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Myrtle

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Going in on Friday for a follow up with my neurologist because I have finished physical therapy with no improvement. I was previously diagnosed with cramp fasiculation syndrome but it doesn’t appear to be the case because I have weakness and atrophy noted by my physical therapist... which at the worst is a two inch difference from one bicep to another.

A few months ago I had a completely clean emg other than 1 fasiculation. I have continued to have constant twitching and I’m to the point that it’s hard to lift a boiling pot of water. How often can an emg miss als on an evaluation? I have tried to find the accuracy statistics online and couldn’t find anything. Does anyone have statistics on an emg accuracy?
 

KarenNWendyn

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Here is what you posted on 12/23/18: “My previous threads are old and have been locked so that is why I’m opening a new thread. A couple months ago I did get an emg and based on the results my neurologist came to the conclusion I have cramp fasiculation syndrome.

The reason why I was given that diagnosis was because to him I didn’t show atrophy or weakness based on the tests given to me. Since then I have started physical therapy and they have noticed my left side is considerable smaller and weaker.

My first emg was done by an neuromuscular specialist and they found nothing other than fasiculations. I was wondering how often does the first emg miss als? Should I schedule a second emg or am I wasting everyone’s time.”

————

Fast forward to now where you’re again asking about EMG accuracy.

EMG interpretation is operator dependent. That said, when looking for ALS, there is no one more qualified to perform and interpret an EMG than a neuromuscular disease specialist. According to your previous post, that is the type of doctor who performed your most recent EMG.

It would be highly unlikely that EMG which was done several months ago could have missed something, especially when interpreted by the neuromuscular specialist in the context of your history and physical exam findings.

So as far as I’m concerned, you’re clear of ALS.

If you feel things have changed and you still have doubts, then you might check back with the neuromuscular specialist to see what they think.
 
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ShiftKicker

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Past threads here:
https://www.alsforums.com/forum/do-i-have-als-als/41984-trouble-getting-neurologist-referal.html
https://www.alsforums.com/forum/do-i-have-als-als/43320-emg.html

Myrtle, if you look at some other recent posts by those who have come here searching, you can see that ALS is not the only reason people experience a whole variety of symptoms. I think you may be jumping the gun with regards to assuming an EMG has missed ALS and trying to find stats for that to prove possible ALS. There are many reasons for symptoms such as yours. Particularly, as quite a few people have already tried to tell you, your reported symptoms simply don't fit in with the normal symptom pattern of ALS. You have pain and digestive issues, for example. The "Read Before Posting" thread has a partial list of differentials, and is not at all complete by any means.
 

lgelb

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Even if you have clinical weakness, there are more likely causes than ALS (and if a pot of boiling water is the main thing you have difficulty with, join the crowd). Following up with your neurologist therefore makes more sense than jumping back to ALS.

Atrophy, if it's new, and several of your other symptoms, can relate to systemic issues as well, a matter for your PCP.
 

Vincent

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Look, you are just going to have to live with the fact that you are going to live. A CLEAN EMG=NO ALS. There isn't a single patient on here with a clean EMG, or who wouldn't trade your clean EMG for our abnormal ones. And an EMG will show significant abnormalities well before symptoms present. Hanging out here is not healthy, nor is your need to be diagnosed with a fatal disease.
Vincent
 
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