Concerned about ALS Dx

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Wildcat0124

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Learn about ALS
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Hello... I'm a 26 y/o Male and over the course of the last 6-12 months I have experienced full body twitching in feet, calves, thighs, abdomen, hands, shoulders arms and eyelids leading me to be very concerned about an ALS DX. I also have noticed muscles getting smaller and weight lost around 15 pounds. Overall, I feel more fatigued as usual and my exercise tolerance has gone down. I have floaters in both of my eyes and am experiencing a level of brain fog as well (I know this isn't usually related to ALS).

I went to a Neurologist and they ordered an EMG/NCS test. Below are my results.
View attachment 18501View attachment 18502
Does everything described above and pictures attached point to ALS?
 
Please read this if you have not already done so:

Twitching is common, nonspecific, and meaningless in the absence of muscle function failure which you have not described. It doesn’t matter how much or for how long you twitch. If you can still do everything you could do previously, you’re fine.

I can’t open your attachments, but I’d be surprised if they showed anything of concern.
 
EMG results below. I have muscle weakness but no failure.
 

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It’s mostly ok. I would expect more widespread changes if you had ALS. This looks more like injury in a few areas. What did your neurologist say?
 
This is an abnormal but non-diagnostic study. There is electrophysiologic evidence of a modest degree of increased insertional activity in several muscles of the cervical, thoracic, and lumbosacral segments. Increased insertional activity of this kind may be appreciated in the context of so-called "EMG disease". EMG disease is generally considered to be a benign condition in with there is no clinical correlate for the electrophysiologic findings. However, these findings may also be appreciated in early generalized disorders of lower motor neurons or in myopathies with muscle membrane instability. While the electrophysiologic findings on today's study are not diagnostic for a lower motor neuron disorder, considering this patient's clinical context they do raise some concern for such a process. Repeat NCS/EMG in 4-6 months to evaluate for an evolving neuropathic disorder may provide additional diagnostic data. Clinical correlation is recommended.
 
What is important when it comes to diagnosing ALS is the big picture: clinical weakness as determined by a physician, characteristic EMG changes in multiple muscle areas, upper motor neuron signs, evidence of disease progression, and ruling out ALS mimics.

If your clinical picture is not consistent with ALS (and twitching without muscle function failure or upper motor neuron signs would not be), then one would be hard pressed to diagnose anything based on your EMG. In the meantime, getting blood tests and MRI scans to look for other explanations and just monitoring symptoms over time is a reasonable approach. I really would not be worried based on your symptoms.
 
great result there really - good luck working with your doctor on whatever is going on. It is certainly not indicating ALS in any way and I'm truly glad for you :)
 
What makes them great results when it says it was an abnormal test? Only my right side was tested and I feel like my left is worse.
 
It is abnormal but emgs can be abnormal in many ways that are not ALS. Yours does not show ALS. The mild abnormalities are diffuse which would not be the way even early ALS would show. My extremely early emg. ( which followed a muscle failure) showed a clear ALS pattern in one place which the surrounding areas showing early signs ( different than what you have) and other body areas being normal. ALS starts somewhere and spreads.

your report raises the idea of emg disease which really should be a syndrome rather than disease because it is benign. When it happens people get what you show. Diffuse emg abnormalities without clinical correlation.
 
wow You certainly do have something going on. I am not a doctor. I am a person dying from ALS. You are not. When I had my first E!MG, my doctor was in tears when he told me. He sent me to an ALS Clinic for confirmation, they did a second EMG. There are no doubts. This is not your journey
 
What if the other side of my body that didn’t get tested is more affected then the right side that did get tested? Also having some swallowing problems and what appears to be tongue atrophy because it’s scalloped on the side.

weight loss and muscle shrinking. I don’t know what else other than ALS would cause this.
 
The hallmark of ALS is abnormal findings even in areas that the person does not feel have any issues, so it does not matter that you were tested on a side with more or fewer issues. EMG examiners usually test some muscles with perceived issues to spot conditions other than ALS, not because ALS can only be seen in those muscles.

Weight loss and less muscle definition apply to many, many conditions more common than ALS. If your muscles seem smaller but still work (twitching aside, they work), that leads you away from ALS. Overall fatigue is not the same thing. I would go back to your PCP and get worked up for systemic disease/nutritional deficiencies.
 
You need to stop trying to convince us wildcat. We know ALS, and you don't. YET we all say wow great result you are clear, tell you why, and you reply back trying to find a way to convince us you should be really worried. MANY other things are highly likely, a doctor can work through them with you, google can't.

Sorry it just doesn't work that way. Please realise some of our members here are using their eyes to operate their computer as they are paralysed, and are using a machine to breathe. You need to go work with your doctors, we have no more to offer you.

PS a scalloped tongue is NOT atrophy nor found with ALS
 
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