Old 01-08-2010, 01:17 PM #1 (permalink)
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Default EMG question for Wright

I posted earlier but realize I was asking to much and was not very specific for any answers. I have read some of your post's and you seem to be well versed on EMG results. I also have read you are sicilian as I am. I am not going to give you some vague symptoms like I have a weak left toe. I would just like to know how you would interpret my EMG results. I realize you are not a doctor and are probably busy and will take both of those issues into consideration. I have had left leg and right arm weakness for 9 months. Just had an EMG done on both areas which tested 5 muscles in the left leg, 7 in the right arm and shoulder and 10 in the spine. All were normal except for the BicepsFemS in the leg which was all normal except for the following:

normal fibs/psw/facs

Amp: Incr
Dur: 12ms
Poly: 1+

I had a normal NCV and neuro exam on all limbs of my body. The neuro did not see any wasting but I think I notice some. He says no way to mnd. He says all my emg's were normal with no active denervation. I am just confused as to how he can say that it was a normal exam and completly rule out mnd with the abnormal finding I cited. What constitutes a normal exam? I have read that my abnormal findings are consistant with ALS. My neuro says it is probably an old injury that is healing. What is your opinion from your experience. He just recommended excersise which is causing alot of pain. This neuro really doesnt impress me and I am thinking about a second opionion but am worried about the cost.
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Old 01-08-2010, 01:35 PM #2 (permalink)
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Default Re: EMG question for Wright

Just for clarification. My Ins Act, Fibs, psw, fasc, recrt, int pat were all normal on the muscle in question just my amp, dur and poly were abnormal. I may have confused everyone with how I wrote it.

Thanks
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Old 01-08-2010, 02:45 PM #3 (permalink)
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Default Re: EMG question for Wright

Wright does not participate too actively these days but perhaps he will speak up. My rough understanding is that "Poly" is what they call a polyphasic unit, meaning a muscle signal that is a bit messy and does not rise cleanly. Also possibly the "Amp: Incr" may refer to a large motor unit (ie "Increased" "Amplitude"). Both of these would be signs of some degree of nerve damage. However the "1+" on the Poly line either means they only saw 1 pulse like this, or else it means "one or more", which would be odd. Usually they put down how many they saw. So maybe there was only 1.

All in all this would sound like a very slightly abnormal EMG. Only one muscle was affected and it only had 1 polyphasic (and possibly large) signal during the test. Your neurologist would have to be the one to determine whether this slightly bad recording meant anything serious. Other things can cause nerve damage, like injuries, and it sounds like he feels that this is the likely explanation. ALS causes continual ongoing nerve damage so will usually show up in more than one muscle and more than one signal.

Keep in mind I am a patient and not a doctor, this is my very amateur understanding. But what your neurologist said seems reasonable given this very slightly bad report.
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Old 01-08-2010, 04:52 PM #4 (permalink)
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Default Re: EMG question for Wright

For what it's worth, I agree with Hal.
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Old 01-08-2010, 05:01 PM #5 (permalink)
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Default Re: EMG question for Wright

Hal is spot on. I agree with Kim, who agree's with Hal..
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Old 01-08-2010, 06:10 PM #6 (permalink)
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I would agree if I had a clue!
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Old 01-08-2010, 09:19 PM #7 (permalink)
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Wright has not left the building. School was out so he was too.

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Old 01-08-2010, 09:24 PM #8 (permalink)
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Default Re: EMG question for Wright

And on Elvis's berthday none the less. He is still in the building. I saw Elvis in concert when I was ten years old. My dad and mom were huge fans, and did not have a babysitter, so low and behold I saw Elvis in Concert. He died that same year six months later. I was talking to my dad today and he said Elvis was 42 when he died. Same age as I am now. Why I bring this up is, I thought he was so old when he died, UGHHH, 42 old...... Well now it is not old, and he died, well we know it was from a lot of things he did to himself. But it just made me think how life can change for anyone at anytime.. Just got me thinking. 42 old, can you imagine...?
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Old 01-08-2010, 11:26 PM #9 (permalink)
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Default Re: EMG question for Wright

Hoping, you're still a spring chicken and congrats on your 1,000th post! I remember that I was living in a house with a bunch of headbangers at the time Elvis died and none of them even noticed.
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Old 01-09-2010, 09:54 AM #10 (permalink)
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Default Re: EMG question for Wright

It seems I remember that recruitment is important, so for yours to be normal is very good. Also that there is no active denervation. That matters because EMG results diagnostic for MND will show chronic and active denervation (and reinnervation)
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Old 01-09-2010, 11:19 AM #11 (permalink)
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Hey, speaking of the number of posts, Rose and I are neck-and-neck in a dead heat to reach that prestigious title of, "Extremely Helpful Member"!
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Old 01-09-2010, 11:57 AM #12 (permalink)
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Default Re: EMG question for Wright

The neurologist cited in his findings that there were slightly increased polyphasic potentials. I do not know what the + after the one is. When I ask him questions he always goes back to asking me about my time in the Navy (I am retired USN). I spend more time talking about sea/war stories than my treatment plan. He did tell me to get an MRI of my right shoulder which will happen Monday. Hopefully we will find some thing there which would hopefully explain my leg weakness also (arthritis,muscle damage ect).
Do any of you actually have MND? If so you are very non selfish people to answer questions like this with your worries. I have found out after my suicide attempt that there are very few good people in the world ( I was a selfish person before). Most just care about themselves or there family. You people are obviously the exeption. Thank you for your time.
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Old 01-09-2010, 12:06 PM #13 (permalink)
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Yes, some of us here do actually have ALS/MND although most of us don't dwell on it much. Not a lot you can do about it so why fret about it. We'll help with answers and support if we can.

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Old 01-09-2010, 01:32 PM #14 (permalink)
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Fallettap,

I'm a retired navy CT. Welcome aboard!

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Old 01-10-2010, 11:23 AM #15 (permalink)
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Default Re: EMG question for Wright

Fallettap

I assure you that your neuro isn't lying to you. The +1 poly with an increase in duration simply means that you had nerve damage (slight nerve damage at that) at some point in your life. It could have happened 6 months or 6 years ago . . . there is really no way of telling.

If you don't have any active denervation along with active reinnervation (and your EMG absolutely says you don't), then you simply do not have any type of active lower motor neuron degeneration, which is a criterion for ALS. The reason your neuro called it a "normal" exam is because it was. If you EMG'd the general population, chances are most people would also show some type of prior nerve damage to some nerve in their body because of the general wear and tear of life.

I'm going to assume that your neuro also gave you a clinical exam, which I'm also going to assume was normal (something else that points away from ALS).

What you now need to do is determine why you have the weakness you have . . . and what I mean by that is . . . let your physicians figure-it-out. Trying to diagnose yourself is obviously a bad idea, because it appears that you were on your way to diagnosing yourself with ALS, and there isn't a shred of evidence that you have it.

I wish you luck.
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