edspec77
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- Oct 11, 2009
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I apologize in advance for my ignorance about this subject. I need a little feedback about my EMG's.
Quick overview...onset of symptoms was in October 2009 following a bad GI virus. My symptoms progressed quickly (literally spread through body in 1-2 weeks) impacting almost every limb....both hands, arms, and right leg and foot were mostly affected. In addition to the weakness (which doc's say is not clinical, but instead muscle fatigue), I have had random twitches throughout the entire body since the onset....noticeably more in my problematic right foot and leg.
First appointment with neuro in Oct. one week into symptoms....he was worried about Guillan Barre, so he did a full nerve conduction study...all fine. He did an EMG...but only stuck the needle in a few locations in my right leg....all normal, so he said he didn't want to do anymore. He specializes in EMG's. Diagnosis: Post-viral Fatigue.
One month follow-up in November....he was still concerned about an atypical Guillan Barre, so he repeated the Nerve Conduction Study....all normal. I was concerned about MND and all the issues with my hands, so he stuck the needle in multiple places in my right arm and hand....all normal; again, he said there was no reason to do anymore. Diagnosis: Post-Viral Fatigue
Symptoms continued (did not progress, but did not resolve) with very little direction for physicians as to prognosis. With the encouragement of my family, I spent a week at the Mayo Clinic in Rochester, MN for a battery of exams and tests during mid Jan 2010. My overseeing physician was a neurologist, so he repeated all of the exams, MRI's, and EMG's. All normal. This time the EMG was very thorough (head to toe on right side) and done by a doctor at Mayo that does EMG's all day long, so I was pretty confident in the results.
Here is my question....I was so confident after Mayo and the EMG results, that I really just ignored the fact that I was still twitching. That foot buzzes like crazy, too. Mayo sent me the 50 page report from my visit and I just pulled it out to discover that apparently she did not even stick the needle in my foot. I thought she had, but the report shows the following muscle groups being tested:
R. deltoid
R. First Dorsal Interosseous
R. Triceps Brachii
R. Tensor fascia latae
R. Tibialis Anterior
R. Vastus Medialis
R. Masseter
The top of the page has the following categories: Insert Activity (Normal for all), Spontaneous Fib (Normal for All), Spontaneous Fasc (Normal for All), MUP Normal (Normal for All). There are other categories like recruitment, duration, amplitude, and phases....but there is nothing under any of those areas.
Here are my questions:
1.I assumed those additional categories had nothing b/c all my other stuff was normal? I am so ignorant about this stuff and the EMG doc and neuro did not explain.
2.Would ALS be detectable with that type of EMG in those locations? They said they were specifically looking at the neuro muscular junction....is that different than looking at the integrity of the muscle. Again.....I'm so ignorant, so forgive me b/c I know this question sounds odd.
3.I remember her sticking the needle in more locations than listed on the report (like eyebrow, etc), so I was surprised only the seven areas were on the report. Is that common just to report general areas?
4.My symptoms had been going on for several months before the Mayo EMG...so I had assumed if MND was present in any capacity, the EMG would have picked it up. Now, I'm a little concerned that the foot with the issue wasn't actually tested. Would issues have been detectable in the other muscle groups....again, I felt she was being pretty darn thorough, but don't know too much about this stuff.
Overall, I've been getting so much better since January and can even run again (around an hour a day) w/ no issues with that foot or leg while running. There are still times throughout the day where that foot and leg still feel odd...and it still twitches and buzzes a lot. I had really convinced myself that it was no big deal and the fact that I was 8 months out and it was still going strong (no progression, no foot drop) met that this truly was just a Post-Viral that will continue to resolve. I'm still thinking that, but wondering if I need to request an EMG specifically for that foot.
Clinical exam of that foot (and all other limbs) by all neuros is 5+ on strength, absent babinski, 2+ reflexes, can heal and toe walk with ease, and can balance on that foot with ease.
