Status
Not open for further replies.

hjlindley

Senior member
Joined
Dec 1, 2011
Messages
760
Reason
PALS
Diagnosis
10/2011
Country
US
State
VA
City
Richmond
He was careful, thorough and cautious until the EMG proved what he had beensuspecting. After he did the EMG, he studied my history for almost and hour before he came to his conclusion. I would trust this guy completely, and I have trained MD's for over 20 years.
 

glupavomomiche

Distinguished member
Joined
Sep 25, 2011
Messages
272
Reason
PALS
Diagnosis
09/2011
Country
US
State
Texas
City
Podunk
Hey Rose,
Yeah I have that crossed aductor thing too in my legs. As a bonus, I also have the ridiculous startle reflex. Everyone had a MARVELOUS time watching me during the new year when the fireworks would go off... I kept jumping and would drop whatever I was holding, which was extremely inconvenient during a card game! I DREAD the 4th of July now... and when the phone rings... and when someone knocks on the door... and when people drop stuff... and... LOL
 

sya15

Active member
Joined
Jul 22, 2011
Messages
80
Reason
Friend was DX
Country
US
State
ct
City
middletown
My boyfriend has had 4 normal EMGS. He goes to one of the best neurologists. She runs the ALS clinics and head of neuro at MGH. She says that ALS is still a possibilty can't rule it out. Yes you need an abnormal EMG plus other criteria(both UMN and LMN involvement) to make a diagnosed of ALS but just because one has had normal EMGS doesn't mean ALS is off the table.
 

clichti

Active member
Joined
Sep 15, 2011
Messages
61
Reason
Lost a loved one
Diagnosis
00/0000
Country
CA
State
ON
City
Toronto
I think again we may be getting partial information - I believe, and I could absolutely be wrong, that there can be a difference between results classified as "normal", and results that are completely clean, no? Meaning, you could have a situation where, yes, your EMG results may come back within the realm of normal, but that does not necessarily mean absolutely nothing turned up. Which would explain why in those instances, patients are usually requested to attend for one (or multiple) follow ups.

Am I on the right track here folks?
 

Ms. Pie

Very helpful member
Joined
Mar 26, 2011
Messages
1,794
Reason
PALS
Diagnosis
10/2010
Country
US
State
CO
City
Colorado
I only know about me. 3 "dirty" EMGs. Dammit.
 

horevo

Active member
Joined
Jan 20, 2010
Messages
50
Reason
Other
Country
US
State
IL
City
Chicago
I think this thread started with the best of intents but is starting to cause heated discussion and a lot of stress and worry from people like me who have real concerning symptoms and clean EMGs. I think we can all agree that an ALS diagnosis is more than just an EMG. I think it's important to reassure people that if a qualified neurologist doesn't put ALS on the table, then neither should we. They are the trained professionals and if you truly had ALS then something would be abnormal, a clinical exam, an EMG, something....and even then, it doesn't mean it's ALS. Hopefully you all agree.
 

wright

Very helpful member
Joined
Jan 12, 2008
Messages
1,160
Country
US
State
xx
City
xxxx
Patricia

What reason would you have to tell half-truths? That's simple: you don't actually know you are because you simply don't understand (you might think you do, but I assure you, you don't . . . ergo, your intial post in this thread). We are actually saying the same things, I simply made it more clear. I am right in what I'm saying . . . so are you . . . you just didn't tell the whole story. It's as simple as that.

Your story, as you told it in your first post, states that you had brisk reflexes as an early sign. That is an upper motor neuron problem. You also state that you had a clean EMG. That tells me that you started with upper motor neuron involvement (at the very least, upper motor neuron dominant ALS and maybe PLS or maybe pseudobulbar palsy, which I explain below). Then your EMG was indicative of lower motor neuron involvement. Then and only then, you were given the diagnosis of ALS. There was always something wrong with you but the neuro's weren't certain what it was. That is why you got further tests and eventually (and unfortunately) it was sorted-out with your dirty EMG's.

You also state that your symptoms were bulbar intitially with clean EMG's. What you didn't tell us is if the EMG was of the bulbar region or of your limbs or both (again, not the full story). If you did get the bulbar region needled and it was clean, that means the bulbar symptoms were from the upper motor neurons and it could have been a pseudobulbar palsy, which is why the neuro didn't diagnose you with anything in particular at that time (they had to wait and see, which is exactly what they did). MG was also a possibility, because a typical EMG is clean with MG (single fiber EMG's will detect it, though), which is why you were treated for it. As soon as the other signs and symptoms were evident over time (that would include your EMG that was indicative of ALS), then and only then were you given your diagnosis.

P.S. I don't like it when people panic, so don't tell me or anyone else on here that "I love this stuff." That is why I stepped-in after your intitial post. I was keen enough to see it was a disaster waiting to happen. Looks like I was right. Oh, and I didn't back peddle for an instant (I was consistent in everything that I stated)

P.P.S. I also want to make it clear to the other people reading this thread that if you have lower motor neuron signs and symptoms and your EMG is clean, you simply do not have ALS. This is especially true if you have a clean clinical exam (this is something that Patricia failed to mention). If you have other types of symptoms indicative of upper motor neuron involvement, then the story is unclear at that time and the neuro will take a "wait and see" approach to see if the lower motor neurons become involved and the EMG will detect it.
 
Last edited:

rcharlton

Moderator emeritus
Joined
Jun 20, 2005
Messages
610
Reason
PALS
Diagnosis
11/2005
Country
CA
State
Ontario
City
Toronto
Following these words of wisdom from Mr. Wright, I think it is time to shut this thread down.
 
Last edited:
Status
Not open for further replies.
Top