EMG question

Lasx

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Hey there,

Sorry, I wanted to post in my old thread, but I asked for it to be closed sometime ago so I'm posting in another.

I got an EMG done seeing as my twitching persisted and have a question regarding it. They needle poked my right thigh, right hand and right forearm - is this sufficient to rule out ALS if the twitches occur mostly in the calves (which they didn't directly poke)? I do get some in my thigh as well, and they did poke there - same with the arm. The conclusion says "no spontaneous activity detected" (as a rough translation from my language).

Thank you very much for the time.
 

KarenNWendyn

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Here is the previous thread: 25, suspicious symptoms?

Fasciculations are common, nonspecific, and meaningless in the absence of muscle function failure which you have not described.
In ALS, denervation is widespread and will show up on an EMG. So it is not necessary to do an EMG on every muscle. Clean EMG and no clinical weakness means no ALS. Congratulations — you don’t have ALS!
 

affected

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yup that clears you, congratulations!
 

Lasx

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So just to be 100% clear, even if the EMG is not done on the exact muscle in the limb that's twitching (but the muscle next to it for example), it will still show as bad if there is an ALS issue, yes? If that's the case, thank you for all your time and I wish you all the best.
 

KarenNWendyn

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So just to be 100% clear, even if the EMG is not done on the exact muscle in the limb that's twitching (but the muscle next to it for example), it will still show as bad if there is an ALS issue, yes? If that's the case, thank you for all your time and I wish you all the best.
Yes
 

lgelb

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Lasx

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Thank you for answering my questions.
 

Lasx

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Update: Since the last EMG I have, surprisingly (not sure why), developed an issue with swallowing food. Not a perceived one, I sometimes literally can't swallow my food until several tries which has gotten me on edge again. I'm not sure if It's not related to my post nasal drip issues that manifest when the weather gets colder as I do have a scratchy throat which occurred together with this.

My neuro, however, suggested I get a bulbar EMG as well on tongue and neck muscles, which I will on Wednesday. Am I to understand if there's an issue with my swallowing related to ASL tongue EMG will be dirty? Also, which muscles should be tested for swallowing issues with bulbar?

Thank you. I won't post further until the results of the bulbar EMG, I'll appreciate the info though :)

PPS - if the swallowing issues are already manifest, will an EMG show an issues now or should I wait for several more weeks? I have read of some people with bulbar who have clean EMGs.
 

Nikki J

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it doesn’t sound like bulbar to me If you do not have upper motor neuron signs on exam and a good emg you are good to go. The three muscles tested for bulbar ( and any ONE is adequate you do not need more than one) are sternocleidomastoid , the tongue itself or a muscle under the chin. It seems to be examiner preference which they use
 

Lasx

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My only "upper motor neuron" signs were brisk reflexes, but neuro said they aren't pathological and are symmetric, so it shouldn't be an issue. I'm surprised with the swallowing issues myself, but I'm uncertain if widespread twitching for 1 month can be followed by such instant difficulty swallowing a month later - I thought it'd progress differently so I'm hopeful it's not ALS.

I will update this topic once I get my bulbar EMG, hopefully with good news.

Thank you.
 

Nikki J

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Brisk reflexes in your limbs are indeed not pathological when symmetrical and limb reflexes were not what I was talking about related to bulbar anyway. I am quite sure you will have good news. Nothing you described sounds like bulbar.
 

Lasx

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EMG is tomorrow, but I noticed something weird tonight. When I laid down, I got a fairly strong burning pain in both thighs at the same time which lasted until I fell asleep - it's still present up until now even if it was gone in the morning. I know pain generally points away from ALS, although I've read of several cases presenting with leg pain before onset of motor issues.

Any ideas? There seems to be contradictory information regarding ALS pain on the internet, so I thought I'd ask you smart people.
 

KarenNWendyn

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please refrain from further posting until after the EMG. You’re on heightened alert right now, so you’ll probably have all sorts of sensations.
 

Clearwater AL

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For all.... Laxs, as you wrote...

"....although I've read of several cases presenting with leg pain before onset of motor issues."

Here goes....

Two in five Americans have falsely convinced themselves they have a serious disease, after turning to 'Dr Google' – according to new research.
Instead of alleviating concerns, 74 percent of those who have self-diagnosed online say searching for their symptoms made them worry MORE about their health.

That may be due to the answers given by Dr Google, as the internet's medical advice was found by respondents to be reliable less than 40 percent of the time.

Key words.... "to be reliable less than 40 percent of the time.." (reliable less than 40 percent of the time.)

Sixty-five percent of respondents who used the internet to self-diagnose themselves the results show typing your symptoms into the search bar might do more harm than good
 

Lasx

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For all.... Laxs, as you wrote...

"....although I've read of several cases presenting with leg pain before onset of motor issues."

Here goes....

Two in five Americans have falsely convinced themselves they have a serious disease, after turning to 'Dr Google' – according to new research.
Instead of alleviating concerns, 74 percent of those who have self-diagnosed online say searching for their symptoms made them worry MORE about their health.

That may be due to the answers given by Dr Google, as the internet's medical advice was found by respondents to be reliable less than 40 percent of the time.

Key words.... "to be reliable less than 40 percent of the time.." (reliable less than 40 percent of the time.)

Sixty-five percent of respondents who used the internet to self-diagnose themselves the results show typing your symptoms into the search bar might do more harm than good
Hey there.

It's true I might have had myself worked up over this and getting symptoms from it, although I don't read random forums where people might be making misinformed opinions, I read about the pain onset from medical papers / journals published online.

But yes, I will wait until the EMG tomorrow and ask the neuro to poke as many muscles as possible so I can have peace of mind finally.

I will post the EMG results tomorrow here.
 
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