EMG results, please help

[winterlover]

Hi!

I'm a 21 year old female. I've been twitching for 6 months. I twitch almost everywhere. Some days I only have 1-2 minor ones. I went to the neuro and my clinical was negative. I was somewhat relieved but for reassuring the doctor sent me to an emg exam. Everyone (including me) excpected it to be negative, but my right vastus lateralis showed PSWs and fibs. I'm scared to death right now, can't think of anything but MND. My doctor said it is nothing to worry, covid infection in february might be the cause. Personally I don't believe this, and I think she's hiding the truth. I'm scheduled for a next emg on 14th June.
Otherwise I don't have any additional symptoms, no atrophy, no weakness, I can walk, run, work etc. My reflexes are normal and I do not have any abnormal ones.

 

[Nikki J]

Doctors don’t lie to make you feel better. They would risk getting sued or losing their license. No one here is going to disagree with your doctor. We have seen people with similar stories - isolated emg findings , no real symptoms and then their follow up is fine. If that emg is recent I am surprised they are repeating it soon- no time for whatever to heal. And covid has been documented to cause some abnormal emgs. Why do you think you know better than your doctor?

 

[winterlover]

Thank you for your quick reply Nikki! They aren't repeating the emg on the previously examined muscles but they will test others. My emg exam was yesterday. My question is if the active denervation/reinnervation is always a really bad sign? I also had some abnormalities in the ncs: axonal loss in my right peroneal nerve. Again, no foot drop, no issues with my foot.
I try to believe my doctor, but she seemed a bit clueless.

 

[affected]

If you don't trust your doctor, you have the right to go to another doctor.
As Nikki said - isolated EMG findings such as you have there mean nothing.
The NCS will most often be normal if you have ALS.

Please find a doctor you can work with as you are going to get nowhere fast seeing a doctor then trawling the net to prove them wrong.

 

[winterlover]

I'm in a process of searching for a new neuro. But I can't stop reading about my findings. It seems that this ongoing denervation/renervation thing points toward MND. I just simply can't see any other causes and I'm scared.

 

[KimT]

If you aren't happy with your doctor, find another one. If your doctor can't make a diagnosis, find one who can.

I totally understand the anxiety associated with not knowing what's wrong with you and having the twitches to keep reminding you that something isn't right. Find a doctor whom you can trust and get to the bottom of it.

I think your findings point away from ALS but you are experiencing symptoms and a good doctor will help you investigate.

 

[winterlover]

Thank you for your reply Kim! I would like to ask one question and after that I will only update my thread if they diagnose me with something. Why do you think that the findings point away from als?

 

[affected]

We have all said that isolated findings such as in your EMG are not what we see in ALS. I hope that is clearer 🙃

 

[KimT]

Only because findings were isolated to one muscle. If you want a second opinion, it’s your call. If you’re having symptoms, seek another doctor.

 

[winterlover]

I really appreciate your answers! I'll keep you updated after my next doctor's appointment.

 

[winterlover]

Hi all,

I just wanted to give you a little update. I went back to my very first neuro because of my emg finding. She doesn't think I have als but also said that we need to see the whole picture to find out what's wrong. She recommended to see a specialist so I got an appointment for another emg on 29th August.
I still don't have any symptoms besides twitching except I feel some tightness/stiffness in my left calf occasionally. Do you think it is significant?
These days I feel a little better mentally but I still have my bad days about all of this. It's just really strange to know that I have peroneal neuropathy and denervation in my thigh altough I have zero symptoms. If I wouldn't have gotten my emg done, I'd just accepted that I'm healthy.
Anyway I try to enjoy the good things in life as much as I can and I'll be back with my results in the end of August.
Thank you for reading this and all the best for everyone on this forum.

 

[KimT]

EMGs and nerve conduction studies can have abnormalities for many different reasons. Most of them have nothing to do with ALS or any other motor neuron disease. Stiffness can be there for many reasons. You made an appointment and, I'm sure, they will do a thorough examination. Write down all your questions and ask the doctor.

I would try not to worry and enjoy life. Keep doing what you're doing and I think all will be good.

 

[winterlover]

Thank you Kim!

 

[winterlover]

I've just had my next EMG. This time there were also abnormalities. The overall impression is that I have increased sarcolemmal irritability, myogen damage in the upper extremity. The doctor recommended thyroid hormone exam and also exams regarding myositis.

 

[winterlover]

I also wanted to add that is asked the doctor about the possibility of MND. And he said that actually we could exclude it. He does not see evidence of it.