curtrill
Active member
- Joined
- Apr 25, 2011
- Messages
- 40
- Reason
- Learn about ALS
- Country
- US
- State
- TN
- City
- Hometown
Thankfully, I have just completed my third clean EMG in six months. The first was of two limbs / the second was three limbs and thorasic / and the last of two limbs, thorasic, pectoral, neck and under the chin. However my symptoms which started 7-8 months ago continue. I am wondering if all this could be UMN and how much may be LMN and would have shown up on the EMG if MND related.
HEAVY, STIFF, FATIGUED LEGS. Started in both calves and has progressed up legs to glutes. Tightness, fatigue occurs while standing or walking and goes away for the most part at rest but can always be felt to some degree if the muscle is stretched. Legs "feel" weak but are not clinically weak. Can actually gain a small bit of strength with exercise but not tone.
LOSS OF MUSCLE TONE IN LIMBS. Especially in the calves where the muscles are flaccid, floppy and loose when relaxed....hypotonia? LMN? An area of suspected atrophy was needled at the last emg and showed nothing.
ASYMMETRIC LOSS OF MUSCLE TONE....ATROPHY? This is on the right/dominant side in the great toe, foot, calf, bicep, pectoral. UMN/LMN?
MUSCLE JERKS Random movements of hand, finger, foot, leg etc. Seem to occur more so when I have anxiety. My jaw was slamming shut during sleep but seems to have stopped....anxiety?
FATIGUE, LOSS OF STAMINA. 10+ hours of sleep and fatigue persists.
SORE, FATIGUED VOICE AND THROAT. Throat has started making a "clunking" sound on the right side when swallowing.....especially when lying down. No big problems swallowing but foods do seem to "stall out" at the top of the throat at times.
TONGUE FATIGUE AT BASE WHEN EATING. Tongue is also white and furry with a widening groove in the center with teeth marks on edges. Tongue is a bit smaller on the right, front side. UMN? LMN?
FASCICULATIONS Of couse....started in the calves now bodywide....Aren't these LMN and if pathalogical would have shown some bad company (fibs,psw's) on EMG?
NOT MUCH PROBLEM WITH CRAMPING.....Not sure how SPACTICITY would present. Can it occur without you knowing it?
REFLEXES have been rated 2,2+,3 depending on the limb and who did the exam and on which visit. They are symmetrical. Upon the last exam the neuro said they were a bit quick but not pathalogical (2+).
EXAM All other parts of the exam were clear. No clinical weakness. Negative jaw jerk, Hoffman, Babinski. Motor skills good. Recent visits and last two emg's have been completed at an ALS center at a major teaching university. The last emg was done by a young neuromusclar specialist that sees about 30 ALS patients.
Tests for mimics have been completed. Neuro states "I have no other tests to run". I know that the neuros are the authorities. I also know the people on this forum have valuable insight that I respect as well.
Could this all be UMN and not detectable on EMG?
Wouldn't calf muscles that have asymmetric decrease in size, tone show on the emgs if related to MND? Isn't that LMN?
Would clean emg of the tongue (one needle insertion) from under the chin rule out LMN?UMN?........would it rule out PLS?
Not looking for any EMG debates just some help trying to sort all this out....
Wright , can you help too?
Thanks to all for reading this. Thanks in advance for all replies!
Curtrill
HEAVY, STIFF, FATIGUED LEGS. Started in both calves and has progressed up legs to glutes. Tightness, fatigue occurs while standing or walking and goes away for the most part at rest but can always be felt to some degree if the muscle is stretched. Legs "feel" weak but are not clinically weak. Can actually gain a small bit of strength with exercise but not tone.
LOSS OF MUSCLE TONE IN LIMBS. Especially in the calves where the muscles are flaccid, floppy and loose when relaxed....hypotonia? LMN? An area of suspected atrophy was needled at the last emg and showed nothing.
ASYMMETRIC LOSS OF MUSCLE TONE....ATROPHY? This is on the right/dominant side in the great toe, foot, calf, bicep, pectoral. UMN/LMN?
MUSCLE JERKS Random movements of hand, finger, foot, leg etc. Seem to occur more so when I have anxiety. My jaw was slamming shut during sleep but seems to have stopped....anxiety?
FATIGUE, LOSS OF STAMINA. 10+ hours of sleep and fatigue persists.
SORE, FATIGUED VOICE AND THROAT. Throat has started making a "clunking" sound on the right side when swallowing.....especially when lying down. No big problems swallowing but foods do seem to "stall out" at the top of the throat at times.
TONGUE FATIGUE AT BASE WHEN EATING. Tongue is also white and furry with a widening groove in the center with teeth marks on edges. Tongue is a bit smaller on the right, front side. UMN? LMN?
FASCICULATIONS Of couse....started in the calves now bodywide....Aren't these LMN and if pathalogical would have shown some bad company (fibs,psw's) on EMG?
NOT MUCH PROBLEM WITH CRAMPING.....Not sure how SPACTICITY would present. Can it occur without you knowing it?
REFLEXES have been rated 2,2+,3 depending on the limb and who did the exam and on which visit. They are symmetrical. Upon the last exam the neuro said they were a bit quick but not pathalogical (2+).
EXAM All other parts of the exam were clear. No clinical weakness. Negative jaw jerk, Hoffman, Babinski. Motor skills good. Recent visits and last two emg's have been completed at an ALS center at a major teaching university. The last emg was done by a young neuromusclar specialist that sees about 30 ALS patients.
Tests for mimics have been completed. Neuro states "I have no other tests to run". I know that the neuros are the authorities. I also know the people on this forum have valuable insight that I respect as well.
Could this all be UMN and not detectable on EMG?
Wouldn't calf muscles that have asymmetric decrease in size, tone show on the emgs if related to MND? Isn't that LMN?
Would clean emg of the tongue (one needle insertion) from under the chin rule out LMN?UMN?........would it rule out PLS?
Not looking for any EMG debates just some help trying to sort all this out....
Wright , can you help too?
Thanks to all for reading this. Thanks in advance for all replies!
Curtrill