Status
Not open for further replies.

JulieBS

Member
Joined
Feb 21, 2019
Messages
12
Reason
Other
Diagnosis
00/0000
Country
BE
State
HA
Hello everyone.

First if aller sorry for my english, it's not my first langage...

I'm a 37 y.o. girl. I have a MS suspicion because i have hearing loss at one frequency in my right ear (-50db in high frequency). My mother, brother ans uncle have MS.

But i have a LOT of fasciculations, especially in the legs (calves and thighs). The neuro told me it's not related to MS. This happens when my legs are relaxed, since a few weeks. I did an EMG but the neurologist only tested one leg, which worries me. the nerve conduction is normal, and he noted a slight contracture in the thigh. obviously I had no fasciculation during the exam...

My clinical exam shows hyperreflexia and a light Hoffman sign on the right hand. This is compatible with MS as with ALS.

I'm totally panicked to have a sla rather than a sep. Here are my questions:
- Can fasciculations precede a weakness?
- Can EMG be negative at an early stage?
- can hearing loss be linked to ALS?

Thank you in advance, sorry but I'm in a panic. :(
Julie
 

JulieBS

Member
Joined
Feb 21, 2019
Messages
12
Reason
Other
Diagnosis
00/0000
Country
BE
State
HA
to complete my post: the rest of my neuro clinical exam is normal, no loss of perceived strength (I walked 7km last weekend ...), I can walk on tiptoe and on the heels .. An I'm an anxious person :)
 

lgelb

Forum Supporter
Moderator
Joined
Nov 5, 2009
Messages
7,663
Reason
Lost a loved one
Diagnosis
09/2009
Country
US
State
WA
Hearing loss is not associated with ALS, but neither is MS the most common cause. The hearing loss may be unrelated to your other issues.

Testing only one leg in an EMG is common. If it was clean and you have symptoms in that leg, there is no reason to worry about ALS. And as you may have read, ALS does not typically present on both sides.

I presume your neurologist will order an MRI to continue the diagnostic process.

Best,
Laurie
 

JulieBS

Member
Joined
Feb 21, 2019
Messages
12
Reason
Other
Diagnosis
00/0000
Country
BE
State
HA
My mother has hearing loss with MS. My neurologist told me it's was not the most common first symptom but that it did occur an was probably underestimated.

My fasciculations are in both legs, but stronger in the left one, that was tested. I guess I should stop worrying but it's all day long, I can't stop thinking about this.

The hoffman's sign and hyperreflexia are a MS sign to. Almost all my family has it, and my age IS more common for an MS disease. So I don't know why I keep thinking about ALS...

Thanks a lot for your answer!
 

Nikki J

Moderator
Joined
Mar 22, 2012
Messages
7,715
Reason
PALS
Diagnosis
04/2014
Country
US
State
MA
I believe hearing loss in MS is around 5 percent.

As Laurie said though we don’t see it with ALS other than coincidentally

I hear people with MS complain of twitching but lots of healthy people twitch as well. I agree that given the emg you are not looking at ALS

Good luck on your diagnostic journey. I hope you don’t have MS either but it sounds like it needs to be explored
 

JulieBS

Member
Joined
Feb 21, 2019
Messages
12
Reason
Other
Diagnosis
00/0000
Country
BE
State
HA
Thanks a lot for your answers. I'm not really afraid of MS. The disease is a part of my life for so long with my family...

Just one last question:

Could someone tell me what fasciculations look like in ALS? Are they limited to one member? Are they incessant or can they appear and disappear over more or less long periods? (Hours or days ...) And especially are they sometimes present in loss of strength?
Thank you!
 

Nikki J

Moderator
Joined
Mar 22, 2012
Messages
7,715
Reason
PALS
Diagnosis
04/2014
Country
US
State
MA
Twitching can present in many ways there is no pattern specific to ALS versus benign.

Hallmarks of ALS are clinical weakness and an emg that shows the typical pattern of ALS. Then , if not already done, tests to rule out other things.

I know you are very knowledgeable about MS. I am sure you would rather skip it however I am glad it isn’t ALS though
 

JulieBS

Member
Joined
Feb 21, 2019
Messages
12
Reason
Other
Diagnosis
00/0000
Country
BE
State
HA
Re: Fasciculations ans hyperreflexia. Update EMG results

Hello again! My concern, which was appeased, came back ...

The neurologist who examined me for my fasciculations told me that the results were not worrying. Last week my GP (who had requested the test) saw the results and told me that there was therefore a little problem. She concluded by telling me that anyway, I was doing a neuro assessment in two weeks. I told her that the assessment was for MS, she told me that it was the same anyway for other conditions like SLA (I do a brain and medial MRI, evoked visual and sensory potentials and a lumbar puncture) .

I have the impression that my GP does not really know what she's talking about ... So I was wondering if you would agree to take a look at my EMG and tell me what you think? Is it really problematic? (I will try to translate what I can because it is in French :))

My symptoms today are therefore:
- Loss of hearing on a specific frequency (first reason for consultation ...)
- hyperreflexia
- Little hoffmann reflex in the right hand
- Fasciculations that come and go to both thighs and legs (very rarely elsewhere, belly, arm, eye, only once or twice ...) at rest for a fortnight.

The rest of the neurological examination is normal.

Thank you in advance for your opinion, I know that I probably stress too much, but I can not think of anything else ... :(

The results in English:

The measured velocities and the H waves and / or the F responses are normal

the electromyographic examination reveals electrophysiological signs of discrete peripheral neurogenic damage in the musculature examined and mainly dependent on the left L4 root.

The analysis of spontaneous contractions in the abduction of the big toe shows only a few normal potentials.

The muscle with the "+10%" is the vastus lateralis ? I'm not certains if the column is "VARIATION FROM NORMAL" or "percentage of multiphase potentials" :/
 

Attachments

Last edited:

KarenNWendyn

Forum Supporter
Moderator
Joined
Jul 29, 2017
Messages
2,578
Reason
PALS
Diagnosis
07/2017
Country
US
State
OR
That EMG looks fine to me in so far as ruling out ALS. With ALS, one would get many more abnormalities on the EMG.

Looking at the big picture, you have not described muscle function failure, and your neurological exam did not show any weakness.

No weakness, no failure, no EMG findings of ALS = no ALS.

That’s great!
 

JulieBS

Member
Joined
Feb 21, 2019
Messages
12
Reason
Other
Diagnosis
00/0000
Country
BE
State
HA
Thanks a LOT for your answer!

I don't know how my GP can be so vague about it. I really think she doesn't know what the results mean... And she wasn't really able to explain why she ordered the test, cause it's not relevant for a MS diagnosis. I suppose she feared something else because of my muscles twitching, but she doesn't know how to interpret the results so she remains unclear.

And I think this stress has made my fasciculations worse. Thank you very much doctor ... :)

Thank a very very much for your time!
 
Status
Not open for further replies.
Top