Pre "clinical weakness" symptoms

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Bestfriends14

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Perhaps you should talk to a professional in the interim between now and your appointment. You're not evidencing anything as horrible and devastating as ALS, so I'm not sure what the folks here can do for you. We have enough issues going on, hence, the suggestion of speaking to a counselor.

I'm sorry you are feeling anxious, but only you can decide how to spend your days between now and then; no one here can do that for you.

Take good care
 

affected

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losing weight can account for a change in how the bike shorts fit, as can having lost condition by not exercising. Don't fall down the rabbit hole of deciding that a change in body size or shape is evidence of atrophy that was caused by a brain disease. the amount of things that can cause a change like that are just huge.
I hope you get an appointment soon as you might drive yourself quite spare. It is highly unlikely that if the doctors truly feel you have a terminal disease they would keep pushing appointments back by months, so maybe take this as good news too?
 

konus3791

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Got my EMG moved up to tomorrow. admit i'm very nervous, but in the end it will be helpful to know one way or another. thank you to those who gave me advice on what to ask. if there is any last minute advice or suggestions would be happy to have them for tomorrow so i'm well prepared and i'm not second guessing everything when i leave.

also, will they give me the results then and there, or will they wait for some report. the neuro is doing the EMG himself. just don't want to be stewing on what ifs if he says i'll get back to you with results and that's normal.
 

Nikki J

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Whether you get results right away depends on the doctor and the institution. If it is your own neuro there is a good chance they will tell you. Good luck. Let us know. ( and remember that ALS is a specific pattern and there can be lots pf things seen on emg that are benign and others that indicate a problem that isn’t ALS)
 

konus3791

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thank you....also had an xray that found:

-"Multilevel spondylosis. Straightening of the normal cervical lordosis".
-"straightening of the normal cervical lordosis. No acute fracture or malalignment is noted. There is multilevel disc space narrowing and osteophytosis from C4 through C7. There is C5-C6 uncovertebral arthropathy. Vertebral body heights are preserved. The prevertebral soft tissues are within normal limits."

wondering if this could be contributing to perceived leg weakness and fasciculations and if i should bring this up with neuro or if EMG will detect it as a problem (if it even is).
 

lgelb

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Yes, it could. The EMG, though, shows if there is damage to the motor neurons themselves, or other kinds of problems. It won't be confused or diagnose ALS from spinal damage.

Of course, the neuro should discuss these X-ray findings, and you should bring them up if not. S/he may recommend PT, for example.
 

konus3791

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well, wanted to close the loop. Had my EMG Thursday and the headline is the neuro said everything was "100% fine". he started with the nerve conduction and then moved to EMG and tested five muscles; left and right calves, left and right quadriceps, and left shoulder. I am relieved to have been given the opportunity to have this test, and i'm going to try to move on from this concern. I know that's been difficult for others in the past, and i think i'ts mainly because the same symptoms persist even after the test. but i truly hope i won't have a relapse to being concerned about ALS.

To that end, i do have a couple of questions for folks here. Main reason i'm asking is because my neuro didn't have the best bedside manner :) and didn't seem to really be open to questions. My guess is he just saw the EMG results and felt like, "you're fine, get out". If anyone has any feedback would love to hear it:

1) Felt like he was pretty sure he wasn't going to find anything, so the test was only about 20 minutes. I will say he definitely checked the areas i was concerned about (legs) and even checked the left shoulder as a bonus. Should i be concerned at all that the test was done too quickly and a little more "effort" might have found a problem? I assume reading the results of an EMG is binary (you either see a problem or you don't; you either see healthy nerves or you don't). But in the back of my mind i was expecting it to be a little more in depth.

2) i assume not all neurologist are equal. This was a general neurologist, not an ALS/MND specialist. But i'm sure he's done hundreds of these EMGs in the past and would at minimum be able to pick up an area of concern if he saw it. My assumption is i don't need an ALS specialist to have done this exam to know what they are looking for; a general neuro is sufficient?

3) what things are they looking for between the NCS portion and the EMG portion? what's the difference? are they both looking for motor neuron issues, or the NCS just to stimulate the nerve and get them ready for the EMG? i wanted to ask him that question, but like i said, he didn't seem real open to taking questions.

4) i still have no clinical muscle weakness, even though my legs are very much subjectively weak and fatigued. i plan to follow up with my GP on this now that the neuro cleared me. But no shot in my situation that the test was done to early? like i said, i have fasciculations nearly 24/7 in my left calf, and fairly persistent in my right calf and thigh. so if those are ALS related, i'm guessing no matter where he stuck the needle, even a quick EMG like i had would have picked up ALS if that was the driver. My thought is it would be completely obvious at this point, but again, i have no real clinical weakness.

i also want to thank everyone who took the time to respond. I know everyone here is likely being pulled in a lot of different directions. The fact that you take the time to answer questions in this forum and help people work through their stress over concerning symptoms we are having is much appreciated.

Would appreciate anyone's input to my questions. but feel free to then close the thread as i'm going to try to move on to other potential causes of my symptoms. just wanted to close the loop and give the results of my emg, and get a final take from this forum to see if any of my thoughts above should be of concern.

Thank you all!
 
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lgelb

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1) Yes, you see a problem or not. He tested multiple regions. No one can test all the voluntary muscles -- there are more than 600.
2) US neurologists who do EMGs are ideally certified by the American Board of Electrodiagnostic Medicine. You can check here whether this one is.
3)Abnormalities in the NCS portion point to conditions other than ALS. Certain EMG abnormalities point to ALS. A normal test is cause for rejoicing and moving on.
4)Certainly, lack of clinical weakness argues against ALS. So does a normal EMG. It wasn't done too early -- ALS damages motor neurons and can be seen even in areas that seem fine, on an EMG.

Block this site. Live the life that others can't. Closing the thread so you can close the book.
 
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