43 Yr old with twiching with abnormal emg

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Darad

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Hi I'm 43. I've being having a tingly feeling in my legs for over 2 and a half yrs now, sometimes feels like it's slightly vibrating feeling. Sometimes burning and aching feeling in my tighs.no other symptoms. Had an emg done in May which showed right hand side denervation in the soleus muscle where there was positive sharpwaves with polyphasic motor units, similarly the gastrocnemius muscle showed positive sharpwaves with polyphasic motor units. On the left hand side the gastrocnemius muscle alone showed positive sharpwaves but these were not sustained. The paraspinal screen on the right and left were normal with no particular involvement of the lower multifidus muscle. The findings were that of a bilateral s1 nerve root irritation however there is no findings in the paraspinal muscle so there was a possibility of compartment syndrome. I've since had a pressure test to rule this out. I had the first emg in May and on the 23rd September started having leg twitching mostly in the left leg but still in both. I'm so anxious since being giving a date for second emg to rule out stuff. I'm having random twitches in my arms, back, butt, lip, and tongue, but not like my legs I have them everytime I sit, but the others are only here and there now and again. Today for the first time my left arm felt tingly and my fingers felt weak, so I panicked and tryed to pick up a pen which I did but my fingers felt like they dident have full power. Its fine sínce but still feels tingly. I have allready a small child who's disabled so I'm so anxious trying to find and answer to my symptoms. Dose this sound like I've als, has anyone similar symptoms or any answer to the findings to my emg.
Thanks so much for reading.
 

Nikki J

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As you know if you read the read before posting sticky twitching is so common as to be meaningless

tingling and vibrating are sensory symptoms which point away from ALS. Your emg findings were not widespread as they would be in ALS and your paraspinals are normal - they are considered very sensitive for lower limb onset ALS. All of which makes it very likely it isn’t ALS.
you did not mention the findings of the ncs? You presumably had one with the emg?

your doctor is obviously looking at things thoroughly. You might ask what is in their differential.
 

Darad

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Thanks for your reply. I spoke with my Dr today because of my arm weakness yesterday. I haven't had a ncs yet and she told me the neurologist has one scheduled along with bulbar emg because of my radom twitch I get in my tongue. I appreciate your time answering me, and would be very grateful to know if this is still the case with having the sensory issues of tingling that bulbar als is still ruled out on my symptoms.
 

Nikki J

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Sensory symptoms are not a sign of bulbar either and tongue twitches are like any other twitches usually benign.

your neurologist is being very thorough fortunately. Let us know what they find
 

Darad

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Hi nicki
Again thanks for your reply.
Can I please just ask 1 more question.I'm sick with worry. My left arm that went weak the other day still dosent feel right, still feels weak, but now my right arm is not right, I was trying to pick up popcorn and I couldent grip them properly it feels like my fingers had lost power and couldent pick them up properly, they kept falling and felt like they were loosing power. I read on another post that you don't feel weak that your limb just dosent work, please can I ask dose it build up to loosing power, or just loose it completely, my arm dident feel weak just dident have full power I really appreciate your response, I'm so worried after this has happened to me.
 

Nikki J

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You are correct feeling weak is not ALS. Regarding losing power sort of but it is because many/ most things use multiple muscles. There will be something that just doesn’t work that uses one or a couple of small muscles and other things that use many muscles that are initially harder then impossible. Of course weakness has many many causes and ALS is one of the rarest.
 

Darad

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OK thanks so much, really appreciate for your quick reply.
 
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