Focal Twitching Near EMG Insertion

[Hawgflyer23]

Thank you for providing this resource. My heart goes out to PALS and CALS who live with this terrible disease.

I am experiencing constant focal twitching in my left tricep just above my elbow which started on Jan 5 (Sunday) and has persisted since. The twitching is literally a cm from a EMG needle insertion site I had on Dec 30.

Background: In early Nov I suffered a radiculopathy causing significant strength loss in my left long head tricep and left pectoral minor. I was assessed as 4/5 in terms of weakness shortly after onset, but through PT and strength training I have recovered to 5/5 and am significantly stronger now than I was before the nerve irritation.

As a hypochondriac, when I realized the strength loss I immediately thought it was ALS onset. I immediately descended into severe health anxiety and had a 2-day bout of random whole-body twitching, no sleep, etc. Since then, I have continued to randomly twitch a few times a day at various places on my body (hands, arms, knee, thigh, hamstring, tongue, glute). However, my calves and foot arches persistently twitch when I’m at rest.

I had an EMG of my left arm on Dec 30. My neurologist tested only 4 muscles in my left arm (tricep, bicep, forearm, and interoseus). His assessment of my EMG was “textbook clean” (nothing observed/heard unless I flexed) and specifically said I do not have ALS. He did not do a strength test on my arm, however, and declined to EMG my calves. He did observe a twitch in my calf and stated “benign fasciculation.”

My PT gave me a full neurological exam on my left arm on Jan 6 (Monday) and said I have normal strength. She also stated that she was surprised at how quickly I recovered from the radiculopathy (my MRI was unremarkable showing very minor stenosisof C7... I’m not convinced I had cervical nerve compression but instead a spasm that irritated the brachial nerve).

TLDR: clinical weakness fully recovered following C7 nerve irritation two months ago, totally clean EMG conducted 9 days ago.

Should I be worried about the constant/persistent focal twitching that started 3 days ago in my tricep very near an EMG needle insertion site?

Thank you.

 

[KarenNWendyn]

Should I be worried about the constant/persistent focal twitching that started 3 days ago in my tricep very near an EMG needle insertion site?

No. The muscle was likely irritated by the EMG needle.
Twitching is common, nonspecific, and meaningless in the absence of muscle function failure which you have not described.
Congratulations on the normal EMG and excellent recovery from the radiculopathy.
Enjoy your healthy life.

 

[Hawgflyer23]

Thank you for your response.

Last question: Is testing only one “head” of the tricep during an EMG sufficient to determine that there is no denervation in the entire muscle?

 

[KarenNWendyn]

Last question: Is testing only one “head” of the tricep during an EMG sufficient to determine that there is no denervation in the entire muscle?

Yes

 

[Hawgflyer23]

Thank you again. You are a gift.

 

[Hawgflyer23]

Hoping someone can interpret my EMG report.

The EMG tested 5 muscles/nerves. All were normal with no evidence of MND.

The NCS had a few high sensory readings:
Median Wrist 3.65 (<3.40)
Ulnar Wrist 3.39 (<3.10)

F Wave 32.24 (<32.00)

Is there anything to worry about?

Thanks for any insight!

 

[Nikki J]

Ncs reading have nothing to do with ALS I don’t believe those mean anything at all but even if they did not ALS

 

[Hawgflyer23]

Thank you, Nikki.