Weakness due to upper motor neuron damage

[aumaliwmedu]

Hello,

First of all I want to sincerely thank everyone for their replies. This site has been the lone bright spot for me in the last 3 weeks ever since my symptoms crept up on me.

I have mild arm weakness that has progressed slightly in the last month. My EMG, which was conducted last week came out normal and the neurologist said that everything looks fine. However, according to various websites as well as Wright's response on some of the earlier posts, the EMG would only pick up on abnormalities due to lower motor neuron death. So why would the neurologist dismiss ALS if they know that upper motor neuron death also causes weakness and yet can't be picked up on the EMG. Isn't that a little premature???

[Danijela]

I presume your neurologist has not noted any upper motor neuron signs during your physical examination, such as spasticity, brisk relfexes, clonus etc.

[wright]

Aumaliwmedu

I got your visitor message and since it is the same question as you are posing on this thread, I thought I'd reply here. Danijela is exactly right: if your weakness was due to upper motor neuron problems, then you would have other upper motor neuron signs. You obviously had a clean clinical exam (that is how they assess upper motor neuron signs), which is why your neuro dismissed ALS. I hope you get some peace of mind soon. Take care.

[hopingforcure]

Like we said UMN damage is dx through CLINICAL EXAM.. A doctor can surely and will surely be able to dx those problems..

[Zaphoon]

If you have hyper reflexes, spasticity would go hand in hand with UMN troubles unless you are just naturally hyper reflexic. My finding has been that neurologist don't get overly excited by brisk reflexes unless they see accompanying signs like spasticity, Babinski and Hoffman signs and progressive weakness.

Even a Babinski sign doesn't get some neuros rattled very much. What will get their attention, and yours, is progressive weakness. Most people are 25-50% into ALS before a diagnosis can be given. a few of the biggest keys to the dx is progressive weakness and a dirty EMG with several limbs and muscles being tested.

Twitching isn't even a part of the picture for diagnosis.

Zaphoon