Passed NCV failed EMG - Bicep Weakness only - Worried I have ALS

[affected]

When there is denervation the report says denervation ... you won't miss it.

Dusty and Nikki have given you wonderful, detailed replies that should have settled all your fears. There are no signs of ALS in your results, and I'm so happy for you.

 

[Nikki J]

Ummm i did not say not denervation I said not indicative of ALS given the isolated finding and mri report

 

[affected]

Hi Dusty and Atsugi,

Here's the UPPER EMG notes - note the right bicep - any thoughts? Is this Denervation?

Sorry Nikki I was responding to this post in the thread, answering the OP question rather than replying about something you said. I wasn't very clear ...

 

[toby1969]

Nikki and Affected,

Thanks you so much for responding - I guess I'm extra worried because in Dusty7's "read this first" report it says that ALS starts in one muscle - everyone else says starts elsewhere - I'm confused -- plus this whole thing with the EMG "gold standard" at picking up the ALS signals before weakness even occurs -- like it can detect nerve struggle before it becomes apparent - my poor wife i'm driving her nuts with this - I just don't understand the timelines of progression -- did anyone notice "something's weird here " before they got to the point that they couldn't pick up the coffee cup etc.

 

[Nikki J]

The thing is Toby you have noticed symptoms in the biceps- that is what drove you to the doctor. By this time the EMG would have shown something in the surrounding muscles as well if it were ALS. I had my EMG so early (less than 7 weeks after a minute symptom) only because I was in a research study yet as well as the muscle I had identified as a problem being abnormal there were also abnormalities in the surrounding muscles because ALS spreads even though I had symptoms only in one muscle

I understand you are anxious but all we can tell you is there other far more likely causes of this and you are just going to have to hang in there and let the doctor do his job.

 

[toby1969]

Nikki,

Thank you so so very much for sharing your thoughts you are so very very kind. I will try to be patient. So just to clarify what Dusty7 said about it
starting in a single muscle - that means, like your situation , that even if i felt it in one muscle it would show up in other muscles as well -- I'm so sorry for being a pain asking so many questions -

thanks a lot, Toby

 

[Nikki J]

Yes. My symptoms were so trivial and it was so early that even I, knowing my ALS risk was close to 100 percent, would not have made a doctor's appointment
Try to forget about this and enjoy the weekend. On Monday you can have the EMG and then go over everything with the doctor

 

[lgelb]

In ALS, we expect the NCS to be normal. Signifies nothing either way, except ruling out some stuff I would have doubted you have.

The key point is that a dent and weird feeling is way behind the atrophy and inability to move a muscle, flat out, that characterizes ALS. BTW, if the doc really thought you had a systemic neuron disorder, as none of us does, he would have tested the L side. And he would have done more than 3 muscles.

You're in the wrong place. Given your hx, I would talk to your endo as well as the back surgeon.

 

[toby1969]

lgelb,
Thanks for responding - he did test my left side
And more muscles than the three I mentioned
The right bicep was the only one that showed being "off"
Numbers-
Thanks,
Toby

 

[GilWest]

Maybe this will help...If you do have ALS, there is no need to worry because there is nothing on planet Earth that could have been done to prevent it nor can be done to cure it. So worry will do no good. If it is not ALS, why are you worrying about ALS?

 

[Atsugi]

If Toby insists on worrying himself despite our reassurances, then all his fears are self-inflicted. I don't think we can help him any further.

 

[lgelb]

OK, Toby -- let's try it this way and then all leave off -- if you only had one abnormal muscle on EMG, and that is the only muscle that anything seems off, that only strengthens the conviction that you don't have ALS. ALS kills most all the motor neurons, not just the ones in one muscle. You seem to have an as yet minor problem w/ one muscle on one side. Every PALS here would happily trade you. Begone.

 

[Nikki J]

I think we are being a little harsh here. As everyone has said the isolated muscle findings point away from ALS but I understand why he is scared. We are always telling people that their EMGs don't have fibs and psws so don't worry. He had them. I am pretty sure it is going to turn out ok but apparently the neuro was concerned enough to schedule a lower extremity EMG. I Think the neuro is just being cautious and I hope Toby can chill for the weekend but I do get why he is worried. I hope he will report back when he gets his diagnosis

 

[lgelb]

ALS is not the only dz that causes abnormal discharges on EMG, so I have never said not to worry for that reason. Splitting the EMG makes very little sense to me anyway. But we also suggested that Toby follow up about two possible etiologies, his endocrine issue and recent spine surg, which I hope he does.