Hand motor skills deteriorating for months, now muscles twitching. EMG shows nerve damage. What is this?!

[Clearwater AL]

When you hopefully post the full results be sure to post the Summary/Conclusion
at the bottom of the report.

You say you are looking for something that irrefutably says no ALS. But then you
write on being more convinced every week it is ALS. And now posting new symptoms.

Again, when you get the report let us know the Summary/Conclusion.

I hope the report will finally move you on from ALS and address your other issues.

 

[affected]

Definitely be sure to post the Summary/Conclusion with the report so we can comment accurately.

 

[Leoppy]

I misunderstood the verbal summary given to me after the test. It looks like abnormalities were in the H-reflex study - not my EMG. Seeing these results I am definitely feeling more hopeful than I was previously. Still very scared at the progression Im feeling and not sure what the heck is going on with me - the finding in my clinical also isnt sitting so well... but Im hopeful that its not ALS as 2 months ago I had an EMG showing radiculopathy in my cervical spine and now this EMG (that happened as my leg and feet were twitching) does not find major issue.

FOCUSED PHYSICAL EXAM:
Lower Extremity Muscle Strength (Score out of 5)

	Left	Right
Ankle Dorsiflexion	5	5
1st Toe Extension	5	5
Ankle Plantarflexion	5	5

Sensation grossly intact bilateral lower extremities
Babinski negative bilaterally
2+b/l patella and achilles
1+ beat of clonus RLE

NCV FINDINGS:
All nerve conduction studies (as indicated in the following tables) were within normal limits. All left vs. right side differences were within normal limits.

All F Wave latencies were within normal limits. All F Wave left vs. right side latency differences were within normal limits.

H-reflex studies indicate that the left tibial H-reflex has prolonged latency (33.16 ms). The right tibial H-reflex has prolonged latency (40.00 ms). Left vs. Right comparison data for the tibial H-reflex indicates abnormal L-R latency difference (6.84 ms).


EMG FINDINGS:

• All examined muscles (as indicated in the following table) showed no evidence of electrical instability

IMPRESSION:

Prolonged latency of bilateral H reflexes may indicate b/l S1 radiculopathy.

There is no electrodiagnostic evidence of entrapment neuropathy, sciatic mononeuropathy, myopathy, plexopathy, or peripheral polyneuropathy on today's testing of the lower extremities.

 

[lgelb]

Radiculopathy does not "progress" to ALS, just like bruising your knee does not make you unable to move your ankle; breaking your ankle does not bruise your knee. But many people have spine damage that affects both the leg(s) and arm(s). Physio and monitoring are often called for, and it can be suggested what activities or exercises might be making things worse.

Does anyone else notice these voice changes that you do?

As your EMG is normal, you are good to go as regards ALS.

 

[Leoppy]

My dad said that I sounded nasaly on the phone yesterday and that was totally unprompted, and a friend has said that my voice sounded "even" deeper than normal recently. (I have a naturally deep voice). My wife on the other hand (who I've entirely worn out at this point) swears I sound fine, look fine, etc. So maybe it's in my head.

I know Radiculopathy doesn't progress to ALS, but I've seen that in a large share of ALS cases, it's misdiagnosed in the early stages, and Radiculopathy was at the top of the list of things it's misdiagnosed as. That's part of what scared me so much coming out of the first EMG. Then when symptoms spread to my lower half - it had me convinced this was widespread nerve damage.

I agree now tho - clean EMG of my legs that have already been twitching non stop for weeks should rule out ALS. I am going to do my best to leave this forum. I appreciate all of the replies/time/perspective y'all have given. I am getting a lumbar MRI to look further into the clonus identified in my ankle - I truly hope this is just addressable issues in my neck/back that my OCD decided to run away with.

 

[affected]

Great results!
I hope you will believe them and let this go.
If you had bulbar issues you would be told something quite different than what has been said.

If you get caught up in fears again, return immediately to your doctor, not to the internet. Something I've learned is that you can prove any fear to be true if you just google enough.

 

[lgelb]

Allergies (some start in adulthood), GERD, and dry air are all worth looking at re that "nasal voice."

All the best.