Abnormal EMG

[mrpet]

Fascs started in late Nov 2015. Had 4 EMGs by start of month 5, all were normal (apart from fascs).

Fascs continued, and at month 8 I went for the first time to the Sydney Brain and Mind Centre, probably Australias leading research centre in the field. There I had an ultrasound (normal nerves and muscles), transcranial magnetic stimulation (normal sici score of 19 and 20), normal clinical exam (no weakness or atrophy, non pathologically brisk symmetrical reflexes). My (now fifth) EMG detected widespread fascs (lower limb > upper limb), one 'focal fibrillation potential' in right thigh, and occasional doublet fascs in lower limbs. No other abnormalities on emg.

I was told very clearly I had no (zero) features to suggest mnd, which surprised me given the EMG results. I was told I have classic presentation of peripheral nerve hyperexcitability (PNH).

Is anyone else surprised that I can be given such a clear categorical all-clear from als notwithstanding the EMG results?

Thanks.

 

[lgelb]

What do you mean "notwithstanding the EMG results?" Having fascic potentials only is a clear statement against ALS (or any other neurologic disorder). It says, "benign."

No evidence of acute or chronic denervation nor reinnervation in your EMG (a single fibrillation potential means nothing).

So, no, none of us can be surprised. You, on the other hand, should be thrilled. If you are not, please find a good health anxiety resource and get on with your life.

Best,
Laurie

 

[mrpet]

Thanks Laurie! With regard to the EMG, the real concern lay in the existence of the fib. Would you mind please explaining why a single fib potential means nothing (I really didn't know this)? Thanks heaps.

 

[lgelb]

Well, only one of anything is usually not significantly more important than lots of something else, and an EMG is no different. Say you've walked thousands of steps and you trip or wobble at step 2002, then resume walking at step 2003. Does that mean you can't walk? Fibrillation potentials were not the pattern revealed by testing. Normal activity was. Does that make sense?

 

[mrpet]

Thanks Laurie. I think I'd built up in my own mind that fibs are the devil when it comes to als diagnosis and didn't appreciate that benign hyperexcitability syndromes can also cause motor abnormalities, like occasional fibs. I've also since read that normal healthy people can have occasional fibs through just wear and tear of neuromuscular junctions or previous trauma. I guess I was just surprised that the professor who saw me attributed zero significance to the fib (but I'm glad he did).


I hope this information perhaps helps others who have the occasional fib on their EMG.

PS my family and I are moving to the Pacific North West soon, so we will be neighbours of a sort!

 

[sunflower51]

May I ask what medicing he prescribed for PNH? I was told I had RLS and an nervous about taking gabapentin. I am sure from having this tingling in legs and within body fasis that I habe PNH but curious about any remedy they recommended. Thank u.

 

[affected]

sunflower you are hijacking someone else's thread. This is an ALS forum not a general health forum so you should ask about PNH on a general health forum.

If you think you have ALS start your own thread.
If you are here because you are a CALS go to that section and talk about that and we can support you as a CALS.