Another is this ALS

[Buglaw]

Summary page is below. I was told I clearly had upper motor neuron issues in the bulbar region (jaw clonus, speech pattern, vocal chord movement (i think) and maybe some other items) and was told those upper motor neuron issues would not show up on an EMG. I'm positive for hoffman's on both sides, have brisk reflexes and clonus in an achilles. I guess my dysarthria is just spastic.

1. ORDER EMG/NCV - NEUROLOGY [553091186] ordered by at 10/06/22 1055

Pre-procedure Diagnoses

1. ALS (amyotrophic lateral sclerosis) (CMS-HCC) [G12.21]

Post-procedure Diagnoses

1. ALS (amyotrophic lateral sclerosis) (CMS-HCC) [G12.21]

Procedures

Focused clinical examination
+diffuse upper body fasciculations
spastic dysarthria

Summary of findings

Nerve Conduction Studies
Sensory nerve conductions were normal.
Motor nerve conduction studies were normal.
Long latency reflexes were normal.

Electromyography
Concentric needle EMG was performed in selected muscles of the right upper and lower extremties, tongue, and abdomen. Fasciculations were seen in muscles in the right upper and lower extremities, as well as in the right rectus abdominus. Voluntary contraction of the right triceps elicited polyphasic, at times unstable, motor unit action potentials.

Impression
Abnormal study.
There is electrophysiological evidence of active neuropathic changes in the cervical, thoracic, and lumbosacral regions, consistent with a clinical diagnosis of motor neuronopathy.

 

[Buglaw]

I should note that I have some mild psuedobulbar effects. When I get nervous or stressed I've begun laughing inappropriately. When I'm in the neuro exam rooms it frequently comes out in full force and effect. Freaked out a neuro resident pretty bad the first time I couldn't stop laughing. I didn't have this before the symptom started, so another upper motor neuron symptom.

 

[Buglaw]

Got in a day early. Said given my clinical exam they don’t see how it could be anything other than ALS. It’s upper motor neuron dominant so they aren’t concerned about the lack of psws or fibs. They re-run it in a few months but there is really nothing left. They don’t think there is much point in redoing the emg today.

They said not pls given the broad fasciculations but very upper motor neuron dominant.