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Had EMG not sure what to make of results

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lawson1012

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Just wanted to get some insights as to EMG and NCV testing that was done regarding some symptoms I had been having these past 4 months. Clinical exam normal, no tongue or other fasciculations noted at time of exam (would being on Klonopin have disguised these symptoms?) The emg (on both arms) reads: all motor and sensory distal latencies were within normal limit. Conduction velocity was borderline slow for motor ulnar nerve on both elbows, slower on right than left. The amplitutde of CMAP was relatively low on bilateral median nerve. The amplitude of SAP was adequate on all nerves tested. EMG needle inserted on right hand and arm showed no spontaneous activities. Insertional activities and Motor Unit Potentials during volitional contractions are normal.
Diagnosis very mild entrapment neuropathy of ulnar nerve at both elbows.
No evidence of MND. Does this qualify as a clean emg?
Also at this time diagnosed with autoimmune Hashimotis with high TPO antibodies. I don't know if that helps explain some of the bulbar symptoms.
Any insight is greatly appreciated.
Thanks so much.
K
 

KANSASTOM

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Yes, at least for ALS.
 

hopingforcure

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Sure does not sound like ALS.. Sure not ALS..
 

trfogey

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"No evidence of MND." ---> No evidence of ALS.

ALS is a MND -- motor neuron disease.

Congratulations.
 

crystalkk

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That is not an emg of ALS, please worry about getting your thyroid straightened out and you should feel much better.
 

Twinsmom

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Congratulations on NOT being MND...takes ALS off the table.
I hope you get some clarity on your health issues.
Peace,
Melody
 

AndyDJX

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Hi Lawson--

You and I have similar EMGs. I had the reduced conduction on my left elbow and I also take Levoxyl for thyroid replacement. It still doesn't explain all of our symptoms, but that EMG does not indicate ALS in any way. Good news indeed.

Best,

Andy
 

lawson1012

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Thank you all for your responses. I would like to be reassured that the EMG shows no ALS but the testing was only done on my arms and not on the area that I had concerns on ie the face/bulbar region. While I do not have troubles talking and swallowing or performing the face tests that are mentioned on this site, I have noticed a trembling on occasion when I smile and my right side of face seems weaker than left. I don't know if being on klonopin at the time of the emg would have disguised the tongue fasciculation that the doctor had noticed a month earlier because this time he did not notice it. My clinical reflexes were normal to my knowledge but something feels not right on my right side. So my question is three fold......would klonopin (muscle relaxer) disguise my tongue twitches, would an emg of the arms indicate any denervation of the rest of the body, and do normal clinical exams exclude a person? I can't imagine that Hashimotos would affect only one side of a person and that's what has me worried still. I appreciate your feedback immensely. Thank you for your time and input.
K
 

lawson1012

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Thank you all for your responses. I would like to be reassured that the EMG shows no ALS but the testing was only done on my arms and not on the area that I had concerns on ie the face/bulbar region. While I do not have troubles talking and swallowing or performing the face tests that are mentioned on this site, I have noticed a trembling on occasion when I smile and my right side of face seems weaker than left. I don't know if being on klonopin at the time of the emg would have disguised the tongue fasciculation that the doctor had noticed a month earlier because this time he did not notice it. My clinical reflexes were normal to my knowledge but something feels not right on my right side. So my question is three fold......would klonopin (muscle relaxer) disguise my tongue twitches, would an emg of the arms indicate any denervation of the rest of the body, and do normal clinical exams exclude a person? I can't imagine that Hashimotos would affect only one side of a person and that's what has me worried still. I appreciate your feedback immensely. Thank you for your time and input.
K
 

KANSASTOM

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I just read an earlier post from you where you describe your neurologists telling you this could be some early signs of ALS. Your neurologists sounds alot like my first one, within fifteen minutes he diagnosed me with ALS, based on two emgs and a MRI, both done by someone else. Since than (2 years now) I have seen three ALS specialists at the MDA clinic that have said no to ALS. I have been diagnosed with Monomelic Amyotrophy a benign lower motor neuron disease. I know what it feels like to worry about ALS, but you have a clean emg and a clean clinical exam, there is absolutely no reason for you to worry about ALS. ALS is extremely rare and hereditary ALS is even more rare. Please stop worrying about this, you are wasting valuable time.
 

lawson1012

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Thanks Kansas Tom
yes it is very scary especially considering my history. I take consolation that my grandfather died 10 years ago in his 60s and none of his 9 brothers and sisters or any of their children and grandchildren have this disease. But knowing myself and my tendencies to worry, I have scheduled an emg of my worry areas in few weeks. I can see little pops in my tongue occasionally while inside my mouth but I'm able to move all over, up down, side to side, out, tent cheeks, whistle, etc... But what sticks in my mind is him saying that the tongue fasics (when stuck outside of mouth) were the BEGINNING of bulbar ALS. But then the next time I went to see him, my dose of synthroid had been lowered and I was taking .5 mg of klonopin and he didn't notice any fasiculations with my tongue at rest then. Just don't know what to think but want to say thanks for sharing your story.
 

trfogey

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ALS is a disease of the nervous system, not just one body part, even in the early stages. Some medical folks estimate that the disease may be active in the body long enough to destroy up to sixty percent of the motor neurons before the first external symptoms are presented. Additionally, by definition, motor neuron problems, both upper and lower, must present in three distinct regions of the body before ALS can be diagnosed. Since the only other part of your body in which you reported symptoms was your arm and hand, the normal EMG in that area shows that you don't have lower motor neuron problems in that area of your body and, therefore, since you lack MND symptoms elsewhere, you don't have ALS.

Your case is a primary example why doctors should not speculate about a patient's condition. One ill-chosen remark on his part planted the notion of ALS in your head, and now you won't turn it loose without a whole bunch of additional tests. He may have planted the seed, but you are the one who continues to cultivate it.
 
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