AbChak123
New member
- Joined
- Oct 26, 2019
- Messages
- 7
- Reason
- Learn about ALS
- Diagnosis
- 00/0000
- Country
- IN
- State
- WB
Hello Everyone
This is my first post on this forum and I'm glad I chanced upon this while desperately looking for a bit of reassurance that I don't have the dreaded disease. My anxiety isn't exactly helping things and it has skyrocketed over the past few days so I'd get into the details without beating about the bush. Please bear with me on this one cause I'll try my best to put everything succinctly in one place.
So I'm from India and I'm an otherwise fit and active guy who's totally into outdoor activities like running and football. I had a disc bulge (L5-S1) diagnosed a couple of years back but through a proper rehabilitation program, I could get back to sports after a few months without any trouble. Recently, a couple of months ago, I noticed my calf muscles (on my left leg) twitching uncontrollably after a 30-minute run. I chose to ignore it but over the next few days, I could sense that it wasn't exactly something that could be brushed aside. The twitching would come and go but it never would stop. Dr.Google compounded my anxiety on this by suggesting the worst possible diagnosis as one of the possible causes. I quickly scheduled an appointment with a Neurologist in my area and when I got there, he checked my reflexes, asked me to walk on my toes and heels, inspected my leg muscles in a supine position. All these went pretty well and I didn't (still don't) have any 'clinical weakness', so to speak. He suggested a few blood tests (TSH, T3,T4, Vit B12,Vitamin D and CPK). It turned out I was deficient in Vitamin D (cause I was in Sweden for a year and didn't take any supplements despite the lack of Sunlight, which I was not used to). My B12 seems normal (but on the lower side) so my neurologist suggested me to take a few Vit D and B12 tablets for the next 2 months. I skipped the B12 tablets (not a good idea) and one month into this time span, I started panicking about it cause the fasciculations had increased in intensity, with near-cramp feelings. I still didn't have any kind of clinical weakness as I would wake up every morning and attempt walking on my toes and heels (I still do it twice or thrice a day for checking any signs of weakness). This time, when I went to him (which was yesterday), he decided to go for a NCS/EMG test. So , yesterday, I finally got my NCS/EMG done and here are the results:
NCS: Appears perfectly normal with no abnormalities recorded in the motor nerve, F wave, and sensory nerve studies. (This was done first so I was relieved)
EMG: This is where my primary concern is now and my anxiety is taking it's toll on me. My neurologist conducted the test on only one leg (the affected left leg) on two different spots (Vastus lateralis) and gastrocnemius muscle (this is where the twitching happens all the time). The results are as follows:
Vastus Lateralis: MUAP Amplitude , Duration seems normal, Recruitment and Interference both seem normal. However, for the gastrocnemius muscle , the recruitment was delayed and interference was incomplete. The impression: "EMG findings were neurogenic pattern in left Gastro muscle"
The doctor said everything else is normal except the fasciculations recorded on the EMG and I don't have any visible signs of clinical weakness or muscle-wasting. There's absolutely no cause of concern. He asked me to follow-up after two months though cause he opined that I might have other autoimmune responses (unlikely, he emphasized though) that could be investigated. "You don't have to worry about anything else cause we still think this is Benign" ..This is what he said as I was about to leave his chamber. He also asked me to continue with my B12 and Vit D tablets for 2 months. Furthermore, he has prescribed two medicines to allay my anxiety problems and help me get some good sleep at night.
As usual, I googled up "abnormal EMG but clean NSC" when I got back home from work and my fears returned again.Since morning, I've been thinking that had it been BFS, the EMG wouldn't have been abnormal, right?
So I want to ask the respected members of this forum a couple of questions:
1. Can an abnormal EMG (I'm not even sure if its abnormal cause for one spot on the same leg, everything seemed okay) rule out BFS and point to something sinister? I'm asking this cause my neurologist said "we have those fasciulations clearly visible on your EMG but nothing else". I read on the internet that BFS wouldn't show any abnormalities on EMG , right? Did he say this just to allay my anxiety so that I don't sweat over it or was he saying this with certainty? Also, are "abnormal" EMG findings commonplace and if these findings don't point to ALS, what else could it possibly be?
2. I still don't have any visible signs of weakness and I can do my daily jobs without any issues. I'll be going for a run today as well in the evening after a 3-week hiatus. I've read on the internet that by the time fasciculations start appearing in ALS, the patient would already show signs of clinical weakness and visible muscle atrophy and this is true for 99% of the cases. Is this true?
