Going Through Diagnosis

[ScaredDude]

Hello,
First off, I want to say how grateful I am to this community and for allowing me to participate in discussion and ask for advice. Has anyone had a similar experience to mine and what does this suggest to the veterans here? Here is my story: 36/M, had pain/weakness in leg from a run back in August that didn’t get better after stretching/strengthening exercises. Shortly after, nonstop twitching 24/7 in legs that has spread to entire body. Legs feel heavy, feelings of pre-cramping in arms, slightly fatigued. Blood work all normal. EMG report showed abnormalities, suggesting Radiculopathy (active and chronic denervation). PT ordered. Evaluation showed global leg weakness in right leg. About 4 weeks into PT, not much improvement and my right leg is about 30%-40% weaker than left. Met with Neurologist last week, said exam was normal but acknowledged my *** concern. MRI for brain and C-Spine came back normal. I attached my EMG report. I expect the neuro to order an L-spine MRI and possibly another emg since the first one only included my left leg. What does this look like to you? I’m scared to death.

 

[lgelb]

This isn't the most informative table, nor is it super concerning for ALS esp. with a normal exam. I don't understand your comment about the EMG only including your L leg. In fact, it tested your R leg. Naturally, the simplest and most likely explanation is that you injured your leg and/or the nerves that control its muscles during the run. Twitching tends to feed on itself so I wouldn't stress over that.

An MRI does sound like a good next step and could help inform whether you need another EMG and if so of what.

 

[ScaredDude]

Thank you very much for your reply. All of my clinical weakness is in the right leg. That’s the one they did the EMG. I wish they had tested an arm but doc was fairly certain it wasn’t MND, even though my results did not rule it completely out (PSW/Fib, MUP, Amplitude, insertional activity). Seeing an ALS specialist next week.

I have been so stressed out and worried that I was hoping the brain MRI would indicate MS because that would mean no ALS. I can’t imagine the pain anyone must go through with this terrible disease. Love and prayers to everyone here who has been touched by it.

 

[ScaredDude]

Say I got another emg and an arm showed the same type of results as the one I already had, would that essentially be a confirmed diagnosis? I have a lot of arm twitching/light cramping during use, along with muscle fatigue in both arms.

 

[Nikki J]

No. If it looked like what you posted that doesn’t seem like a diagnostic emg. Plus an ALS diagnosis also requires an abnormal exam which you said you didn’t have

 

[ScaredDude]

I am curious what else would be needed for a diagnostic emg since it wasn’t really explained to me. More PSW/Fibs in additional muscles? From my understanding all of the +1’s and 7k amplitude are not good. I don’t think there was anything that stuck out to the Neuro during the exam (upper motor wise) but there is clinical weakness 4/5 in a lot of muscles in my right leg along with fascics so it wasn’t totally clean. Is it possible to be diagnosed with only lower motor neuron symptoms? I have been so fatigued lately. Is that an early symptom?

I am having painful, nonstop muscle cramping mainly in legs that seems to be exacerbated by activity and not much relief from stretching/hydration. The cramping/soreness is unlike anything I have never felt before and pretty much all day everyday, making it difficult to even sleep. My question is does ALS present early on with cramping or does that happen after diagnosis once the disease has progressed?