Please help me figure out if this could be als

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Vivz

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Hi everyone,
I would like to ask your opinion on my emg results and symptoms. I started about one year ago with widespread twitching. Then about 6 months later I started having hypernasality and my soft palate deviates to the left when I say ahhh. Then I noticed that I cant smile as well on the right side. Long story short, I had a few emgs during the year, they all came back normal except fasciculation potentials picked up during surface emg only. However, the last emg tested my facial nerves and it shows chronical denervation in 2 muscles. See report attached. Could this be the beginning of als? I already have brain scans and bloodwork, all normal.
Clinically I have trouble with my speech, twitching, hiccups, nasality, cant smile nornally. I am 33 F.
 

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Nikki J

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What do your doctors say? We see that type of report fairly frequently in limb emgs and it never seems to come to anything. Where are you being seen ? Where was that emg done?
 

Vivz

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Hi, the doctor doesnt know what caused the nerve damage in my facial nerve. They want to wait and see and re test. I am based in UK.
 

Nikki J

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Yes but I was asking where? What hospital/ clinic? What kind of doctor?
 

Vivz

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Someone really senior from royal free hospital - neurophysiologist
 

Nikki J

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Then you are in good hands. Unfortunately you will really just have to wait and see As they said. Keep busy and try to enjoy every moment. Neurological limbo is hard but not that unusual
 

Vivz

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My emg is not normal
 

Nikki J

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Fiona was just linking your previous thread That was the title you gave it then Not commenting on this thread
 

Vivz

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Hello

is there a pattern on emg that suggests slow progression? I read chronic neurogenic changes without much active neurogenic changes could point towards that?
 

lgelb

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I moved your last post from a new thread. Please post only in this thread, as is our rules. As for EMGs, there is no point in getting into that, as you don't have a diagnosis and even if you did, you cannot derive progression from the EMG since everyone's EMGs are at a different point in their disease(s). A diagnosis of ALS requires evidence of both acute and chronic denervation.
 

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In short, no what you heard about EMG patterns is not the least bit correct. Your latest EMG might not be normal, it is not an EMG that indicates ALS. Truly it is time to celebrate and get back to your doctor and say, ok no ALS what do you think we should do next. Your doctor can work through all this with you.
 

Vivz

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I have progressing symptoms in my bulbar area. My soft palate doesnt lift properly so my speech is nasal and low tone. Then my smile got crooked and thats what the emg picked up. I dont think it is time to celebrate for me as I am struggling with speech / excess saliva/ weakness all over the region
 

ShiftKicker

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Vivs, it's not clear what the conclusion your neurologist has drawn from this report. Are there additional pages to your report? When will you be seeing your neuro next?

Please understand the folk here are not the folk who can help you get a diagnosis of anything- that is up to the specialists you see. They can only provide the most basic of guidance- which is what you have already received on your threads.
 

Vivz

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They will re test me in 2 months. No conclusion. They are clueless
 
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