EMG results - Please advice

[Panos1978]

Merry Christmas to everyone,

Over the past one month i am experiencing muscle twitches in several parts of my body and also a kind of tremor especially on my right thumb. Tremor gets better as the day progresses.
With regards to the twitches they are generally coming only once and twice every now and then especially when my muscles are relaxes.
Except twice. 3 weeks ago when i had a constant twitching on my right bicep for almost 3 days (especially when muscle was relaxed) and now the last 3 days that i am having a constant twitch on my left quadricep. You could see this movement whenever the leg is relaxed.

Went today and had an EMG on both arms and legs. There was nothing pathological except the fasciculation potentials from my left quadricep.
Is this enough to exclude ALS as a possible diagnosis?
The neurologist is confident that it is nothing wrong with me.

Previous week i had another EMG which came up with 2 fibs on the left arm bicep and nothing else. This suggested small radiculopathy of C5-C6 from a hernia disc (which actually i got and checked on an MRI)
On the latest MRI there were no Fibs on left bicep...

Well these different outcomes made me even more concerned and i really dont know what to believe and if i should just take it easy.
I am under enormous stress with everything that happens to my body at the moment and i am checking every single small detail again and again...

Thanks for taking the time to read my post and look forward hearing back

 

[Tootiredofthis]

It's very strange that you had 2 EMG's in a time span of one week. So I can only guess that you went to a different doctor for the 2nd opinion.

I can only speak from personal experience, as someone who hasn't been diagnosed with ALS, but had everything you have (both physical and mental). That includes twitching hot spots, tremors, "worrisome" EMG (yes, I too had fibs and some other stuff), spine problems, etc. But worst of all was the psychological side of it. If your neuro says you are fine, try to believe him/her.

The more you check on something, the more it will happen. It's how anxiety works. I started twitching in February and still do, probably around 30% less than 10 months ago. And I had my EMG 1 year ago. Still haven't developed anything, and your case looks VERY similar to mine. Regarding conflicting EMG results, from what I understand it's open for interpretation depending on a person who is doing it, so it might look different when performed by different persons. But I really think that they would notice if there was something serious. Do you second-guess your GP when he tells you it's just a cold and you should go home and rest?

Merry Christmas!

 

[Panos1978]

Thanks for your response. It seems we are also neighbors as you come from Serbia.
Yes i had several EMGs over the last month because i heard different opinions from anyone who was performing it. The only good thing was that noone believed that it might be the beginning of ALS.
On the other hand i was never sure how they could decide if the signs were Fibs or other non pathological potentials... That was the reason i chose to have quite a few EMG's. Out of the total 4 EMG's 2 came out absolutely normal (except one which caught the quadricep fasciculation) and the other two came up with 2/10 Fibs in left bicep due to a Hernia C5-C6 (Which MRI actually shows that there might be radiculopathy)...

Today i got a new symptom... I have a terrible pain on my right underarm when i am raising my hand... I am not sure if this has to do anything with ALS symptoms but it really makes me mad....

Concerning your situation i would definitely be relaxed. 1 year is a long time so if nothing has developed yet then you should take it easy...

 

[vickim]

You should take it easy too. Everyone twitches and the more you focus on it the more it will happen. Pain in als doesn't usually happen until the PALS can no longer move the arm or leg and muscles get stiff and joints seize up.

Please believe your drs, you can get meds to help with the anxiety. I wish you peace.

 

[Panos1978]

Thanks for your kind response.
I really need peace in mind. I am almost destroying my life and my family with this fear.
As we speak i am experiencing this pain on my right underarm which reflects to half of my arm when i am stretching it or moving it.
I just went to an orthopedic who advised that it shouldnt be something from the central nervous system but it might be something localized in that area.
At any case i am very worried how this whole story will progress. I am afraid that i will wake up tomorrow morning not being able to use my right arm...
In theory after the last "clean" EMG (except the quad fasciculation) ALS should have been ruled out BUT with all those developments i remain alarmed and highly worried.

 

[vickim]

You have lymph nodes in the armpits. Maybe you have an infection brewing. Only a dr can tell for sure. I really believe that you don't have als. Go back to the dr if you are worried. We have given you advice and that is all we can do, advice.

 

[Panos1978]

Its like a strain. No lymph nodes. They checked carefully for that.Muscle strain but honestly i dont remember injuring that part of my body...

 

[Tootiredofthis]

If I've showed you a list of symptoms I had when my mind was in similar state like yours, your jaw would drop. Mind is a very powerful thing. I also had pain in my arm (left one), feeling like it isn't "mine", muscle fatigues easily, ping and needles and a whole bunch of other sensory symptoms, which are, btw, very unlikely in early stages of ALS.

As for your EMG results, check out this study:

"The extensor digitorum brevis and abductor digiti minimi muscles were examined bilaterally with electromyography in 53 healthy subjects. In 72% of the subjects either fibrillation potentials, positive sharp waves or fasciculation was seen in at least one muscle examined. These slight, usually symmetric neuropathic signs are believed to be associated with normal aging and to some extent also with external trauma to the nerves and muscles in the distal parts of the foot."

They focused only on foot muscles here, but you get the point. When we hear words "fibrillation potentials", "positive sharp waves" or "fasciculation" , we get scared right away. But that's the difference between us and people who know what they are doing - they are trained to recognize when something is pathological.

 

[Panos1978]

Thanks for your encouraging message.
The pain in the right arm was examined and I was told is a kind of inflammation maybe from injury from the needle of the EMG. It's a red line throughout the arm which is very painful when I'm moving the arm.
I was also told that this is nothing to do with neurological issue.
Additionally I arranged an appointment tonight with a Professor in Neurophysiology to make a final EMG and get some final answers.
My biggest fear is that maybe theses fasciculations are the beginning of ALS and that the next few months will be a nightmare for me waiting and analyzing new symptoms.

 

[Panos1978]

In addition... Has anyone heard that Muscle Twitches could be caused by Genital Herpes?

 

[Tootiredofthis]

I can't share anything useful on that connection, but I do know that I felt exactly the same about waiting new few months and see if something develops. Unfortunately, that's what it took for me to calm down - time. But I am sure there are better ways. All I can say is try to keep yourself busy and stay away from computer.

 

[vickim]

A red line after a needle puncture could be blood poisoning. I had an employee that got poked in the finger and ended up in the hospital with blood poisoning and also had a red line leading up the arm. I am not saying that is what it is but might want look into it.

 

[Barbie]

Benign fasciculations. Very real, not ALS. nothing to worry about.

 

[Panos1978]

Hi Everyone again and thanks for your kind support and proper advising.
Last night i had another EMG to the best neurologist in my country. Actually he is a specialist in EMG since late 70's and the majority of people visit him for second opinions.
He is also a university professor.
The reason i went to him is because i realized that EMG is a purely objective test. Anyone can judge things differently.
He said that there is nothing that i should worry about as he didnt see any pathology during the testing.
Muscle twitches can continue and i shouldn't bother.
I felt good because over the past few months i am in a very bad psychological condition which creates problems to my family and job.
My real happiness only lasted for a day.
Today as i was talking to friend i slurred a word... Immediately panic and then i tried again and couldnt pronounced it properly for the second time. Noone realized that but i was in shock trying to understand if that is bulbar onset.
After that everything was again normal but my panic was there.
Could that be a possible start of bulbar onset?
Does bulbar onset sounds similar to that or there is continuous slurred speech?
I dont have any problems swallowing until now.

I really want to get everything out of mind. Life is short and you never know what comes up tomorrow so it doesnt worth wasting time to worry but its really hard when you have all these in the back of your mind.

Thanks again