Is EMG considered clear if there are fasciculations on atrophic/ weak muscles?

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Voulafar

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Hi all. I am confused about EMG results. I had weakness handling things like fork with my left hand and noticed that my hand muscles around the thumb were atrophied. Had an EMG and showed fasciculations on that muscles. Also my right foot feels unstable and the fingers feel loose causing me to walk funny. Had needle testing ext dig brevis and also showed fasciculations. Is that considered a clean EMG?
 

Nikki J

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Clean and dirty are not medical terms. Simple fasciculations on emg with nothing else do not indicate ALS. It is important to talk to your doctor about your symptoms and what to do next
 

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I have atrophy on the APB and FDI muscles of the hand. The neurologist says is not denervation. Split hand is on the table but he insists is not anterior horn disease. I am very confused.
 

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Which is why it is important to get clarification from your doctor as to what they think it may be. Atrophy can happen for many, many reasons, and ALS is pretty much at the bottom of the list for 99% of folks. The fantastic news is that via your clinical exam and EMG, your doc does not think anything sinister is going on. Again, if you are confused by your EMG results, it is imperative that you ask your doctor for clarification.

Best of luck to you
 

Voulafar

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Hi all.My right foot feels unsteady when I am walking. My toes feel like they are loose in my shoes and feel like I am walking a little off balance. I did a test that shows weakness of 17% on the foot. Is this is what we call clinical weakness,? It does not go away or get better. The EMG showed fasciculations on the two muscles that were tested there. Trying not to go crazy since my neurologist said the EMG showed no als signs. Still trying to understand, what is indicative of als in an EMG?
 

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No, what you described is not clinical weakness. 17% weakness? I've never heard it termed like that before. Did a doctor tell you this? Clinical weakness is weakness that is found by a doctor in a clinical setting. Are you a doctor? Why are you self-testing, then making up your own results instead of believing a medical professional?
 

Voulafar

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I had a test done by my physical therapist measuring the strength of each foot. The readings had 17% difference. I am anxious because the fasciculations on the EMG were detected on the muscles that seem weaker. I am sorry I am just trying to understand. I ve read in the forum that fasciculations in EMG can indicate denervation but my neurologist insists that there should be positive sharp waves and fibrillations. I am so confused
 

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Even if you had fibs and psws which you did not an emg indicating als has other abnormalities and needs to be across multiple nerve roots. I believe also that the fasciculation potential that you read is suspicious looks different than a simple fasciculation but I am not an electrophysiologist or neurologist. Neither are you. Trust the person who is.
it is not unusual for one side to be weaker than another and even if it is a change from before there are a gazillion reason other than ALS for weakness.
please address further concerns with your doctor. No one here is going to say your emg looks like the one they had that diagnosed their ALS
 

Voulafar

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Still confused. Checking the results of the report spotted in four different muscles fasciculations+1.
My question is could this be indicative of als since it involves three different areas?
When the doctor says no active denervation that is his personal opinion or the EMG by itself will offer a result?
Still very confused whether I should go to another doctor. He insists that denervation would exist only with fibs and PSW. Please help me
 

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There is a saying it isn’t fasciculations but the company they keep meaning you need other findings to start to worry. And even if you had fibs and psws without other signs indicating chronic denervation too ( which you did not have either) it wouldn’t be an ALS emg. I f you aren’t happy and don’t believe your doctor sure see another. you have been answered repeatedly. You don’t seem to believe us which is certainly your prerogative but we aren’t going to say anything different. Follw up with your doctor or get a second medical opinion. closing this thead. Please don’t start another. Good luck
 
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