EMG/NCS Question

[NYC08]

Hi, after a few weeks of twitching, I went to a neurologist that my doctor referred me to. He is a board certified electromyographer and conducted the EMG himself. However, one of the nurses/assistants conducted the NCS.

The neuro exam, EMG and NCS were all normal and he told me that I categorically do not have ALS (no weakness, reflexes fine, tests normal, etc.)

However, since I am still twitching I keep coming back to ALS. How confident can I feel in these tests (especially since one was performed by someones else)?

Thank you.

 

[wright]

Hello NYC08

A question for you before I respond: where was your EMG/NCS performed (arms, legs, tongue)?

Performing the EMG portion and reading the raw data from the traces is definitely an art and should absolutely be done by an experienced neuro.

The NCS portion can be done by a certified electromyographer who doesn't necessarily have to be a neuro because it isn't as much of an art form. However, the electromyographer needs to be experienced enough to tease-out the sensory and motor portions of a nerve when stimulating it and be experienced enough to know how much stimulation to give to obtain the full picture, so to speak.

Anytime someone has a clean EMG/NCS and a normal neurological exam is reason to feel good. If you keep twitching and you continue to worry, simply call your neuro and explain your concerns. There are many reasons other than ALS that people twitch: stress, illness, some medications for examples . . . and some people simply twitch and there is absolutely no explanation.

Bottom line: trust what your neuro told you and if you have more questions, please let us know.

 

[crystalkk]

All my NCS were performed by the tech/assistant, and then the dr did the EMG part.
I am not a dr, but I would feel pretty confindent that everything gave back normal.
You can have twiching for alot of reasons, stress, aniexty, certain meds, caffine, a virus.

 

[NYC08]

Wright, thank you for the reply. The EMG was performed in my arms (well, right arm) and legs. The NCS was in both legs and an arm (might have been both, I can't remember). My tongue was not tested. My twitches are all over the place but seem to concentrate in certain areas depending on the day. I believe this neurologist - - while not an ALS specialist -- is very good and has been written up a lot (in NYC). So I am hopeful that he is competent.

But after reading so many stories of clean EMGs and then eventual ALS diagnosis, I, like so many, remain deeply unsettled.

He did say to follow up with him in 8 weeks which I will do. I'm not sure if he'll perform another round of tests if I'm still twithing or not.

Thanks again.