My thread from a couple months ago was closed, wanted you guys to take a look my EMG.

nhenderson

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My thread was closed. I finally got a smart phone and could take a picture of my EMG of my left arm and I wanted you guys to take a look at it. I only took a pic of the last page. It includes the Motor nerve conduction part of the study and the EMG part. The sensory was pretty much normal except that there was no sensory response to digit Five. I have been told it is Ulnar nerve damage only, and have been diagnosed with cubital tunnel. My pinky finger is constantly numb and I am starting to loose some grip strength, have been dropping things mostly though I notice it is at work when I am in a hurry(I am a nurse).

I also have been having body wide twitching and some places more than others, guess people refer to them as hot spots. I thought that the twitching was related to low magnesium and vit. D which I found out was low in March. I have been on supplements ever since and also stopped taking a medication that could cause low levels of some vit/minerals and still have the twitching, some days worse than others.

I have always been concerned about the +1 PSW part of the test. I have had the MRI and x-rays which didn't find anything in my arm, to cause this. I also have been doing months of PT as well and tried the night splint.

I do go back to the neuro in June and she will order a new EMG, she wanted to wait until it had been six months since the first EMG, before any other decisions are made going forward.

This EMG study was Dec 28th. In your opinions does this seem like the start of ALS and it is picking it up super early or really just and Ulnar nerve problem. If it were the start of ALS would the other muscles tested also be abnormal?

Since I have posted before I thank anyone for the time to look at this and respond. I am just a little worried since I have started dropping things in that hand and it is weaker than my right. Also this was not a neuro that did this first EMG.
 

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KarenNWendyn

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I think you’re in the clear as far as ALS. A couple psw’s and everything else is squeaky clean. With ALS there would be widespread abnormalities, more than just a couple psw’s.

The followup with the neurologist in June is a good idea to track the issues you do have, but nothing in your story is concerning for ALS.
 

nhenderson

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Ok thank you so much for your reply. Like I said I am being treated now for Ulnar neuropathy(cubital tunnel) which I have been just reassuring myself that is all that is going on. As I am sure you already know it can cause weakness as well, I only seem to really drop things at work but I am in a hurry a lot. Will you guys keep my thread open so I can report back in June after I have had the 2nd EMG?
 

KarenNWendyn

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The thread will close automatically 30 days after the last post, so that’s June 16. If you need to start a new thread, we can always include a link to the previous threads.
 

nhenderson

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Oh ok thanks, I probably won't end up getting the second EMG until closer toward the end of June. Again I thank you so much for taking the time, it really means a lot to me and is very helpful. I am trying not to worry about it, the neuro didn't seem really all that concerned when I did see her in March.
 

lgelb

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Yup. I don't see anything to be concerned with in terms of ALS. I'd follow the recommendations to avoid pressure on your elbow, forearm and wrist -- it does make a difference, and ask about appropriate exercises if you don't have a regimen as yet.

Best,
Laurie
 

nhenderson

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Ok thanks so much Laurie for your reply. I have been doing PT exercises for months and wearing the night splint, nothing seems to be working. I am now trying something called ionotopheresis. If this doesn't work and depending on what the 2nd emg shows in terms of further damage or even some healing, I may have to have surgery.
 

nhenderson

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I think you’re in the clear as far as ALS. A couple psw’s and everything else is squeaky clean. With ALS there would be widespread abnormalities, more than just a couple psw’s.

The followup with the neurologist in June is a good idea to track the issues you do have, but nothing in your story is concerning for ALS.
Karen I didn't really think to ask you before but would the PSWs likely be from Ulnar nerve damage or just maybe a non clinical finding? I am wondering since it was only Ulnar nerve muscles. Since there was slow motor NCV at the elbow and in the wrist/palm, I do know that the nerve has damage and have been told it is neuropathy. I am trying to find some good sources online to answer my questions(without worrying myself to much). I am seeing that PSW means active dennervation, and I hope that it is something that can heal, but it doesn't seem like it can in some cases. Thanks. :)
 

KarenNWendyn

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PSW in isolation (which is your situation) is not worrisome. But since both of your PSWs were in the distribution of the left ulnar nerve, then your theory that injury to that particular nerve is causing these PSWs makes sense.

The good news is that peripheral nerves such as the ulnar nerve can recover over time. Sometimes surgical decompression is indicated. Sometimes cortisone injections and PT can help. Your doctor will advise on what’s most appropriate for your situation.
 

nhenderson

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PSW in isolation (which is your situation) is not worrisome. But since both of your PSWs were in the distribution of the left ulnar nerve, then your theory that injury to that particular nerve is causing these PSWs makes sense.

The good news is that peripheral nerves such as the ulnar nerve can recover over time. Sometimes surgical decompression is indicated. Sometimes cortisone injections and PT can help. Your doctor will advise on what’s most appropriate for your situation.
Thank you, so much for your reply that does make me feel a lot better to know that. The internet is just not clear.
 

nhenderson

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Ok so I have been not only following with the Ortho dr but also the Neuro. I have been having twitching mostly all over though in random areas. Twitching and concerns over my EMG were why I went to the Neuro. Anyway I went for my first Neuro visit in March. She found low Vit D and magnesium and put me on supplements which I do notice I don't twitch as much, but I still do and in some of the same places and randomly all over my body. What now has me concerned is that when she checked my reflexes in my arms/knees they were Hyper in all limbs, which she said was the same as in March, which I didn't know that I even had that in March. I asked her if that was a bad thing and she said not really but it can be, especially if I don't have weakness. So she said that she can order a full EMG to rule out if I wanted to so I opted to do so. I already had one scheduled tomorrow for my arm. Should I be worried since I have twitching, a couple PSW on my first emg which was just my left arm and now hyper-reflexes? She didn't do any other tests just the arms and knees. I am just not sure what to think, and I am really worried again, but it doesn't seem like she is terribly concerned since she was leaving it up to me to do a more extensive EMG. I do have anxiety so could that cause hyper-reflexes? I should also add I am a 36 year old female.

Thanks,

Nicole
 

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I'm confused as to your ongoing worry and fascination with a disease you've been cleared of more than once. Your neuro doesn't think you have ALS, your test results say you don't have ALS, and the members here don't think you do either. Don't you think it's time to let it go? For your own happiness, please let go of your focus on a disease members of this forum would give anything not to have.

Take good care and best of luck to you in your life.
 

nhenderson

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Ok I will re-read everything again and I will try to not be so worried, but basically Hyper reflexes are ok if it is all four limbs. Thank you so much Karen for your time and answering me.
 
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