EMG Timing and Symptoms

[Normalguy1]

Hi great people of this forum.

I’ve hesitated to post because I know there are more serious cases than mine, but I had a question.

I’m a 32 year old dad. The beginning of this year I began experiencing twitching and sore muscles. I went to my PCP (who has been unhelpful at best) and he told me to go to a numerologist. So I went to one who said I seemed fine but he wanted to clear me of a few things, including ALS. So I had an EMG done a few months later on my arm and leg (I guess maybe three months ago now) and it was clean. The twitching is still around, although the soreness is basically gone and I haven’t been too worried. I really never was I guess, until now.

About a month ago my throat started having all sorts of problems. It feels tight, almost like it’s being closed. My voice also seems to sound slightly off too and my breathing has been labored. There’s a lot of mucus in my throat and nose. It almost feels like my throat is twitching too, but I have no idea. When I brought this up to my PCP, he listened to my lungs and said they sound clear. He said it’s probably acid reflux, although he made a comment that maybe the EMG was wrong and I do have ALS that is not affecting my throat. He didn’t send me back to the neurologist though because he said we will just have to wait. I’m not sure what to do. I thought from my research a clean EMG = no ALS. Is that so, or am I missing something. Any information would help.

Just wanted to see if there are any thoughts on this.

 

[Normalguy1]

Just seeing if there are any thoughts on this?

 

[Nikki J]

Twitching and sore muscles are not red flags for ALS so I am not at all surprised your emg was normal. It sounds like your clinical exam was normal too as the neurologist said you seemed fine. Normal emg and normal exam mean no ALS. Of course like most tests it is no guarantee of the future. If you had a normal ekg you wouldn’t think you could never have a heart attack

If your pcp thought acid reflux did they suggest treatment? Diet and lifestyle? Medication? It certainly won’t improve if it is reflux unless addressed.

Frankly that comment was most unhelpful. The emg wasn’t wrong. You didn’t have ALS or any symptoms of it. I doubt you have it now. If your symptoms don’t improve perhaps imaging or a visit to ent might be in order

 

[Normalguy1]

Thank you so much, Nikki, for your reply. I hope you know how helpful you are to so many - same to everyone who writes for this forum.

I have taken the reflux medicine but it hasn’t improved the labored breathing problem. So I’m assuming it’s something else.

So if I’m clear, based on what you said to me and others on this forum, an EMG would detect widespread problems caused by ALS, so my EMG on limbs that were twitching this year would have been “dirty” even if the disease were to be attacking my chest region first?

Thanks again.

 

[Nikki J]

You think you have respiratory onset ALS? It is very rare - 5% of all ALS and when it happens it tends to be in the elderly.

If your doctor had concern for this the correct test is pulmonary function tests. Was your finger oximetry normal?

 

[Normalguy1]

I dont think I do? I didn't even know that was a form of ALS to be honest. My PCP, who as you said has been unhelpful, is the one who mentioned maybe the breathing problem is ALS and the EMG was wrong. But my oxygen is normal (i just took it, it was 98) and the neurologist said my EMG and clinical was normal. So if I had a normal EMG and clinical after the twitching this year, that would not be ALS and the chances the breathing problem is connected to that is low I am assuming? I guess I should add I have no problem swallowing or speaking if that counts for anything.

 

[Nikki J]

So you had an exam that was normal , an emg of your limbs so no limb onset, no swallow or speech issue ( so no bulbar signs) and you have an excellent oximetry. Sounds like you are good to go. And maybe you need a different pcp?

 

[Normalguy1]

Thanks Nikki! I figured as such.

So just final question, my EMG of my twitching limbs would have been dirty if there was a problem in my chest caused by ALS?

 

[ShiftKicker]

Heya-

Twitching caused by ALS, no matter where it is and no matter where the onset begins would show some very specific patterns on an EMG. I think you are not being logical here and are looking for any tiny reason why you still have a chance at ALS. This is not a healthy focus for you and indicates a gigantic dose of health anxiety.

We are not telling you there's nothing wrong, only that you have been very comprehensively cleared of ALS and that you need to cross it off your list. Please find a way to manage your anxiety while you work with your doctor to track down cause for your twitching. It is not here. It is not ALS.

Take care

 

[Normalguy1]

Hello,

I’m sorry to be back. I know you all said this is not sound like ALS but I just want to make sure and if I should contact the neurologist or my PCP.

I have mucus that has been staying in the back of my throat consistently. And then when I have been talking, my throat closes for a second and I have to clear my throat again to begin. I’ve not been slurring my words at all, and I cannot see or feel any twitching on my tongue. I’ve not been having problems swallowing food, but spit is not going down naturally and I am swallowing a lot more of my saliva than usual. It does feel like my throat is different, not painful, just a weird feeling. Does this sound like Bulbar at all? I’m sorry again if this is out of line or unhelpful to your mission to ask these questions.

 

[ShiftKicker]

Please speak with your doctor for next steps, if any. This forum is not the place for general medical advice. II am closing this thread. Please do not start another.

 

[lgelb]

It does not.

Your PCP can look at your throat and refer you to an ENT as needed but the leading causes for what you describe are lack of sleep, anxiety, GERD and allergies.