Nervous about ALS

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Hello,
I have a question regarding fasiculations. The EMG of my left arm was normal. Since then I have begun experiencing visible fascinations of the arches of both of my feet. My questions are

1. Are fascinations on both sides of the body less common in motor neuron diseases and more common on one side ?

2. I know that the normal EMG is a positive thing but I’m assuming because it was my arm and has nothing to do with my legs an EMG of the legs would be necessary to truly rule out any issue?

3. Are fasciculations that are associated with motor neuron disease and ALS constant once they start? Mine do not appear to be constant and I don’t really notice them during the day when I’m up and moving around. It’s only when I settle down at night. It’s sort of feels like little bugs crawling under my skin but when I look at my feet the skin is clearly jumping around.

Thank you.

I tried to take a video but I can’t attach it for some reason even though it’s only five seconds long.
 
We have no need of video. Twitches are meaningless so watching you twitch is too.

people with ALS have twitches due to dying motor neurons so PALS tend to twitch in one area that is weak and spread as or after weakness spreads. It is weakness that matters not twitching

you complained of arm symptoms now you think just because of lower extremity twitching you have ALS in your legs and coincidentally something else in your arm?

twitches are common and non specific. Patterns vary. You can’t read anything from them
 
Thanks so much for responding. No I think I just was so hyper focused on my arm because it was much mor symptomatic. I experienced some relief from that normal EMG, but it was short lived. Today when I was laying down with my daughter I noticed some sensations in my feet. I laid very still and watched them twitch for a while. I know that I have high anxiety and I am kicking myself for not having the doctor test my legs while I was there. I have scheduled another appointment but I can’t be seen until January 5. Was hoping for some insight until then.
 
Danielle., from your post above...

"I know that I have high anxiety"

What you describe above is the circle of Health Anxiety. Until Jan 5th
seek help for anxiety. If you had asked the doctor to do your legs while
you were there... you may not have been pleased with his response.
They know what they are doing....

"Was hoping for some insight until then."

I'd bet more is coming... it might not make you comfortable.
 
I may not have been pleased with his response ? Please clarify....: do you mean he would have likely not done the test on my legs because he would have felt it unnecessary due to my normal arm EMG?
 
The doctors know how to do these tests, you might find it surprising that they have years of training and experience which guide them. As twitching is meaningless, you do need to go back to your doctor and ask for help.
We can't keep reassuring you to have you keep questioning that on and on as it is not healthy for you.
Your doctor can help you, and I wish you the very best.
 
good evening,
Just a general question about EMG testing. Can an EMG performed on only one limb “miss “ ALS in the early stages if the symptoms are occurring in a completely different limb? I only had a EMG on one arm and the fasiculations are occurring in my calves and feet. Is a second EMG on my legs necessary to help rule out ALS?
 
Please make sure to read the Read Before Posting to ensure your questions are not already answered there.

From the link;

EMGs
Does a dirty (abnormal) EMG mean I have ALS?
EMG, properly done, is the gold standard test for ALS. But an abnormal EMG can indicate hundreds of other, non-fatal, diseases. So listen to your doctor.

My EMG was done “too early”

EMGs cannot be done too early. 70% of a nerves fibers die before you feel weakness. An EMG will detect that process long before you can feel it.
Here is a simplified summary:

1. ALS causes nerves to die.
2. EMG detects effects of nerves dying.
3. For ALS, muscles get weak and atrophy when they lose their nerves (no pun intended).
4. Therefore a weak or atrophied muscle due to ALS will absolutely, positively show up on EMG. Clean EMG = No ALS

Special note on assessing bulbar function: The most common areas EMG'd to assess bulbar function are under the chin or the sternocleidomastoid, and sometimes the tongue. If any of these sites were assessed , yes, you have been tested properly.

However, an abnormal EMG does not necessarily mean ALS so a so- called dirty EMG needs to be interpreted by your doctor. There are many other more common things that will cause EMG changes and some of those findings will be PART of what is seen in ALS. Listen to your doctor and do not try to second-guess him/her.

Why do I see people saying their EMGs were normal when their ALS started? For those people who are accurately reporting their diagnosis the answer probably is that their ALS started in their Upper Motor Neurons and then progressed to the Lower Motor Neurons. Upper Motor Neuron disease is found on clinical exam so these people were not told they were fine. They had an abnormal exam and the neurologist knew there was something seriously wrong. If your exam was fine ( or just some brisk reflexes which are normal in many cases) this is NOT you.

Another EMG question that is frequently asked is if I have ALS in one location but the EMG was done elsewhere in my body would it still show? The answer is maybe, however if you are having symptoms in several areas and the neurologist only tests one if that is negative that is sufficient. There is no need to EMG every muscle that is symptomatic.

You must also realize the doctors know their anatomy. Just because you see/ feel something in one specific location does not mean that is exactly where the needle goes. It may be above below or surrounding. If you have symptoms only in your left hand it is possible that an EMG of your right foot would miss something. But if it is your left hand and they examine that extremity don't worry.
 
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This is the area I’m confused about. So I guess the answer is maybe? So I should have theEMG done n my legs since that’s where my symptoms are? NEver had fasiculations in my arm ( where the EMG was done) but now they have appeared in my legs and I’m worried I should have the emg done in my legs . I’m sorry if I’m confused.
 
The hallmark of ALS is specific EMG abnormalities in muscles that do NOT yet have problems moving. You do not have clinical weakness so that would describe any muscles they tested.

You do not need to worry that the EMG was done in the wrong place. So you don't need a second EMG. That said, if you are obsessed with getting one in your arms, go ahead rather than hold your life hostage to a "what if," even if it's one that we are telling you doesn't exist in your case.
 
Danialle, from your very first post...

"I also do have medical anxiety to be perfectly honest."

How true.

You've had 29 replies, this has gone on for two pages.

Then on this page...

"I know that I have high anxiety"

You have a diagnosis.
 
You have health anxiety, not ALS. Continuing to asked terminally ill folks on what your issues are, is completely unfair. Please think about that.

Good luck to you and take good care.
 
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