my apprehension
My first EMG also done by a senior Neuro , he also done it very carefully , in the both EMG muscles are different , One thing strikes me
that the Denervation & Innervation may be going on in the first three muscles which was not reflected in second EMG as the muscles involved are different and also Clinical DTR was normal 2+ suddenly be deteriorate to general Hyperreflexia . i have searched the net there was no where any type of general hyperreflexia is mentioned , the neuro which has mentioned this is also a trained with advanced diagnostics from Zurich , I am very much puzzled
 
"Hyperactive" reflexes come and go. As Nikki notes, they are often attributable to anxiety. They can also relate to fatigue, diet and pain states.

As to your EMG question, a typical motor neuron disease pattern would show abnormalities in all or most muscles tested, whether symptomatic or not, so the actual muscles tested would matter little in that context.

The best available evidence shows that you are far from having MND. The advice of those here, most of whom are in the opposite situation, is to rejoice and live a full life.

Best,
Laurie
 
Thanks Lourie

Members are extremely helpful

Can any body from group can have same experience of Bad EMG and then a good one

My lower limbs have some persisting pain that i am connecting with my degraded DTR like what members suggest borderline Hyperreflexia

As my body twichings ar continuing with this week long Lower limb mild pain iam in psycological pressure as my age is 46 with a good Carrier having small loving family
with one KID of 17 Yrs

Request more forum members to help me guiding

Just 10 days back i have to the best MND doctor of India , while i mailed him my mild pain in lower limb she suggest me to wait and continue with Vit D# therapy
 
Sabby, two of our most knowledgeable members have agreed with your neurologist, and so do I. Follow your doctor's advice.
 
Thaks Mike for your views

But the apprehension continues with me as my first emg suggest denervation & Innervation , second one is OK and also DTR reflex downgraded , If any member experienced same situation ever . I know all members are facing the desease progression with tremendous courage and lot of positive hope if they can release some of my pressure over this type of results
 
Help full members
please post your views on this differed medical opinions as described in this thread , I am facing pain in my calf muscles & Right elbow also , My diagnosis still not yet completed
 
dear members what to do now - my neurodoctor advised for 3 months wait , already reflexes are deteriorating

one option open from employer side a voluntary retirement scheme with monetary benefit till 28 th feb 2016
the complete diagnosis is not over , at present weakness observed in legs and right elbow with some strange feeling

please assist me in my tough to take decision process like voluntary retirement , if there will be no als after taking retirement to find suitable job in our country is also very difficult . please post reply with your experience
 
Tough decisions need a lot of information. Let me research this. Others will no doubt come here to comment, too.

ADDED: OK, Sabby. I know you're worried and have a family to care for. I know what that feels like.

EMGs are not perfect, but they are only one diagnostic tool. I count FOUR neurologists have done EMGs, including the best neuro in India. None of them suggest ALS. Also, the two of our members who have commented above are really very smart and experienced.

And then your last post complained of pain and strange feelings --- that's not how ALS works.

I must agree that you chasing the wrong disease. I don't see any ALS in your future. You've been thoroughly cleared by the best and brightest people.

I must agree, you are NOT looking at ALS. Keep your appointment and finish getting a diagnosis.
 
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Thanks Mike You really understand What Psycological Pressure Going on With me
Consulted Four Neuros But done two EMGs First on 21/01/2016 which suggested Chronic denervation & Inervation with Increased MUAPS and Fasciculation in tested for three muscles other things Normal including DTR , Planter reflexes

Second one really a Authority over ALS in India who also in to research , EX Chancellor in Premium Neuro Science University

Her EMG (10/02/2016)involved 12 muscles including Trunk ,Cheek, Neck , Her findings no significant abberation in MUAPS,No Significant Polyphasia, Doubt ful Fasciculation in Distal Upper Limb , Hence a Normal NeuroPhysiology Study , but her Comment in my reflex DTR is 2 to 3+ , Again one brightest young neuro review the reflex Commented General Hyperreflexia

I have Completed my Blood works like Ca, Na,K,ANA,Protein, Creatine, Glucose, CBC, Vit D3 (which comes 33nmol/Lt)


I am taking Methyl Cobalamine, Calciferol, Vit e now , from last week also i have feeling some kind of weakness in my lower legs and Right elbow the diagnosis process every neuro telling wait as you have done two EMGS in one month

But to secure my family retirement application Cut off date is 28/02/2016

The seniro most neuro who last done EMG is also 1000kms away , on my email advised to continue Calciferol presciption for Vit D3 & Calcium , Twiching also my primary Concern Continuing

Pray almighty for this poor member and Keep Guiding
 
Sabby, work with your doctors. In our opinion, you do not have ALS. That's really all we can say. You must see your doctors, now.
 
Thanks Mike

When you are in opinion that this is not ALS it subsides our agony

Request to other members like Lourie, Nikki those are quite experienced to give their own view or guidance

As my communication is little poor due to poor English any thing on investigation report you want to know i will have aprompt reply
 
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