A question about which muscles are emg'd, please & thankyou too

[Justme111]

Do ALL the muscles show problems if its due to als? Can ya just stick any muscle? If I had a clinical weak finger , which muscles are appropriate to check? Does anyone know? Can The specialist just stick anywhere in the arm?

I guess im asking if a neurologist does the emg, will ANY muscle that he sticks show denervation, (if symptoms of lower motor are already present)? Can you be kind enough to explain.

thxxxxx

To all of you on the forum, Thank you!

 

[halfin]

In the early stages I believe you may still have a clean EMG in a part of the body which does not show weakness. If your first symptoms are in your hands, your leg EMGs may be OK for a while. However EMG changes will come before you are aware of weakness. In my case my first symptoms were in my mouth and then hands, but my leg EMG was bad way before I felt anything there. In fact I ran a 13 mile half marathon the month after my diagnosis even though I had had dirty leg EMGs when I was diagnosed.

If you feel weak in one finger, chances are your whole hand is affected but you don't feel it yet. The doctor would investigate the muscles of the forearm (which are the ones that control the hand and fingers). If the weakness is due to nerve damage then that should show up on the EMG.

 

[Shilly]

Before I was diagnosed my arm, wrist and hand were emg'd. Not helpful for a diagnosis. About nine months later mt legs were emg'd. Again nothing. I switched neurologists. About a year later my tongue was emg'd to confirm the diagnosis. You can expect any or all voluntary muscles to be emg'd but it isn't as bad as you might think.

Good luck.

 

[Justme111]

Hi Halfin,

TY for your reply to my post! That would certainly make sense, especially with Bulbar onset.

I wonder are there certain muscles that LEAD to the affected weakened muscles. (Like an electrical outlet that leads to its source). I was just wondering if the surrounding muscles would be affected too or if the Dr needs to specifically Stick the affected muscle itself. Is there a specific protocol?

SHILLY, Sorry for your DX..... Thank you, for your help,

Im not sure why it didnt show till years later. Do you have bulbar onset & can this be the reason? If so, why did it take your neuro so long to find abnormalities on the emg?

This here is my question. Could The Dr Emg the wrong muscles?

 

[trfogey]

This here is my question. Could The Dr Emg the wrong muscles?

Obviously, since doctors are human, they are capable of making mistakes, so it is possible that they could perform any procedure on any patient and get erroneous results.

I presume there is a point to your asking a question which has such an obvious, yet useless answer. If you feel like your doctor made an error in his evaluation, you have three basic choices. One, you go back to your doctor and get him/her to repeat his/her examination and testing in the hope that correct answers will turn up this time. Two, you can consult another doctor for a second opinion about your condition to see if that doctor agrees with the findings of the first doctor. Three, if you believe that your first doctor has made a grievous error, then you should consult a qualified attorney in your area that specializes in medical malpractice cases.

Any of the three options I gave you above will give you quicker and more accurate answers than what you've been doing here. Of course, that assumes you are really in search of answers to real questions about a real patient. No one here has either the information or the qualifications to deal with that real patient, but your local doctors do.

Good luck.

 

[Justme111]

Mr Fogey,

I am so sorry that something is just not sitting right with you in my posting that you have taken offense.

I hope & pray that you are healthy & feeling good, as I know I get moody when Im not feeling great. I understand & still care about you,

 

[trfogey]

Actually, Justme111, I'm not offended by your questions. I simply wonder what you have in mind when you construct these improbable scenarios and expect everyone to treat them seriously. It strikes me as a behavior consistent with a person who was trying to create uncertainty and doubt rather than certainty and confidence by focusing on the rare and the theoretical instead of the commonplace and the practical.

The diagnostic criteria for ALS are clear and they are specific. If you don't meet those criteria at a given point in time, then you don't have ALS at that same moment in time. Not having ALS at one moment in time does not in any preclude that you might develop ALS at a later time. It simply walls off a specific timeframe and set of bodily conditions and says "At this time, these symptoms are not caused by ALS."

The overwhelming majority of people that come to this section of this board don't have ALS and will never have ALS. They land here because there is some very bad information available on search engines that points them this way. By entertaining idle speculation such as that which you posted, this board is adding to that store of misinformation out there, and that does bother me.

 

[Justme111]

Mr Fogey,

I can appreciate all that you say. I really can. This is a board for you & those who need it. I truly do not mean to crowd it with unnecessary posts.

You said that By entertaining idle speculation such as that which "I" posted, this board is adding to the store of misinformation on the internet. I only wanted to ask if anyone knew if ANY muscle would show denervation or must a specific muscle be emg'd.

Again, I realize you may find this as an "improbable scenereo" as you say, but I suppose there must be SOMEONE out there who can understand my concern knowing I had an abnormal biopsy & wondering if my clean emg could have not picked up something.

