Status
Not open for further replies.

stvhck

Active member
Joined
Apr 19, 2011
Messages
44
Reason
Learn about ALS
Country
US
State
CA
City
Irvine
Hello All-

Its been awhile since I have been on the boards but wanted to check in and post an update on my "condition" along with EMG results from today.

I have been twitching since Nov 2010. My twitching presented in both calves and feet and has remained a constant since day one. I also get random, unexplained twitches/spasms throughout my body and I have not been able to link them to any activity or reason. I was finally diagnosed with bilateral ulnar neuropathy earlier this year (FEB 2012) after my third EMG.

Today I consulted with the ALS specialists at Cedars Sinai hospital in Los Angeles. I had the head of the department use me as a guinea pig of sorts by allowing a doc in training to perform an EMG/NCV on my arms. The doc in training made several mistakes and the head of the department had to redo many of the steps on the exam.

Good News: The ulnar neuropathy in the right arm has improved and is barely borderline now. The left arm is still mild to moderate but is either the same as previous results or slightly better.

Bad News: They found positive sharp wave potentials in the muscle between my thumb and index finger on the left arm. Also the reflexes in both arms/elbow region are very diminished and took several attempts to locate.

The doctor did not seem overly concerned however I wanted to check with folks here to see if you have had a similar experience? I assume the positive sharp waves could be from the ulnar neuropathy? What would cause the diminished reflexes in both arms?

Thanks!
 
I've had three EMGs and they were straight ALS diagnosis. No question. I'm glad you are improving!
 
Hello Ms. Pie,

Thank you for sharing your experience and I am truly sorry to hear about your diagnosis. I see a lot of conflicting information about hyporeflexia...do you know if this is something of concern with motor neuron disease?
 
Not as far as I'm concerned. When you can't do something that you used to be able to do, then I'd be a little concerned.
 
Congrats on the good news, and I hope things continue to improve for you.
 
I go to a teaching hospital also and had one of the Neurology Fellows do my EMG/NCV on my first visit. Fortunately , she was good. I'm glad to help with educating all of the students that pass through our Clinic in all of the specialties. The Fellow is now practicing in Florida.

Sounds like good news for you.
 
Hi All,

I received the report from Cedars Sinai on my EMG/NVC study. Much of the explanation and terminology reads like a foreign language to me. Any advice or help? I'm concerned since the impression suggests the study is abnormal. Thank you!

EMG & NCV Findings:
Bilateral median, radial and right ulnar sensory response was normal. Left ulnar sensory response had
moderately prolong peak onset latency, reduced amplitude and slowed conduction velocity. Bilateral median
motor F-wave responses were normal. Bilateral ulnar motor responses had moderately prolonged peak onset
latencies and delayed conduction velocities across the elbows, but normal amplitude. Bilateral ulnar F-wave
responses were prolonged.
Needle examination of selected muscles ofthe left upper extremity were normal. There were a few complex
repetitive discharges in the left first dorsal interosseous muscle.

Impression:
This is an abnormal study. There is evidence for bilateral ulnar mononeuropathy across elbow, which is
mild on the right and mild to moderate on the left. Clinical correlation is advised.
 
Wright is the go to guy here for interpreting the EMG. I don't see anything about active denervation and re inervation, so I guess that's good.
 
I agree that Wright is the guy to ask about this report, but I'm fairly certain of a few things: it sounds like the abnormalities exist in peripheral motor and sensory nerves, but nothing really sounds like it points to motor nerve damage. Nerve conduction studies are often normal in ALS patients, so I'm thinking your results point away from ALS. Just my layman's understanding, but I feel pretty confident that's the deal. Good luck.
 
Thank you Deb and Luke for your feedback. I was concerned when I saw the report suggested issues with the ulnar motor nerves.

I have been twitching all over for 2 years now immediately following a vaccine I received. One week after, the widespread twitching began and had been here ever since. I also feel numbness and tingling at times but concentrated in the 5th digits on each hand (guessing the ulnar issues are causing this). I also have moderate joint pain in both elbows and left shoulder. The EMG results would not be as bothersome if not for the fact I twitch all over my body and cramp as well.

Clinical evaluation seems to be okay with the exception of some weakness in the 5th digits. My reflexes are good in the legs but slightly diminished at the elbows. Thanks again for your feedback!
 
Status
Not open for further replies.
Back
Top