Getting Follow-Up from EMG

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Dodgeville

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Learn about ALS
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Washington
Thank you all for letting me join the community. My Mother was a lurker here a few years after my father was diagnosed with ALS and the advice and community support was great in answering some of the more arcane questions and available resources related to ALS.

As for me, 35M, in good physical condition who has been having a persistent twitch on right arm (right above the elbow) for the last month and a half. Coupled with this, I've had some minor "come and go" twitching in other parts of the body (calves, upper legs and left hand) and neck pain (last four months) which was related to an injury from a recent military deployment.

Following the advice I read on a couple of these threads, I went to my primary caregiver who got me a nuero appointment and neck MRI. MRI showed nothing out of the ordinary; minor wear and tear stuff due to aging.

Completed nuero today. Doctor said I overall look good, no visible nerve damage but noticed my left hand muscle between my thumb and forefinger (which has had some twitches recently) showed some minor muscle differences/atrophy from right hand. He said there was no need to conduct an EMG if I hadn't noticed any muscle atrophy, but I scheduled one just to be sure and gain some peace of mind. I've read there's a lot to gain from an EMG, but the Doctor noted it might be too early to gain a conclusive diagnosis. Wondering if anyone can refute or if it's an accurate assessment?

In the meantime, he prescribed me some magnesium tablets. Previous bloodwork had come back within normal parameters for sodium and other minerals, so we'll see how it goes. I hadn't noticed the atrophy in my left hand until he mentioned it, so I'm now a lot more concerned, but glad I scheduled the EMG.

Thank you for your time and will update this thread post-EMG results in March.
 
Sorry about your father Dodgeville.
Not much we can add. Neuro finds nothing wrong.
You insist on EMG. Will you believe it if it is clean since you have already started questioning that before even getting it?

Try reading this through carefully so help you understand why you have been told you are not presenting with anything of concern. That is the reason it might be 'too early' - you don't have any ALS symptoms for the EMG to find.

I hope you can get help with your concerns. Do let us know the results in March. Until then, we can't really add anything as the post I've linked you to is extensive.
 
If there is true atrophy due to ALS the emg should show did they absolutely call atrophy? Is it your non dominant hand? When I was first diagnosed with left leg onset one of the neuromuscular people questioned atrophy in my non dominant hand. I said I thought it looked normal. This proved to be the case It was not an early sign of impending hand issues for me. It was four years before any issues at all appeared in that hand

i am sorry about your dad losing a loved one to ALS is so traumatic. I am glad your mom found help here and hope she is doing ok
 
I'm sorry about your dad.

I agree that atrophy can be a normal variant and/or in the eye of the beholder who has not seen the evolution of your body shape. Let us know how it goes.
 
Thanks all for the highly considerate replies. I don't think my Mom will ever get over losing my Dad to ALS... He was 55 upon his passing and would have just reached retirement age this year. It's a bummer (to put it very lightly) and we all miss him very much. I can't sympathize enough with those PALS and CALS who have to witness this disease firsthand.

Neuro noted atrophy on non-dominant hand... Not jumping to any conclusions until the EMG. Thanks again for all the support and will revisit this thread in March.
 
Returning post-NCS/EMG appointment. Mostly reassuring news;

Doc only tested arm having the persistent fasciculations (still have the twitches and cramping other places but intermittenly). Motor conduction test was normal in 2x tested nerves (median/ulnar). EMG was normal in 2x muscles and abnormal in 4x muscles. Overall, doctor called it "mildly abnormal", with fasciculations seen in several muscles. Doctor noted findings mostly consistent with BFS, but wants me to return in 3 months for another EMG (same arm and a leg next time) since I have a family history of ALS.

So, we'll see what happens in 3 months. Attached EMG table since I have no idea what it means.

As an aside, anyone get more twitches following an EMG? Right arm has been twitching up and down like crazy since the test.

Thanks again for all the help/patience you all provide.
 

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It means what it says -- most consistent with a benign fascics syndrome. Doesn't show the kind of damage that would most concern anyone. Take and it and run. It's like if you look down and your leg has a bruise, but you don't know why. You can obsess about the cause, or realize that it's not keeping you from doing anything.

Twitching post-EMG would be consistent with BFS.
 
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