TonyS
New member
- Joined
- Mar 13, 2025
- Messages
- 2
- Reason
- Learn about ALS
- Diagnosis
- 00/0000
- Country
- US
- State
- MO
- City
- St. Charles
I have had constant right bicep twitching since the end of November. It will come on for a week, then stop for a week, then come back, and it's been doing this constantly. I also have minor twitching in other areas of my body as well that seems to be a bit more frequent. I don't have any clinical weakness or atrophy. It's also affected by breathing, When I take a deep breath you can see the twitching increase in frequency in my arm, when I hold my breath, it slows down, and when I breathe out, it speeds up again. Some days it won't twitch at all, some days it's nonstop. I had an EMG done at the end of January and I had mild isolated denervation, but they said no evidence of MND. At the end of February, I had another EMG done, and it came back clean as well. That doctor thinks it could be benign fasciculations. I had an MRI of brain done, and they said that was fine, an NFL test, and that was ok. I also had an MRI on my cervical spine and they did see cervical radiculopathy that they said could be compressing a nerve and contributing to twitching, but usually that comes w/ burning/tingling or some other symptom so they weren't sure. I'm still worried. I have two different diagnosis, still worried this is going to get worse and maybe something was missed on my tests? My 2nd EMG was done about 3 months into my symptoms. If I had ALS, would that have shown up by now? Do EMG's have false negatives? I just can't shake this anxiety, and I'm hyper focused on it and want to know I'm fully in the clear. I would appreciate any feedback.
Here is my first EMG results: Also attached 2nd EMG Results as well.
EMG/Nerve Conduction Test Report (Jan 23) About 2 months after it started
History of Present Illness: The patient has had intermittent muscle twitching in his right medial posterior arm for more than one month. He also noted occasionally muscle twitching in his left trunk muscles and left anterior thigh muscles. He has no neck pain and no weakness, pain, numbness or tingling in upper or lower extremities. He denies recent vision changes or swallowing problems.
Past Medical History: No history of diabetes mellitus, thyroid problems or recent trauma was noted.
Physical Examination: The patient normal manual motor strength and sensory examination in his upper extremities. Tinel's test is negative at the right wrist and elbow. Spurling test is negative bilaterally. Right medial posterior arm muscle fasciculations were noted.
Referring Diagnosis: Right arm muscle twitching.
Referring Physician: Rachel Harris, NP
1. Right median nerve conduction study showed no normal distal latency, normal CMAP amplitude and normal conduction velocity.
2. Right ulnar motor nerve conduction study showed normal distal latency, normal CMAP amplitude and normal conduction velocity.
3. Right median sensory nerve conduction study showed moderate prolongation of peak latency.
4. Right radial and ulnar sensory nerve conduction study showed normal peak latency.
5. Needle EMG examination of right Supraspinatus, Deltoid, Biceps Brichii, Pronator Teres, Extensor Digitorum Communis, Flexor Carpi Ulnaris, First Dorsal Interosseous and Abductor Pollicis Brevis muscle showed normal insertional activity, no abnormal spontaneous activity and motor unit action potentials of normal amplitude and duration. Needle EMG examination of right Triceps muscle showed mild chronic denervation.
Interpretation:
2. There is an electrodiagnostic evidence of an isolated mild chronic denervation in right triceps muscle which could represent a right C7-8 cervical radiculopathy. Please noted that MRI of cervical spine could be the next appropriate step in further evaluation of patient's symptoms if his symptoms are getting worse or not improving.
3. There is an electrodiagnostic evidence of a moderate prolongation of right median sensory latency at the wrist which could represent a right carpal tunnel syndrome. This is of unclear clinical significance given that patient has no symptoms of right carpal tunnel syndrome at present time.
Here is my first EMG results: Also attached 2nd EMG Results as well.
EMG/Nerve Conduction Test Report (Jan 23) About 2 months after it started
History of Present Illness: The patient has had intermittent muscle twitching in his right medial posterior arm for more than one month. He also noted occasionally muscle twitching in his left trunk muscles and left anterior thigh muscles. He has no neck pain and no weakness, pain, numbness or tingling in upper or lower extremities. He denies recent vision changes or swallowing problems.
Past Medical History: No history of diabetes mellitus, thyroid problems or recent trauma was noted.
Physical Examination: The patient normal manual motor strength and sensory examination in his upper extremities. Tinel's test is negative at the right wrist and elbow. Spurling test is negative bilaterally. Right medial posterior arm muscle fasciculations were noted.
Referring Diagnosis: Right arm muscle twitching.
Referring Physician: Rachel Harris, NP
1. Right median nerve conduction study showed no normal distal latency, normal CMAP amplitude and normal conduction velocity.
2. Right ulnar motor nerve conduction study showed normal distal latency, normal CMAP amplitude and normal conduction velocity.
3. Right median sensory nerve conduction study showed moderate prolongation of peak latency.
4. Right radial and ulnar sensory nerve conduction study showed normal peak latency.
5. Needle EMG examination of right Supraspinatus, Deltoid, Biceps Brichii, Pronator Teres, Extensor Digitorum Communis, Flexor Carpi Ulnaris, First Dorsal Interosseous and Abductor Pollicis Brevis muscle showed normal insertional activity, no abnormal spontaneous activity and motor unit action potentials of normal amplitude and duration. Needle EMG examination of right Triceps muscle showed mild chronic denervation.
Interpretation:
- There is no electrodiagnostic evidence of a large fiber neuropathy, peripheral neuropathy or motor neuron disease at present time.
2. There is an electrodiagnostic evidence of an isolated mild chronic denervation in right triceps muscle which could represent a right C7-8 cervical radiculopathy. Please noted that MRI of cervical spine could be the next appropriate step in further evaluation of patient's symptoms if his symptoms are getting worse or not improving.
3. There is an electrodiagnostic evidence of a moderate prolongation of right median sensory latency at the wrist which could represent a right carpal tunnel syndrome. This is of unclear clinical significance given that patient has no symptoms of right carpal tunnel syndrome at present time.
