EMG result

[victor11]

I started having fascikulations in both calves in november, that went along with tingling and numbness.
I had appointment with neurolog in the beginning of march.
I have some problems with right leg when walking long.
Atrophy started to show inside both palms, first left and then right ( interossos muscles). Now I have an atrophy in calf, and right buttock have lost muscle.Also sometimes get sore in leg muscles.
Joints in hands and arm are cracking all the time.
I made an EMG april 6. They found some old changes in right leg, but say it comes from back, and nothing indicating ALS. They put needles in right leg, both arms and back, but not in left leg.
I don´t know how reliable this is, and I didn´t get any explanation for atrophy.
What is your experience about EMG-tests, how reliable are they? Can they for sure differ old injury from motor neuron disease?
I would be thankful to get any of your thoughts or experiences.

with regards
victor

 

[Twinsmom]

It's really important to have someone who specializes in EMG/NCT testing and specifically MND. We have others, more clinically savvy than me who can answer your questions regarding old injury from MND

Good luck,
Melody

 

[limegreenphysicist]

Hi,

An EMG is very reliable in distinguishing old injury from motor neuron disease. However, I will say that not all Neuros are created equal and I would suggest seeing an MND specialist. An old injury would show old denervation/renervation eluding possibly to previous radiculopathy. Did you have a MRI of Lumbar or Cervical Spine? In ALS there is acute and chronic denervation and ongoing renervation which I am sure even the most incompetent neuro could tell the difference which is why they said no ALS.

What was your clinical like?

 

[bubble12]

i have a question. melodyparrish said if the emg is made you have to pick the right muscle AND the right area in the muscle. is this true, because i have some probable atrophy of my calf and the neuro just stick the needle in one area of my calf. i'm scared that he misssed something.

 

[Justme111]

Hi Bubble,

Im wondering the same. I did post this question to Wright, He knows a lot of emgs. I hope he will answer.
GL

 

[victor11]

Thank you limegreenphysicist ( nice name .
I feel a bit releaved. Neurolog didn´t send me for MRI or Lumbal spine, I guess he thought that unnecessary.I will try to get a second opinion from doctor that specialize in neuro-muscular diseases, the closest I come to MND-specialist in Sweden.
My clinical was no clinical weakness, I had no achilles reflexus, and a bit loss in sensory area in feet, but was concidered mild neuropathic signs.
What bothers me too ( I asked a doctor on MedHelp), is that atrophied areas would give bad response for EMG, according to him What is your experience? Maybe Wright have an opinion of that too?

However I developed atrophy I described before after that examination. I told neurolog, but he dismissed me, which really pisses me off. Atrophy wouldn`t be normal, and I really think I can require an explanation for that, from him.

 

[limegreenphysicist]

Hi Victor,

Something weird happened and erased my post to ya. The loss of reflexes and presence of sensory loss point away from ALS and are the rule with neuropathies. This is why the NCS is so important in regards to the electrophysiological findings of the EMG. In ALS, sensory and conduction velocities are normal.

In regards to atrophy and ALS, if the atrophy is caused my ALS there will most definitely be abnormalities on the EMG. Has this atrophy been documented by your physician/neurologist? ALS is not even remotely close to the only disease that causes atrophy. And I would fair to think that your anxiety is playing a huge role in the observation of this atrophy.

I can assure you if you have anything sinister there would have been findings on the EMG long before you ever had symptoms. Wright has explained these types of abnormalities on these threads so I will not repeat them myself to avoid redundancy.

I want to reiterate though that ALS is truly rare and there are so many things that are similar in clinical and examinations. Take me for example. I have Mononeuritis Multiplex caused by Lyme's Disease. It has the same electrophysiological findings on EMG as ALS minus the chronicity of denervation/renervation but it freaked me out. It also causes weakness, atrophy, and autonomic problems seen in CIDP.

Wright will probably comment further but keep your head up and go see your neuromuscular specialist to relieve your worries but I am sure you will be fine.

Have a great week

Love to all

Kelly

 

[victor11]

Thank´s a lot Kelly.
Neurolog didn`t observe atrophy, because it developed after he saw me. It´s quit obvious though, in hands, calf and buttock. Also start in wrist, and right wrist is starting to get weak, and embarass me when lifting and turning hand in awkward position ( for example getting card out of wallet). Neurolog didn`t tell about possible findings in Nerve Conduction My right leg also embarass med when walking 20 min, or go downstairs.
However you encourage me not to give up, and I will certainly try to get opinion from specialist, I already mailed them.
Thank you, and have a nice week, you too !