Old 11-16-2018, 10:19 AM #1 (permalink)
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Default Abnormal EMG results

Hi all,

I've had widespread twitching for quite a while but know by now that twitching is non-specific. Some other symptoms have come up however that have been causing me more concern. Some of my muscles, including obliques (both sides), calf muscles and foot arch have been feeling 'crampy', so that if I start to contract them strongly enough I seem headed for a cramp. My right hand has also started to go in that direction after just a bit of writing.

My main concern, though, is that I've been to a neurologist, and while the clinical was clean (reflexes normal, strength normal), a limited EMG study of three muscles-tibialis posterior, medial gastrocnemius and tibialis anterior-revealed positive sharp waves and fibrillations in the two former muscles but not the latter. On the other hand, recruitement, amplitude and duration of the MUAPs was normal with no polyphasicity. NCV was also normal.

Possibly connected to this-or maybe not-I have developed these strange paresthesias, a very specific buzzing/needling sensation just below my big toe on the inner side of my foot. It started on the right foot, seemed to resolve and now has moved to the left. I don't know what to make of these.

I suppose my main question has to do with the psws and fibrillations. The physiatrist seemed to conclude that there might be some radiculopathy, although I don't have any lower back pain or pain radiating down the buttocks at all. The fact that he found psws and fibs in two muscles innervated by the same root but not in one innervated by a different root could point in that direction.

I'm just wondering though what it would mean to have evidence of acute innervation but no chronic innervation? This has been going on for a while now. Wouldn't there be some early evidence of attempted reinnervation in the form of some polyphasicity or of axon loss in the form of reduced recruitment or larger motor units?
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Old 11-16-2018, 02:48 PM #2 (permalink)
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Default Re: Abnormal EMG results

Radiculopathy does not require LBP.

Acute but no chronic findings argues against anything that we discuss here, as does normal size and recruitment of the motor units. I would follow up with the neuro as it is he who should come up with a diagnosis or further plan, based on the EMG and exam findings.

Best,
Laurie
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back, clinical, early, emg, foot, muscles, neurologist, pain, symptoms, twitching


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