EMG accuracy

[michelleG]

I was wondering how accurate an EMG is in showing abnormalities if they are occurring in the tongue. My neurologist scheduled an EMG of the tongue for me because of my pulsing twitch that hasn't gone away on the tongue. Will it give me the answers I'm looking for or are tongue EMG not very sensitive at the onset. I am not slurring my words or having difficulty moving my tongue around.

 

[Zaphoon]

If the EMG only picks up fasciculations, then your current symptoms are not due to ALS. If the EMG also picks up PSW's and MUP's, then there is probably cause for concern that something is afoot. At least, this is my understanding.

Someone spank me if I've got this wrong...

Oh, EMG's are very sensitive and very accurate. The people that perform the EMG's are usually highly trained, highly skilled neurologists.

Zaphoon

 

[BarryG]

Michelle, sorry I can't answer your question because even though I have bulbar ALS and can hardly eat or talk I have never had an EMG of my tongue. I was given my diagnosis after an EMG of my arm showed irregularities and the difficulties with my mouth, throat and tongue became evident.

 

[Erica]

Barry,
Why did they decided to do the EMG on your arm if you complained about your tongue and throat? Did you have any weakness in your arm?
Cookie

 

[BarryG]

Cookie. it was all part of the diagnosis program. When I first complained of slurred speech my GP sent me for an MRI to check for a stroke and when that didn't show anything he referred me to a neurologist. The neurologist did a preliminary exam and then sent me for a full body EMG (both arms and both legs). I thought that it was strange that the EMG did not include my face and tongue but what did I know, they were the experts not me. Anyway, even though at that time I had NO limb issues they found something and referred me to the ALS clinic for more EMG and NCV testing. I have never been inclined to know all of the technical details involved so I can't tell you what they found but a few months later they gave me my diagnosis and my speech and swallowing has gone downhill steadily since then. My right arm (where they found the problem) is now starting to cause me problems and I use a cane because of floppy feet.

 

[KeeKer]

Do you have a scooter? Or should I say a three wheel motor cycle? Bet you would look real cool! My bro just loved his!

 

[BarryG]

No scooter for me yet and hopefully not for a while yet but you know I do love things with motors. I just got a special permit from the government so that I can ride my quad while hunting. They have a rule here about not carrying a firearm on an ATV between sunrise and noon and because I cannot walk very far now the special permit makes me and a helper exempt. My wife thinks that I am nuts for looking forward to fall (because of what comes after) but I do love getting out into the bush and want to do it for as long as I can.

 

[Erica]

Hi Barry, Thank you for your reply. BTW, I love your new avatar.
One more question, I started having issues with excessive saliva and sometimes even choking on it. Any suggestions?

 

[BarryG]

Hi Cookie, thanks for the avatar comment. There are so many cool pictures out there to use!

Ah yes the whole saliva thing makes me so mad that I could spit (or at least drool all over the floor cause my spitter doesn't work anymore! No lack of ammo but the gun is broke). Last fall I had radiation treatment to the main salivary glands in my face which is supposed to reduce my saliva output by 80% and I think that it worked even though I still drool more than I would like. My doctors told me that it is done more to reduce the risk of aspiration pneumonia than for aesthetic reasons but whatever the reason I am glad that it was done. I also tried Amitriptyline but it lowered my blood pressure too much and I would almost pass out when rising from a sitting or laying down position so that was out. Now I have a prescription for Glycopyrrolate and it seems to work to dry me up completely. Others on the forum have used patches and Botox and I will leave it to them to comment on those. As far as choking, do you have a suction machine? That was the very first piece of equipment that I got and I have used it to suck out the nasty goo that makes me gag and choke.

 

[BethU]

Cookie ... I'll chime in on the patch that you wear behind your ear. It's Scop(something), and many people don't like it ... they say it makes them feel funny or feel a little crazy, but with me it's hard to tell the difference. Basically it's a seasickness med, and it does dry up the saliva for most of the time.

I still get gushers when I try to eat anything (like yogurt with pills), and I have to suction in the evenings.

Even with the patch, I walk around most of the day with Kleenix stuck in my mouth, because I have no lip seal, and even reduced saliva immediately drips out. I forget sometimes, and stuff a tissue in my mouth when I'm out in public, and get very strange looks! I'd recommend the Scop patch as a measure of last resort. It works OK for me and I can tolerate it, but a lot of people can't.

 

[Erica]

Barry, BethU, Thank you very much for your advice.
I'll try the patch, if not will talk to my doctor at my appt in September. Cookie.