emg questions

[daddypix]

i had an emg done last week that included all limbs and he stuck me in the back of my neck...ouch....i dont remember if he stuck needles in my hand and feet.........anyway........... 1. he stuck the needle in only one muscle group and had me flex ...ex...forearm.....bicep....etc...is this normal procedure to get an accurate reading.... 2.my legs appear to be losing muscle mass.......i ve lost about 7 to 8 lbs...in last month...if i had atrophy going on in those muscles would it be reflected in emg.... 3.is there an area that als might attack an not show up on an emg....different location......thx agian guys...

 

[Alyoop]

1. Yes it's normal procedure. What you would have not noticed, is that they use the same needle stick and move the needle around into slightly differ nt areas, by w withdrawing it slightly and pushing the needle back in on a slightly different angle. The most painful part of any injection or needle insertion is just going through the skin, where most of the sensory nerves are.

2. Yes if you had muscle atrophy from LMN involvement it would show on the EMG. You cannot possibly tell how much weight you ave lost off your legs. Makes no sense. How do you know you have not lost weight off your stomach or all over?

3.no, if the neurologist has tested a muscle carefully, then it will show up. There is not an area that would not show up.

 

[trfogey]

1. he stuck the needle in only one muscle group and had me flex ...ex...forearm.....bicep....etc...is this normal procedure to get an accurate reading....

Borrowing from abbas child in the first thread you started on this board:

daddypix, if you will go to the "Do I Have ALS?" section of the board, look in the second thread from the top (author is Joel C), open it, and go down to #7, "Read This about EMG & ALS".

The first post in that thread, by Al, has a link to an external site that will tell you everything you could possibly want to know about how to perform and interpret EMGs.

2.my legs appear to be losing muscle mass.......i ve lost about 7 to 8 lbs...in last month...if i had atrophy going on in those muscles would it be reflected in emg....

If you had denervation atrophy caused by lower motor neuron death going on in those muscles, the evidence of lower motor neuron death would be in the EMG, even at subclinical levels. Other causes of atrophy might or might not be seen on the EMG, but they also wouldn't be ALS.

3.is there an area that als might attack an not show up on an emg....different location......thx agian guys...

See answer to #2. EMGs can detect lower motor neuron death at subclinical levels -- before signs like weakness and (especially) atrophy are even measurable. There is a form of MND that attacks the upper motor neurons in the brain first and can't be detected by EMG, but the UMN symptoms will be found in a clinical exam. If the UMN disease becomes ALS by subsequently attacking the lower motor neurons of the spinal cord, those lower motor neuron problems will be visible on EMG even before they cause enough problems to be detectable at the clinical level.

Clean EMG == no LMN problems. No LMN problems == no ALS. Therefore, clean EMG == no ALS at that moment in time, provided there are no UMN problems that need to be observed over an extended time. It really is that simple.

You really should be asking these questions in the Do I Have ALS? part of the board.