EMG question

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Darlav

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I just had my first EMG today at the Cleveland Clinic. Unfortunately, the neuro. performing the test would not share any results with me. She said my Dr. would have to do this. This makes me a bit nervous! Why not give me some sign if things looked O.K.?

I'll stop worrying out loud, and get to my question.

My husband was with me during the test and noticed when the muscles were contracted, there was a large curve upward on the graph (computer). When she tested my right lats ( where I get the constant twitching), when I contracted the muscle, the curve on the graph hardly moved at all. He said about 1/3 the height of all the other muscles. Could this mean my muscle is dying? Or has no electrical conductivity?

I know he wished he never shared that info. with me because I am very nervous.

Has anyone had any similar experience? If so, what does this mean?

Could it be a good sign that she did not test my left lats for a comparison?

I was only tested on my right side for both the NCS and EMG. Do they test both sides if something concerning shows on one side?

Sorry to ramble. I know things have always been out of my hands, but now theres no turning back. I will get the results and they will be what they will be.

I'm hoping for a quick Sat., and Sun.

Thanks for listening, and I would appreciate any Emg info.

Sincerely,
Darla
 

judylyne

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When my husband had his emg the doctor said it sounded like rain on the roof and he was able to tell how long this disease had been going on. He tested all of his extremeties. I wish you the best
 

awieleba

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Hi Darla.,

when I had mine they only tested left leg/thigh and right hand/arm. and back. those are the spots that I had the most twitching and thinning out of muscle. I am not sure about waves on the machine. My neuro said it is the sound on the maching. after the needle is put in it should be quiet. it will make noise going in or when you contract your muscle. So, did you hear noise?

Anyway, it is maybe a good sign that they said to follow up with your normal doc. IF they fond somthing that they thought was neuromuscular they would not send you back to you normal doc. I am surprised that they would not say anything! Even when it is clean or dirty, it seems they always tell you somthing! but, I think it would be good. What would your GP do for a problem emg?

have a good weeklend, I think it is a good sign!

April
 

Darlav

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Hi April and all,

I don't think I explained myself correctly. The neurologist who did the EMG was not my neurologist who I had my first exam with. After the test, she wanted my neuro. to be the one who would go over the results with me. Not my GP.

My neruo. explained that they never perform the EMGs on their own patients. He said they may have a bias oppinion and consider another Dr. performing the test similar to getting a second oppinion.

As far as noise goes, I believe my muscles were quiet when the muscle was still, but when I contracted, I heard some static and some popping. I hope this is a good sign.

Thanks for answering and for the encouragement. I hope Monday brings good news.

Take care,
Darla
 

wright

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If your muscles were silent while they were relaxed, that is a very good sign. A denervated muscle will be "noisy" due to the spontaneous activity (positive sharp waves and fibs). A healthy, fully innervated muscle WILL NOT have spontaneous activity.

As far as the smaller amplitude in your lats: you can't read into that. There are so many variables, including how hard you contracted the muscle, what muscle they are testing, etc. Could it possibly mean something . . . maybe . . . but not necessarily, especially given the fact that your muscles were silent at rest.

I think you should be cautiously optimistic given what you have conveyed to us. Let us know what your neuro says.
 

Darlav

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Hi Wright,

Thanks for writing. I am always intersted in your posts because you are so educated on this subject. I do feel better knowing that the sound is a bigger concern than the wave amplitude. My husband did say that he didn't think I was in a good flexing pose for the lats.

I will definitely wite in when I get the results. If they're bad, I'm not sure if I'll feel like posting right away or not. I'm afraid I'll be a basket case if I hear anything other than it was a perfectly clean test. I know this would not be the best way to react.

Are there other things the emg could show besides possible ALS (aside from carple tunnel)? I'm pretty confident that the nerve conduction test was fine. I feel like if something showed up on the emg portion of the test, it only points to ALS. Is this true in most cases?

Thanks for you help,
Darla
 

wright

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A "dirty" EMG doesn't necessarily mean ALS; it could mean soooooooooooo many different things: pinched nerve, slipped disk, neuropathy, myopathy, etc., etc.

There are so many things that go into diagnosing ALS. The EMG is certainly a part of it, but it's only one piece of the puzzle.

As I said in my initial post to you: I would be cautiously optimistic that all is fine. Do your best to take your mind off of it until you get your results and make sure that when you have your meeting with your neuro, that he/she answers all of your questions.

The other thing you have to do, is believe what your neuro tells you. If your neuro tells you that you're fine, then believe that you're fine.

Take care.
 

wright

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Something I forgot to address in my last post: the waveforms mean EVERYTHING with the EMG; that is how the EMG is interpreted. The noise on the machine correlates to the waveforms . . . in other words . . . the waveforms are what make the noises happen. For example, the positive sharp waves and fibs (signs of active denervation) are what make the pop, pop, pop sounds.

So again, the absence of popping sounds when your muscles were relaxed is a very good sign. The meaning of the smaller amplitude with your contracted muscle is something that you'll have to wait for, because it would be pure speculation as to what caused it.

I hope you're still relaxing.
 

Darlav

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Thanks Wright!

Thank you so much for your great explanation and caring words. You have definitely helped to ease my mind. Your kindness is greatly appreciated.

I am doing my best to relax. I plan to phone the Dr. Monday morning, so it won't be long now.


Have a good night and I'll be in touch soon,

Darla
 

awieleba

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Hi darla~
It is monday and I am wondering about you!

WRIGHT:
If you have a clean emg can you still have a myopothy? would MG or GBS show on a emg?

thanks!

April
 

Darlav

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Hi April,

I phoned my Dr. at 8:40am and left a message with his receptionist. It is now 2:12pm and he has not called me yet. I'm starting to get really nervous.

I'm going to call back now.

Darla
 

awieleba

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dont be nervous! they are busy, thats all. I know how you feel, I have been waiting for my neuro to call me since last tuesday!
If they dont call by 4:00, then call again! the squeeky wheel gets the oil.

april
 

brendapals

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You girls are too funny! I work in a doctors' office, and yes, it is Monday, and there are phone messages all over the place. But we will get everyone called back before 4pm, so there's hope for you all too!
Don't stress too much, it gives you wrinkles!
Keep the faith,
brenda
 

awieleba

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you are soooo funny brenda! ( you keep amazing me)

Darla.......let me know....pins and needles over here......april
 

Darlav

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Results!

I got a call from someone in my Dr.'s office around 3:30 to tell me that my emg was normal! I felt a bit like a deer in the headlights. I was like --O.K great. After worrying for so long, I didn't quite know how to react. I think it takes a little time to let go of this anxiety that I have been carrying around for the past 3 months.

The great news has since sunk in and I feel like I can finally exhale! What a relief!

I was a bit suprised that I didn't hear from the doctor at all. I did call back to ask his nurse a few questions. According to them, my twitching is not due to any neurological issues, and I do not require any more follow up with him (twitching or not)!

Good enough for me!

I can't thank all the wonderful people on this site who give of themselves and their friendship so generously! I will never be the same since this experience.

I even look at others, who may not be so friendly or kind at first differently. You never know what someone is going through on a personal level. Who am I to be quick to judge? I have learned to treat everyone with more compassion and understanding.

I will keep in touch with all of you and willbe reading your posts. I will donate to this forum and the MDA, as well as pray for a treatment/cure for ALS to be discovered.

God bless all of you and your families! I wish I could do more.

I am thinking about starting a new post telling of my symptoms and my outcome, hoping to ease others worries about twitching.

Thank you all for your concern! You will all stay in my prayers.

Your friend,
Darla
 
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