Clean EMG Then Calf Muscle Loss

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dall104610

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Hi guys,

Thank you for taking the time to read my post.

In mid February I started getting a strange sensation / altered feeling on the bottom of my right foot. Over a couple of weeks this became a very stiff right leg and then after around 3 weeks I started with widespread muscle twitching.

The stiffness in my upper leg reduced and the only stiffness I had was in my calf / ankle and foot area on my right side. I then noticed I couldn’t separate my toes on my right foot as I could on my left, but I felt like I should have been able too if that makes sense. My brain asking the movement to happen but it just wasn’t.

Long story slightly less long, I went to see a neurologist who thought I was fine but said we can do tests like head mri and EMG / NCS (right leg and both arms) for further reassurance if I wished (as I was paying).

So I booked both, MRI was clear and my neurologist told me in person that the EMG / NCS test test showed no sign of MND. He didn’t use the word “clean” or bring anything else up that’s all he said, he didn’t talk through anything in the report that could point to any type of alternative diagnosis or give me a copy of the report . I did have Covid about 4 weeks before my symptoms started and he said that could have something to do with it potentially but we can’t be sure.

His later letter stated “the neuro physiology tests did not show any evidence of motor neurone disease and there was no evidence of cramp fasciculation syndrome”.

This was about 1 month ago and since then I have had a noticeable reduction in size in my right calf muscle which still feels pretty stiff and irritated although it is not weak in my opinion. I am also getting sone stiffness in my right thumb and my twitching continues.

From what I have read an EMG would have picked up an issue if atrophy was present in a leg right?

Would you suggest I re visit my neurologist to talk through the report and or get his thoughts on the muscle reduction in my calf?

Any other suggestions would be welcome if you feel they may help.

Thank you again guys!
 

affected

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Ah, the thing is - "clean" is not a medical term. It is something people with no medical training have taken up using. So of course your doctor did not say it.

Congratulations on being cleared of ALS. You should definitely go discuss the report with your neurologist. However, it sounds like he is willing to let you keep paying money for more tests when you bring up all your fears, so I hope you have deep pockets!

You might find it really helpful to read this carefully, and then discuss your concerns with your doctor. We only deal with ALS here and you have been cleared so whatever is going on needs a doctor to work through. All the best.

 

Clearwater AL

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Tillie, from your second paragraph...

"However, it sounds like he is willing to let you keep paying money for more
tests when you bring up all your fears, so I hope you have deep pockets!"

There are neurological facilities that do not chase further expensive testing
when it is clear from the initial exam it is not needed. But... there are some
who are profit driven. No exam, no test has a zero profit structure.

Thank you, thank you for pointing that out. For others too.
 

dall104610

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Thanks guys. To be honest the neurologist did say he believed I didn’t require an EMG so he wasn’t trying to push me down that route abs I did t feel he was chasing £££, I could be wrong as this is all new to me. He just said if I wanted further reassurance these tests were available. I left it a couple of weeks because I really wanted to just walk away and carry on with my life and just trust his experience and judgment.

But my continued symptoms mixed admittedly with my anxiety got to me and I decided on the tests for hopefully some further reassurance and the positive news after the EMG most definitely helped until the loss of muscle on my calf got more obvious.

I will most definitely go back to my neuro on the report.

Would he also be the best person to speak to about my calf or given that he has done the EMG with no real findings wound I go back to my GP?

Thank you
 

affected

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When you go discuss this with your neuro, ask what is next, then follow that advice.
 

lgelb

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Actually "clean EMG signal" is a recognized medical term, but it refers to something different than many use it here -- a signal from which extraneous electrical noise has been stripped out, through various means. However, recognizing that patients frequently refer to "clean" test results, I would not be surprised to hear a clinician use it colloquially.
 

dall104610

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Going back to my Neurologist next to discuss things. I also need to speak to him as I now have developed tongue twitching which is constant and really worrying me. My body muscle twitches are there then gone normally but it’s like my tongue is almost vibrating abs I can’t feel the movement as such, just that something is going on.

A couple of weeks ago I tried to go back to football to start feeling better but part way through the game I lost my voice. I didn’t think much of it. Since then my voice hasn’t quite gotten back to normal and it’s a bit scratchy. I put it down to hayfever but now these tongue symptoms are adding fuel to my anxiety fire.

I had a clean EMG about 5 - 6 weeks ago on right leg and both arms which was a relief. I’ve read the stickies but still worried as I know Bulbar can potentially could be missed?

I may be wrong but is bulbar normally more related to LMN problems? As you can tell I’m no expert just trying to reassure myself where possible which I know is a dangerous game as it can lead to more worry 😔
 

Bestfriends14

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Exactly, you are no expert and the experts have told you you do not have ALS. Put together with the fact that you have no ALS symptoms and clean clinical exams, you can rest assured you do not have this disease.

If your throat is scratchy, there are many throat lozenges on the market that can help you with this. Congrats on no ALS! I truly hope you're grateful for this good news.
 
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affected

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Please see a doctor and have all your questions ready to ask. That way you can be examined in light of your concerns and the appropriate tests and treatments options discussed.
I hope you can stop trying to find some way it can be shown to be ALS despite all evidence, but discuss that with your doctor too as you can be helped.
 
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