post EMG. What's next

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Jdawg

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Howdy Gang. First - thank you for all the Support and information you give worried and anxious people like myself. I’ll start from the beginning:

44yo male. In mid-January after staying up most of the night Finishing a illustration job, I awoke to the Shoulder on my Dominant side buzzing. There was no visible shaking and my wife Couldn’t see nor feel anything. I described it like a tuning fork or a buzzing cell phone inside me. Over the following days, a numbness and pins/needles developed down the same arm into my hand (mostly top of hand/outside fingers and outside forearm). There's a general 'tiredness' in the shoulder through arm but nothing debilitating. Honestly, I wasn’t too worried and figured it was a pulled muscle or carpal tunnel so I scheduled a visit with my general practitioner. Blood work looked OK though I was borderline low in a few vitamins including B12 deficient and will start shots for that next week. She scheduled a neuro specialist for me.

Over the coming weeks (and what really has me anxious) is the same buzz that first appeared in my shoulder is Now Across the back of my shoulders, through my trapezius and into my other shoulder. No visible tremors but the persistent vibration makes it hard to sleep at night and my anxiety is sky high. During the day, I barely feel it but at night, the 'buzz' seem pressure sensitive as I feel it more when I lay on my backs and sides.

Fast forward to today - EMG and nerve study with a well-respected neuro doctor who runs two ALS Clinics. I described my symptoms and after the nerve and muscle tests in the shoulder, arm/hand and neck (plus a quick strength test), he said they look good and I didn’t have ALS but he couldn’t tell me what Was going on. He didn’t detect any pinched nerve either though which I was HOPING he would since that would help diagnose me. He said to start my B12 shots and wait and see. I don't have a copy of the EMG yet but hope that comes in the next few days.

I’m, of Course, relieved my nerve and muscle tests seem clear but it still doesn’t give me any answers for the last 2 months of buzzing and jitters.

Are most ALS tremors external and visible or can some be internal? But then, shouldn't the doctor picked up on those w/ the EMG?
Should signs of weakness (dropping things, foot drop,etc) come before the any tremors?
Is this just me being overly anxious (because I definitely am)!

I've read multiple times about clean EMGs in the beginning but after later physical changes, ALS is finally diagnosed. At this point, should I just wait and see if there's any strength issues or other physical changes (atrophy?) over the coming months?

Thank you again for your time.
 
People with ALS don't really get tremors unless it's hard to hold their arms up. The EMG cleared you of ALS.

I would take ALS off the table. There are hundreds of other possibilities that are treatable. Work with your doctors. If you are B-12 deficient, you'll feel much better after you get that corrected.

Please work with your primary care doctor to get feeling better.
 
Thank you for taking the time to reply. Yes - I was told at the appointment that the EMG looked good so at this point, I'll see how the coming months play out while getting my shots.

thank you again.
 
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