EMG - is it ever too early?

[Teedot]

My family doctor gave me the results (read them off the report) - when I asked what that meant, he said he wasn't sure. It was phrased as follows:

"There is no spontaneous activity, interference pattern full, volitional potentials normal, expect a long volitional on the vastus medialis"

 

[Nikki J]

And this is the person referring you? At the request of the EMG neuro? Or the original neuro? It looks like they are talking about motor unit potentials ( MUPs) but if so the finding in ONE muscle without spontaneous activity should not worry you. Wait for your appointment but stop searching and worrying in the mean time

 

[Teedot]

My family doc referred me to a neuro - I had a clean clinical exam. He did note he felt an EMG would be advised.

I had the EMG and the neuro performing it said it is "basically normal" with the exception of long volitional on the vast, med (the increased duration of the motor unit action potential, which I have since clarified). My family doctor did not know what it meant but said not to worry as it is "basically normal"

I still don't know what that means (a tech said this is what it means).

 

[affected]

So they all say DON'T WORRY.

That's your ticket out of this door! LUCKY YOU.

Please take Nikki's advice.

 

[Teedot]

Quick update.

My doctor does not feel a referral to a muscular clinic is warranted and said it would be a waste of everyone's time. The long volitional was explained to me by the neuro that did the exam (who was kind enough to call me) . It is a long duration MUP but he does not believe it to be an issue as other muscles of that nerve root did not show the same thing. For this reason he considers it normal and he explained that even increased strength can be the reason of one large MUP in a study.

He said he did not even have to report the finding, it was insignificant in light of the other tested muscles. I asked if he felt I should follow up in 6 months and he said he did not, the only reason he recommended the referral was due to my own worries.

While I am still feeling mighty uncomfortable, I think it's in my best interest (having created a fair bit of health anxiety over this) to avoid tossing fuel on the fire and to stop poking around here and on PubMed. I have one remaining question: is a normal EMG (with the noted above exception) still considered a clean emg?

Thank you kindly for your insights this past week.

 

[Nikki J]

Large MUPs do indeed happen in those who exercise and weight train. So that comment about extra strength makes perfect sense. So does canceling the consult which always seemed very odd.

Clean/ dirty is not a technical distinction but I think most everyone would call yours clean

You are wise to let this go. Those who can not have wasted time and energy that could be much better spent. Several have reported loss of relationships. If you are finding it difficult to move on or if you find yourself chasing some other dire diagnosis get help. The gold standard is cognitive behavioral therapy.

Good luck. Enjoy your long healthy life ( and block this site)

 

[Teedot]

I got a call yesterday that a cancellation appointment freed up for an emg - a list I was on. Against my own advice I accepted it and went. Things popped up in red during the exam and I took a picture of my report and it seems I have reduced recruitment, increased amplitude and duration and funny things popping everywhere and I am freaking out :-(

I am so afraid now.

 

[Nikki J]

That is not REMOTELY like the EMG of ALS. What did the doctor tell you?

 

[Teedot]

She wants me to relax and start working out again. She believes that by working full time doing an MBA and still breastfeeding my 20 month old through the night I have put my body into sleep deprivation. She said I created the perfect storm for anxiety and depression. I need to focus on mental health .

For the sake of reassuring me she is suggesting a spinal and neck mri .

She said that I am still under a normal curve and does not believe anything is sinister. I am at a point where I have convinced myself I know better than professionals by doing some pubmed searches and I am starting to collapse.

I am a bit embarrassed for chasing myself down this rabbithole. But I can't let go of the fact that this was clean 35 days ago and now ... all these anomalies.

 

[Nikki J]

EMGs are an art not a science. As a carrier of a genetic defect I have had EMGs from different doctors for research - not out of fear- very close together and the results were mildly different more than once. These doctors are among the top EMG doctors in the country and internationally known.

You are deep in your rabbit hole I fear. You were told by the doctor it was ok, yet posted here in a panic? We are not neuromuscular doctors. You must see that seeking our opinion when it has been explained already by yet another doctor that you are ok is not sensible. Please follow the excellent advice you were given by the doctor. Past time to let this go!

 

[Teedot]

Thank you for sharing that with me. I too come from a family with genetic defects but my test is a conclusive one. Carrier or not. Perhaps the gray of emg and the nauances are what is getting me.

I had an intake for CBT last week and will proceed that way and do what was suggested and wait the 6 months to review (which is what this doc proposed)

I wish they could label what the findings of today could mean. Apparently they are non specific.

Once again, thank you for replying both so quickly and openly.

 

[affected]

Totally non-specific results that are normal.

Please, calm down or go back to your doctor and fall apart and make them work out your best course to control your anxiety. This is not the place to do that, as much as we sympathise.

You really are CLEAR, that's wonderful news, and you need to embrace it as you are wasting days of your life now with this anxiety and you will never have this time back.

We can't help any further, and that is the best news you can ever get.

 

[Teedot]

Thank you. I am assuming this is not a clean or normal EMG though right?

 

[codyclan]

Oh my gosh--you really, really, really need to stop. You do not have ALS. We are not doctors, but your actual doctor told you relax, exercise and concentrate on your mental health and yet you want us here, who have never met you, and who are not doctors to analyze your EMG report. You absolutely must move on. You do not have ALS and we are supporting people who are dying or caring for those who are dying. Best wishes to you.

 

[affected]

I bet if they did an EMG on me it would not be completely normal. Human bodies are far from perfect, normal is usually a range, and based on averages. Many people live outside the averages without having any specific disease process.

Get a grip please.