EMG Question

[Penn1966]

I have had 2 EMGs both came back clear, 30 days apart, only symptoms before were fasiculations & an FVC of 84 which I was told was concerning by the pulmonologist, said it was more so my ability to get air to my small airways & the value of FEF25 While I feel good about my EMGs I am having pain around my rib cage, up to left shoulder and my neck feels weak. I understand my limbs were cleared in the EMG, if MND was going on in my trunk or lungs should have something shown in my EMGs? This pain is like a stabbing/sore pain & at times tingles, I also feel fatigued at times. Thank you.

 

[KarenNWendyn]

Two things here argue against MND:
1) clean EMGs. This should alleviate your worries.
2) Pain. This is not consistent with MND, especially early in the course (pain later in the course can result from immobility and contractures).

 

[Penn1966]

Thanks you, but I have read threads where trunk or respritory onset does not show in limb EMG, hace also seen where pain can be presenting feature, I do not believe these are cramps as they are constant, more like tight sore muscles. Do not want to be concerned if there is no need. Thank you for the response.

 

[KimT]

FVC of 84 is in normal range. If your pulmo is concerned, have her/him be more specific about why? If it is a gas exchange issue and you have a problem with your lungs, that isn't consistent with ALS. There are different patterns in pulmonary function tests and each pattern leads to various issues. ALS shows a restrictive pattern but so do other things. Get your pulmo to better explain the concern.

Also, if you are having pain in your rib area that could explain a lower FVC than your pulmo expected.

 

[Firefighter58]

If you don’t want to listen to the advice and opinions given here then why are you here asking? After not believing two EMG’s it sounds like you have made your mind up and nothing is going to change that, so go on believing you have ALS and leave those of us that have it alone. This is not an exclusive club that you want to be a member of believe me.
Al

 

[Penn1966]

I understand Al and will not post again until I speak with my Dr., my frustration is getting answers from Drs and new symptoms, what the limb EMG means in regards to trunk & rresp symptoms, the breathing, new fatigue & pain concerns me, it is unfair for me to cone to you all, thank you for your feedback and for this site

 

[Penn1966]

I heard from pulmonologist & my test was normal, he monitored a normal PFV of 84 and almost normal TLC of 79.5 & a diffusion of 103% make him feel good about the test, they are looking to schedule an EMG to test my back & neck. I have 2 EMGs where they tested 3 limbs & 1 muscle in my back which were clear, I understand I do feel very good about all the results, but I have symptoms no one can explain, pain tight muscles in left shoulder & all around ribs and a sore muscle, when I swallow & to touch on the left side of my throat, plus fatigue. I have read where people have similar symptoms above & ended up getting diagnosed, I do not want to upset anyone but in your experiences do the clean EMGs on limbs over ride the symptoms I am having? Hoping to get additional EMG to rule out shoulders, back & neck. Appreciate feedback & apologize if I upset anyone, that you for your insight

 

[Penn1966]

One other thing, started having throat pain, noticed that when I stick my tounge out it deviates to the left, also the tonsil looks more flaccid on that side, no speech or swallowing issues, is tounge deviation a sign on LMN

 

[KimT]

Yes, the clean EMGs override anything you feel. I'm also glad to hear your pulmo got back to you with good news!

It seems like overkill to get a third EMG but if it makes you less anxious and your doctor is willing to do it, then go for it.

Best wishes. Glad you don't have to join us here !!!!!!!

 

[Penn1966]

Kim thank you, even if am EMG was not done in bulbar, yet my tounge deviates to left, new thing, concerned about deviated tounge but if that was present due to als I am guessing something should have shown up in one of the limb EMGs, is that what your saying? Thank u

 

[Penn1966]

Something new going on, find myself needing to urinate badly & before I get to toilet having some leakage, 3 clean EMGs, no clinical weakness, twitching still going on, feeling it in abdomen, is this kind of leaking common among NMD esp on beginning?

 

[Clearwater AL]

Buy some adult diapers and make an appointment with a Urologist.

 

[KimT]

No, that isn't a common problem. Please see your doctor. We can't continue to answer questions. Thanks and best wishes.

 

[Penn1966]

Going tomorrow to get EMG on back, neck Have had one on limbs & pataspinals, both clean, after test will meet with Neuromuscular specialist, brain MRI today, crossing tests off the list. I do not want to upset the forum but my frustration is ongoing symptoms & no answers. Dull pain has been present in left hand now for 3 days, have not done anything to hurt it, not dominant hand, feeling fatigue with no known cause, these things concern me that weakness is coming , I am meeting with another NM specialist on Friday. Have a list of questions for both Drs, want to ask them if EMGs are clean, then despite dull pain, fatigue, twitching, lung concerns, etc can I be confident this is not als, am assuming if pain on left hand is due to weakness it will absolutely show on EMG. I will admit anxiety has gotten the best of me, due to very real symptoms, hopefully I will be an example of an over worrier , I appreciate everyone here, abd will report back post appointments

 

[Penn1966]

Had my EMG which is posted, in addition they tested my tounge, shoulders and T11 & T7 paraspinals. All came back negative for MND but were abnormal? I have attached my EMG, my question is the note reduced amplitude in a number of sensory nerves in both right and left, is that a concern? The only motor nerve affected is the left perineal and she said that was noted on previous study so no concern.

Please if anyone can help explain the reduced amplitude let me know. They also said no sign of MND despite the twitching, fatigue and breathing issues, I am assuming by the hypoglossol nerve testing clear does that mean no bulbar?

Good news today, no sign of MND, said she does not see signs of ALS, helping me get to an end game, no explanation for what is causing symptoms, she saw my twitching we set a game plan I will call you tomorrow, she said the sleep study will provide solid information