Can someone please help me understand my EMG results?

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Borrie

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Hi everyone,

Thank you for everyone who is taking the time to read this and help. I gave birth in november(emergeny c-section with spinal anesthesia. I started to have symptoms (numbness, body aches) a week after.
I was sent to the hospital for further testing, first they checked for MS, I had clean brain + neck MRI, normal nerve conduction study, normal blood work. I had hiperexcitability, brisk reflexes, spasticity, left ankle achilles clonus..so the neurologist ordered blood work for GAD antibody to check for stiff person syndrome(negative), however she suspected that hiperexcitability was only caused by anxiety.
But of course i googled hiperexcitibility, clonus and etc which all lead me to go down the ALS rabbit hole.

A few weeks later I started to have widespread twitches, so went back for a follow up, and had a normal exam(no descrepancies this time), so she did not think any further testing was necessary.

My symptoms at the moment:
  • widespread twitching
  • pain in ankles - at the top of the ankle (not sure how thats called) it feels like my foot is about to tear off (the pain is mostly at night and when i am resting)
  • pain in right thumb, also feels stiff and feels like it is harder to move
  • occasional sharp pain in fingers, toes
I went to a private clinic for EMG for reassurance, I thought it would give me relief. The nerve conduction results are okay, however my emg result is not quite normal. The neurologist said there are no motorneuron specific descrepancies, but I have increased sarcolemmalis irritability, and some neurogenic lesions. I attached my result. Anyone here had similar results? What does it mean? Is this an abnormal EMG? Anything that would suggest ALS or the early onset of ALS? He said all this could be caused by anxiety, i was super stressed(nervous reck) during the exam, went numb, and was shaking, and obviously when i was asked to relax I wasn't really able to.

I know my symptoms are mostly sensory and I have health anxiety and also OCD, but the symptoms are real, been suffering from them everyday for 3 months, I just need to understand my results. The doctor was brief, only saying no reason to think it is motorneuron disease. There are a lot of people here who are experienced in EMGs, this is why I turn to you for your insights as I don't know how does an ALS EMG look. Can I exclude ALS and let it go or is there any reason to keep looking into this?
Again thank you for taking the time to help.


(I am from Hungary, but I think the results can be understood, they are mainly in english anyway)


Thank you for your help in advance!
 

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Hi, just checking: I know I am only allowed one thread, what happens if no one answers?
I am really worried about this EMG result, even though they said it is okay and it is just anxiety.
Could anyone please help me understand why this EMG result is negative for ALS?
(there are fibrillations, fasciculations, amplitude +, polyphasic potentials, increased insertional activity, complex repetitive discharges)
How can this many descrepancies be due to anxiety?
 
Hi
first I am so sorry that no one answered you. We weren’t intentionally ignoring you. Sometimes , especially with technical questions there are fewer people who answer and especially when it is complicated we might look at it, plan to get back and then get distracted.
you did the right thing to bump it. If it had only been a day or so it wouldn’t have been but you were more than patient

now to your questions of course anxiety doesn’t cause abnormal emgs but if you were tremulous it might be harder to read.

there are lots of reasons for emgs to be abnormal besides ALS. There is a particular pattern in ALS that you are not showing. If you have a normal exam now that is a good thing. Did the neurologist who I believe was not the emg doctor? say anything about the emg? She is really the person to ask. It does seem that these very nonspecific emgs resolve on repeat in cases we see here when the clinical exam is normal
 
I would ask about physio, which helps sometimes in the spine issues suggested by this EMG.
 
Thank you so much for your kind words!
My neuro did not want to send me for an EMG as she did not think it was necessary. I went to a private clinic, the doctor who did the exam is a specialist, so I don't have a reason to go back for a follow up to my first neuro as I have been examined multiple times by her and I was told it is just anxiety and postpartum hormonal changes, which I wanted to prove to myself by getting a normal EMG..

So if I understand correctly this EMG is abnormal but it is not ALS? Or is it possible that these changes are showing the begining but don't meet the diagnostic criteria yet?
If these results were due to ALS should I be experiencing weakness already?

Sorry for asking too many questions.
Thank you again for your help.
 
It really doesn’t suggest ALS at all. Please do work with your doctor ask about physio and feel better
 
Will do, Thank you so much for helping me out! 🥰
 
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