My apologies for the very long post. Any insight is greatly appreciated.
Quick overview...onset of symptoms was in October 2009 following a bad GI virus. My symptoms progressed quickly (literally spread through body in 1-2 weeks) impacting almost every limb....both hands, arms, and right leg and foot were mostly affected. In addition to the weakness (which doc's say is not clinical, but instead muscle fatigue), I have had random twitches throughout the entire body since the onset....noticeably more in my problematic right foot and leg.
First appointment with neuro in Oct. one week into symptoms....he was worried about Guillan Barre, so he did a full nerve conduction study...all fine. He did an EMG...but only stuck the needle in a few locations in my right leg....all normal, so he said he didn't want to do anymore. He specializes in EMG's. Diagnosis: Post-viral Fatigue.
One month follow-up in November....he was still concerned about an atypical Guillan Barre, so he repeated the Nerve Conduction Study....all normal. I was concerned about MND and all the issues with my hands, so he stuck the needle in multiple places in my right arm and hand....all normal; again, he said there was no reason to do anymore. Diagnosis: Post-Viral Fatigue
Symptoms continued (did not progress, but did not resolve) with very little direction for physicians as to prognosis. With the encouragement of my family, I spent a week at the Mayo Clinic in Rochester, MN for a battery of exams and tests during mid Jan 2010. My overseeing physician was a neurologist, so he repeated all of the exams, MRI's, and EMG's. All normal. This time the EMG was very thorough (head to toe on right side) and done by a doctor at Mayo that does EMG's all day long, so I was pretty confident in the results.
Here is my question....I was so confident after Mayo and the EMG results, that I really just ignored the fact that I was still twitching. That foot buzzes like crazy, too. Mayo sent me the 50 page report from my visit and I just pulled it out to discover that apparently she did not even stick the needle in my foot. I thought she had, but the report shows the following muscle groups being tested:
R. deltoid
R. First Dorsal Interosseous
R. Triceps Brachii
R. Tensor fascia latae
R. Tibialis Anterior
R. Vastus Medialis
R. Masseter
The top of the page has the following categories: Insert Activity (Normal for all), Spontaneous Fib (Normal for All), Spontaneous Fasc (Normal for All), MUP Normal (Normal for All). There are other categories like recruitment, duration, amplitude, and phases....but there is nothing under any of those areas.
Here are my questions:
1.I assumed those additional categories had nothing b/c all my other stuff was normal? I am so ignorant about this stuff and the EMG doc and neuro did not explain.
2.Would ALS be detectable with that type of EMG in those locations? They said they were specifically looking at the neuro muscular junction....is that different than looking at the integrity of the muscle. Again.....I'm so ignorant, so forgive me b/c I know this question sounds odd.
3.I remember her sticking the needle in more locations than listed on the report (like eyebrow, etc), so I was surprised only the seven areas were on the report. Is that common just to report general areas?
4.My symptoms had been going on for several months before the Mayo EMG...so I had assumed if MND was present in any capacity, the EMG would have picked it up. Now, I'm a little concerned that the foot with the issue wasn't actually tested. Would issues have been detectable in the other muscle groups....again, I felt she was being pretty darn thorough, but don't know too much about this stuff.
Overall, I've been getting so much better since January and can even run again (around an hour a day) w/ no issues with that foot or leg while running. There are still times throughout the day where that foot and leg still feel odd...and it still twitches and buzzes a lot. I had really convinced myself that it was no big deal and the fact that I was 8 months out and it was still going strong (no progression, no foot drop) met that this truly was just a Post-Viral that will continue to resolve. I'm still thinking that, but wondering if I need to request an EMG specifically for that foot.
Clinical exam of that foot (and all other limbs) by all neuros is 5+ on strength, absent babinski, 2+ reflexes, can heal and toe walk with ease, and can balance on that foot with ease.
My apologies for the very long post. Any insight is greatly appreciated.