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lynnj1602

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Hello everyone

I have multiple diagnosis's.

Dx: Atrophy of frontal and temporal lobes (1999)
Parkinsonism (2002)
Small fibre peripheral neuropthy (2002 Sweat test and Surel Nerve Biopsy)
Axonal degenerating sensory polyneuopathy (2008)
Gastroparesis



My chief complaint today is Right heel pain for the last 3 months.

Prior EMG's have been negative

Results of EMG done (Oct 2008):

Right median motor study normal.
Right peroneal motor and right tibial motor conduction study is not signicantly abnormal.
Right tibial distal motor latency normal.
Right abductor hallucis motor response was of normal amplitude.

EMG of right peroneus longus and right tibialis anterior normal.
EMG of the right medial gastorcnemius showed mild chronic neurogenic change with motor unit potentials increased in the amplitude.
1+ fasciculation was present in the right abductor hallucis.
No active denervation was present in the right abductor hallucis.


Conductions Studies result (Oct 2008)
Right median and ulnar parm to wrist sensory latency is normal with normal sensory amplitudes.
Right superficial peroneal sensory response normal. Left sural sensory response normal.

In the right leg, the sural sensory respone was absent but this related to her previous sural nerve biopsy. Right superficial peroneal sensory was not detected.


The doctor noted:
The only weakness the doctor could detect was weakness of the right great toe extension and right plantar flexion. Deep tendon reflexes were 1+ and symmetric being hypoactive at the right ankle.
Slight atrophy of the right posterior calf muscles and a small area of very focal subcutaneus lipoatrophy over the right lateral leg.
No other wasting of the thigh left leg. Tone normal.

The doctor suggests that I have an Xray and or bone scan of my foot.


My grandfather became ill at age 53 and by age 57 died mute and motionless.

I am 53 now and am anxious about my symptoms especially since I have Frontotemporal atrophy.

Is this slightly abnormal EMG anything to worry about?

Thanks in advance for your help.

Lynn
 
Lynn, did you receive a diagnosis of ALS?
 
The only "abnormal" things I see in your EMG:

1) A mild, chronic neurogenic change in your gastrocnemius muscle indicated by an increase in motor unit potential, which means you denervated that muscle and then reinnervated it. It could have happened 6 months ago or 6 years ago. It means nothing in the absence of active denervation, which is indicated by positive sharp waves and/or fibrillations (you have none of that).

2) Fasciculation in your right abductor hallucis muscle, which again means nothing in the absence of active denervation and reinnervation.

It appears as if you have a string of health issues but ALS is presently not one of them, so your heal pain is due to something else.
 
Thank you for the information Wright.
It clearifies my concerns.
I have not been diagnosed with ALS at this time.

Lynn
 
what is frontaltemporal atrophy and how do you see it or know it?
 
Frontotemporal Atrophy (FTD) is a form of dementia.
Some people with FTD have an ALS component to their disease.

I was actully diagnosed because of memory and behaviour problems.....but at the same time my right foot was going numb.
I thought the memory problems were hormonal or from being over tired and over worked.

A neurologist ordered an MRI of my brain thinking that the numbness and cognitive symptoms were probably being caused by a brain tumor.

It was at that time they say the extensive brain atrophy of the frontal and temporal areas and after much more testing I was diagnosed with FTD.

Lynn
 
I am sorry, I am such a dumb A**! Of course, ftd. I thought there was an atrophy on your temporal side of face, uh....dumb. Sorry, I am slooooooooow...
 
A question for Wright:

When the elderly become frail and are not able to move - do their EMG's show positive?

Lynn
 
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