I'm really worried and anxious and any sort of advice/opinion on this would be highly appreciated.
Thanks and Warm Regards
AbChak123
This is my first post on this forum and I'm glad I chanced upon this while desperately looking for a bit of reassurance that I don't have the dreaded disease. My anxiety isn't exactly helping things and it has skyrocketed over the past few days so I'd get into the details without beating about the bush. Please bear with me on this one cause I'll try my best to put everything succinctly in one place.
So I'm from India and I'm an otherwise fit and active guy who's totally into outdoor activities like running and football. I had a disc bulge (L5-S1) diagnosed a couple of years back but through a proper rehabilitation program, I could get back to sports after a few months without any trouble. Recently, a couple of months ago, I noticed my calf muscles (on my left leg) twitching uncontrollably after a 30-minute run. I chose to ignore it but over the next few days, I could sense that it wasn't exactly something that could be brushed aside. The twitching would come and go but it never would stop. Dr.Google compounded my anxiety on this by suggesting the worst possible diagnosis as one of the possible causes. I quickly scheduled an appointment with a Neurologist in my area and when I got there, he checked my reflexes, asked me to walk on my toes and heels, inspected my leg muscles in a supine position. All these went pretty well and I didn't (still don't) have any 'clinical weakness', so to speak. He suggested a few blood tests (TSH, T3,T4, Vit B12,Vitamin D and CPK). It turned out I was deficient in Vitamin D (cause I was in Sweden for a year and didn't take any supplements despite the lack of Sunlight, which I was not used to). My B12 seems normal (but on the lower side) so my neurologist suggested me to take a few Vit D and B12 tablets for the next 2 months. I skipped the B12 tablets (not a good idea) and one month into this time span, I started panicking about it cause the fasciculations had increased in intensity, with near-cramp feelings. I still didn't have any kind of clinical weakness as I would wake up every morning and attempt walking on my toes and heels (I still do it twice or thrice a day for checking any signs of weakness). This time, when I went to him (which was yesterday), he decided to go for a NCS/EMG test. So , yesterday, I finally got my NCS/EMG done and here are the results:
NCS: Appears perfectly normal with no abnormalities recorded in the motor nerve, F wave, and sensory nerve studies. (This was done first so I was relieved)
EMG: This is where my primary concern is now and my anxiety is taking it's toll on me. My neurologist conducted the test on only one leg (the affected left leg) on two different spots (Vastus lateralis) and gastrocnemius muscle (this is where the twitching happens all the time). The results are as follows:
Vastus Lateralis: MUAP Amplitude , Duration seems normal, Recruitment and Interference both seem normal. However, for the gastrocnemius muscle , the recruitment was delayed and interference was incomplete. The impression: "EMG findings were neurogenic pattern in left Gastro muscle"
The doctor said everything else is normal except the fasciculations recorded on the EMG and I don't have any visible signs of clinical weakness or muscle-wasting. There's absolutely no cause of concern. He asked me to follow-up after two months though cause he opined that I might have other autoimmune responses (unlikely, he emphasized though) that could be investigated. "You don't have to worry about anything else cause we still think this is Benign" ..This is what he said as I was about to leave his chamber. He also asked me to continue with my B12 and Vit D tablets for 2 months. Furthermore, he has prescribed two medicines to allay my anxiety problems and help me get some good sleep at night.
As usual, I googled up "abnormal EMG but clean NSC" when I got back home from work and my fears returned again.Since morning, I've been thinking that had it been BFS, the EMG wouldn't have been abnormal, right?
So I want to ask the respected members of this forum a couple of questions:
1. Can an abnormal EMG (I'm not even sure if its abnormal cause for one spot on the same leg, everything seemed okay) rule out BFS and point to something sinister? I'm asking this cause my neurologist said "we have those fasciulations clearly visible on your EMG but nothing else". I read on the internet that BFS wouldn't show any abnormalities on EMG , right? Did he say this just to allay my anxiety so that I don't sweat over it or was he saying this with certainty? Also, are "abnormal" EMG findings commonplace and if these findings don't point to ALS, what else could it possibly be?
2. I still don't have any visible signs of weakness and I can do my daily jobs without any issues. I'll be going for a run today as well in the evening after a 3-week hiatus. I've read on the internet that by the time fasciculations start appearing in ALS, the patient would already show signs of clinical weakness and visible muscle atrophy and this is true for 99% of the cases. Is this true?
I'm really worried and anxious and any sort of advice/opinion on this would be highly appreciated.
Thanks and Warm Regards
AbChak123