Nearly a year since the 'dirty EMG'

[jim_bravo]

A year ago (nearly - 12th April 2008), I was faced with this.

EMG: (Neurologist Sidipa Chotchaisathit, M.D.)

- Increase insertional activities, few spontaneous activities, Fasciculation and polyphasic MUAP, late response and large MUAP (0.2-10mV), long duration (8-12ms) and reduce MUAP recruitment of bilateral 1st DI muscles, at bilateral 1st DI, Tibialis anterior, Lt Vastus femoris muscles.

- Normal insertional activities, no spontaneious activities, few fasciculation and polyphasic MUAP, late response and large MUAP(0.2-5mV), long duration(8-12ms) and reduce MUAP recruitment of bilateral Vastus medialis and Lt. Biceps brachii muscles, at bilateral 1st DI, tibialis anterior, Lt Vastus femoris muscles

- Normal insertional activities, no spontaneous activities, normal MUAP of Orbicularis oris muscle (mouth)

- Interpretetion: Needle EMG showed sign of membrane instability, fasciculation and chronic denervation neuropathic pattern in general limbs, esp. bilateral 1st DI muscles, but still normal study in bulbar muscle.

- Most likely cause: Motor neuron disorder disorder was probably

- Moderate inact neur: Left bicep
Pronounced inact neur right quadricep
Pronounced subac neur Left quadricep, left hand, right hand, left shin, right shin
Normal: Left mouth

A year later, and nothing has changed. Left hand still visibly wasted, but no further wastage (in terms of severity nor range) or movement losses.

The moral of the story? - A dirty EMG doesn't mean it's 'all over'

Anyone else had similar-looking gloomy EMGs that (touch wood) seem to have been false alarms?

 

[GlenBrittle]

Good for you Jim.

I think a lot of us would like to have those false alarms.

I like to live day by day , keeping a positive attitude . If I get slowed down , so what , Im still here aint I !

Glen

 

[jim_bravo]

Well by 'false alarm', I mean it's not looking like an ALS-speed progression. Even for a young person, who often tend to have a much slower progression (I was 25 at the time of test - 26 now).

Of course that doesn't rule out PMA, Kennedy's, certain myopathies etc. Or even something that was caused by maybe a poisoning etc.

Anyway, I hoped that my post would show people with 'dirty' EMGs that there are other causes of such results. The tendency now is to think "dirty EMG = ALS", even amongst some of the more ignorant members of the neurological medical profession.

Another key thing from my experience is that the dirty EMG made other 'syptoms' arrive that co-indided with an ALS diagnosis, but are no nowhere to be found:

- yawning
- various weaknesses
- anything to do with speech

I still get fasciculations and still have a wasted left hand, as before. Twitchy eye-lids (especially left eye) is ongoing.

I'd say the only think that has actually progressed is that I often get violent involuntary movements - especially when lying in bed. These can involve my leg kicking out to 90-degrees or my entire body suddenly doubling-up. Does this sound indecative of anything?

 

[jim_bravo]

(how do I edit my posts? - a few typos in that last one)

 

[11bravo]

Whats up Jim, I too had a "dirty" EMG. I am scheduled to have another when I get back in the states sometime this summer. I have to admit that I personally have been fighting that inner worry wort on whether I really have something wrong with me or not. I just remember the doc saying yeah thats not good, and went on to explain that I had fasculations and chronic denervation. I am still hopeful that it is just BFS with side of neuropathy.
Anyway I still workout and try and push myself as I figure I am NOT going out without a fight.

Good Luck Jim I am totally happy that you have had NO progress (the bad kind) Lets keep it up.

11B

 

[wright]

Jim

If you were given a diagnosis of MND . . . or even a possible diagnosis of MND, then you need to change neuro's. That is not at all indicative of what an MND EMG would look like; that is the EMG of a peripheral neuropathy or some event or condition that caused you to denervate, which is why you haven't progressed any further.

Congratulations (if that is appropriate to say) but go elsewhere to see if they can help you.