Old 02-15-2017, 07:21 PM #1 (permalink)
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Default Clean emg but still questions

Hi !

For almost 5 months now my tongue have strange behaviors. It fasciculates, twitches, ans sometimes get stuck between my teeths while i'm talking.

I've seen a neurologist last month who tell me that I should have an Emg done. Since then I got fgasciculations everywhere (stress I know...) I manage to find onespot in Montreal neurological hospital. Luckily, I learn before the test that the doctor who will perform the test it's one of Canada specialist of ALS.

The technician did the electrical shock part (NCV or something like that) on my four limbs. She could't say anything.

Then the doctor came in, ask me questions about my symptoms, do some test (reflex hammer, walking, tongue protrusion). Shethen stuck the needle in my right calves and right thigh. She then say that the examan was normal that theres aboslutly no sign of ALS. Shetoild me that we some others things can cause my tongue behavior, that we will do blood test and an MRI.

The technician then do more electrical test on my facial nerves (not fun at all!).

Questions:

1) Why would she exlude putting needle in bulbar region ? It's a bit of a worry for me since my problem is there ? I tend to have confidence in the doctors so I didn't ask her.

2) I read here and elsewhere that bulbar als could exist despite a clean limb emg. After 4-5 months of tongue biting/fasciculations. Would my mouth problems would be worse with ALS ?

3) Should I look for another emg that would include the tongue and/or bulbar region ?

Thnaks a lot in advance !

Last edited by tonguetwitcher : 02-15-2017 at 07:34 PM
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Old 02-15-2017, 08:49 PM #2 (permalink)
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Default Re: Clean emg but still questions

The doctor examined you, including your tongue, and told you there is no sign of ALS.
Now you want strangers who can't see you to second-guess an ALS-experienced doctor?
If you don't want to ask your doctor, get a new doctor.
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Old 02-16-2017, 11:16 AM #3 (permalink)
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Default Re: Clean emg but still questions

Second guess the neurologist is not exactly what I was looking for. Like I've said, it bugs me a bit that the bulbar region wasn't checked since it's where my main problem is (beside fasciculations everywhere). Since she want to do other test it means that she aknowledge there is a problem in that region.

Also what i'm asking is that within 4-5 months of tongue biting and perceived slurring (thats me not other people), if bulbar als was progressing would I have more obvious/desabilating problems ?
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Old 02-16-2017, 06:00 PM #4 (permalink)
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Default Re: Clean emg but still questions

Also I forgot to mention that she want to see me again in three months. Maybe she's guessing somethimng and she want to see how it evolves (Bulbarl ALS ?). The bl;ood test and MRI could be also to confirm that it was ALS.

The only thing that ease my mind is that it would have been really unprofessionnal to say to someone nothing indicates AlS and that all tests where normal if in her mind ALS could be a possibility. Can sto thinking about why she have not stick her needle in the bulbar region.
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Old 02-16-2017, 06:23 PM #5 (permalink)
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Default Re: Clean emg but still questions

Any doctor will be honest with you. They don't "hide" things from their patients if they observe something wrong.

When you question a doctor's technique because you don't think they did the right thing, that's the very definition of second guessing someone. There's nothing inherently wrong with that, but the person to ask why a doctor did not test something is the doctor doing the testing. They can provide further information about their logic behind testing one thing and not another.

We here can not tell you what the doctor was observing and why they made the decisions they did. Your referring doctor will receive a report from the specialist that outlines what tests were conducted and what the specialist concluded. Ask your gp for the report and have a read. If you still have questions after reading the report, communicate them to your gp/specialist.
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