Thanks for caring
Best wishes

 

[trfogey]

And my question to you, Justme111, is "Why don't you ask your doctor about this unusual situation?" He/she has all the information necessary to answer the question -- nobody here does. If you don't trust your doctor any more, then see another doctor and get a second opinion. It really is as simple as that. Your situation, as you presently perceive it and are able to relate it to us, goes way beyond any of our expertise or experience, so we can't help you, regardless of how sympathetic we are to your situation.

The "someone out there" who can answer your questions is far more likely to be found in a neurologist's office than frequenting an Internet message board. Why you appear to think that you'll get a better answer from amateurs on the Internet than from a trained and licensed physician truly baffles me, but to each his own, I guess.

 

[Justme111]

Fogey,

You say, My situation as I presently perceive it and are able to relate it to the forum, goes way beyond anyones expertise or experience........Dont you mean, goes beyond "your" area of expertise?

How can you answer that for everyone on the forum. You have no idea how much information people have here regarding my question. Halfin & Shilly did a Perfect Job!

I really feel that you are being rude to me but maybe Im just misreading things~~

All the best,

 

[Justme111]

PS: For those who care to know.......I did ask my Dr & he told me if you have als any muscle should show it.

Whether or not he was saying this just to alleviate my fears, I cant say but that was his words. Im sure theres a lot of truth in that statement but I believe he may have overexagerated.

Still, it sounded better than him saying, that A "peticuliar" muscle has to be searched for & analyzed. I felt better.......



Thx to you all,

 

[trfogey]

And thank you for showing me that I need not take you seriously from now on.

You have noticed that no-one but me has attempted to answer your last question, haven't you? Halfin and skilly answered your first set of questions with information that you could have found yourself with a little bit of effort, either by reading more on this site or by G--gling around a bit. Obviously, whatever troubles you isn't significant enough to spur any serious effort on your part, so I'll happily direct my efforts toward other folks here who are seeking real answers instead of playing parlor games.

Am I being rude to you? No, but I am being confrontational. I get that way when I think someone is trolling the forum. Are you a troll or am I misreading you? If I have misread you, consider this an apology.

Feel free to have the last word.

 

[Justme111]

Thank you, I will have the last word.

Is this what you call an "Attempt" to answer my question?

"I presume there is a point to your asking a question which has such an obvious, yet useless answer. (Yeah, Duh! There is a point to my question)

If you feel like your doctor made an error in his evaluation, you have three basic choices. One, you go back to your doctor and get him/her to repeat his/her examination and testing in the hope that correct answers will turn up this time. Two, you can consult another doctor for a second opinion about your condition to see if that doctor agrees with the findings of the first doctor. Three, if you believe that your first doctor has made a grievous error, then you should consult a qualified attorney in your area that specializes in medical malpractice cases. (Oh MY! Good thing you ATTEMPTED to answer my question)

Any of the three options I gave you above will give you quicker and more accurate answers than what you've been doing here. Of course, that assumes you are really in search of answers to real questions about a real patient. (NO IM FAKING ALL THIS BECAUSE I HAVE NOTHING BETTER TO DO) No one here has either the information or the qualifications (YOU MEAN YOU DONT) to deal with that real patient,(AGAIN.......HMMM.....STRANGE THAT YOU ARE HOOKED ON A PRETEND PATIENT) but your local doctors do.

Summary: A lil FYI,

You have been NO help.

You never attempted to answer anything.

This is not the first post but one of many where you just instagate with rude remarks that personally, I think, you get off on.

Im sorry you seem like a bitter nasty person...........Seems like such a waste of time that you jump into a post to write an entire paragraph, only to really say "you" Mr Fogey doesnt have the answer, so I say to you, keep on movin & if someone else has that answer, at least be respectful enough not to FILL it up w/ your bitterness!

 

[Fernando]

PS: For those who care to know.......I did ask my Dr & he told me if you have als any muscle should show it.

Whether or not he was saying this just to alleviate my fears, I cant say but that was his words. Im sure theres a lot of truth in that statement but I believe he may have overexagerated.

Still, it sounded better than him saying, that A "peticuliar" muscle has to be searched for & analyzed. I felt better.......



Thx to you all,

Hi Justme,

Relax! Dont let anyone drag you down that path! Take in the knowledge from those who WANT to help & leave all the rest behind.

I know how frustrating it can get, Hang in there.

I was interested when I read this statement your Dr told you.

I wonder if Wright will come along & comment. He knows all about emg's.

Halfin explained it very well. At the top in the stickies, (it was Halfins sticky) there is one that says, most people will FIRST have a dirty EMG, then the weakness, ect will FOLLOW.

I often wonder if the Dr missed the appropriate muscle too but Im gonna have to live (for now) with the notion that, as the folks here say, the surrounding muscles will show the dying nerves too!

 

[phoenix.ar]

hi!~ justme111....dont pay much heed as to what has been responded back by master of insolence ~ Trfogey ~...and dont worry you are in good company coz this is not the first instance and you definately are not the first or the last of his derogations....he has the knack of getting in to the tussle.... so relax...you have been responded well by other very helpful members of the forum....get on get moving leave the rest behind...wishing you well....take care.