Abnormal EMG - Feedback Appreciated

[ChelseaB]

Hi Everyone,

I've been lurking for a while now but decided to post today after my EMG results came back in.

I would like to preface by saying that I really appreciate anyone's feedback. No matter the outcome of my situation, this process has really opened my eyes and encouraged me to get more involved with awareness and advocacy towards MND.

That said, my issues started about 3 months ago. It began with noticeable (perceived) weakness and fatigue in both my legs and arms, accompanied by incidents of tripping and dropping things; difficulty opening bottles or using my keyboard/mouse. I also have non-specific pains and tightness - especially in my right forearm/hand. I originally went to my GP who then referred me to my Neuro.

1st clinical exam, no weakness, or atrophy detected and my reflexes are normal. He also didn't notice any fasciculations, but did say that I have essential tremors.

He ordered a brain MRI two separate EMG study (one upper and lower extremities). Brain MRI came back normal, but both EMG's were abnormal. Below are the quick-version interpretation of both EMGs:

Upper Results: This is a partly abnormal EMG, there's electro-diagnostic evidence only for mild, chronic denervation in L4-5 innervated muscles bilaterally to suggest lumbar radiculopathy. There was no EMG evidence for motor neuron disease nor myopathy.


Lower Results:
This is a partly abnormal EMG, there is electro-diagnostic evidence on EMG only for bilateral, mild, chronic denervation, most c/w cervical polyradiculopathy in C5-6 distribution.

I asked my Neuro what he thought, and he said MS is ruled out because of the normal brain MRI. That said, he acknowledged there's nerve damage - particularly in the areas I'm having issues with (hands/tricep/forearm), but that nothing specific points to MND at this time, though he wants to monitor it for the next 6 months. Additionally, he ordered a spinal/neck MRI.

In terms of questions, I'm just curious (of course I thought of this after I left), but is it normal for a seemingly healthy 30 year old with no history of back issues to suddenly have nerve damage in their limbs? My immediate concern is that my hand and forearm to continue to feel weaker and even tightening/painful - especially when holding things.

Likewise, is simply having 'chronic denervation' in the absence of other clinical findings normal, or cause for concern?

Again, any guidance or feedback is greatly appreciated.

 

[Lkaibel]

Your age and the simple fact that your EMG does not show both chronic AND active denervation points away from MND. Also, you do not seem to be described the sort of marked weakness noticed in MND.

The waiting has to be hell, but at this point I think your Doctor is on the right track in saying let's monitor it for the next six months.

There are many, many reasons (and sometimes no specific reason is even found) that an EMG can show abnormalities. ALS is actuLly pretty low on the low st of reasons for abnormal test results.

 

[ChelseaB]

Thank you for the response, Lkaibel.

Since I am still learning about this and not well-versed, do you mind explaining the difference (or importance) of 'chronic denervation' vs 'active and chronic denervation'.

I assumed my EMG findings simply showed nerve damage period, which given my age and seemingly good health appears somewhat odd, despite the weakness and twitching I am having in my arm.

And yes - the waiting is not fun, but I'm trying to stay positive and truly appreciating every day going forward.