Question about EMG

Status
Not open for further replies.

Gorbos

Member
Joined
Oct 26, 2018
Messages
18
Reason
Other
Diagnosis
00/0000
Country
IT
State
IT
City
Milan
I would like to ask one thing about EMG. I had my EMG (clean) but still I have some concerns, since i've been reading scientific studies on the Internet which made me a little worried. (Symptoms lasting from september)

I don't understand how a little group of muscles can be in fact useful for saying "there is/there is not" als. In fact, muscles tested in my EMG were 6 in the four limbs (also, I did forget to tell the examiner about some other muscles I saw as "strange").
What if those muscles have not been involved by denervation process? Are 6 muscles enough in your opinion?

I have searched on the Internet and didn't find any satisfying answer to this! so if someone can give me a scientific explanation I would be very grateful.

Thanks.
 
Last edited:

lgelb

Forum Supporter
Moderator
Joined
Nov 5, 2009
Messages
8,140
Reason
Lost a loved one
Diagnosis
00/0000
Country
US
State
WA
City
Seattle
There is no set number of muscles to test, as the examiner is guided by what s/he sees. If s/he sees acute and chronic neurogenic changes in the most severely affected muscle(s), s/he keeps going into other regions. If not, it can be a shorter exam. Think of blood tests. No one tests (or could) everything at one go. The doctor is directed by a few initial tests.

If they thought you might have diabetes, there is basically one blood test that is most definitive for that.
If they thought you might have had a heart attack, there are a couple of tests (blood, EKG) that would say yes or no.

Etc.

If you had changes that could be multiple diseases, they would need to look more closely, but when there are no changes from good health, they do not.

So there is no need to worry that you forget to mention some of the skeletal muscles you have issues with. No examiner can test them all! There are hundreds.

Best,
Laurie
 
Last edited:

Gorbos

Member
Joined
Oct 26, 2018
Messages
18
Reason
Other
Diagnosis
00/0000
Country
IT
State
IT
City
Milan
Thank you for your explanation.
The point is: I mentioned some muscles in which I noticed changes since the neuro visit (which instead the EMG showed as 'ok' muscles) and I forgot to mention those muscles of the hand which made me initially go to the neurologist.

In fact, I forgot to mention the most important muscles, and this is why I was asking if just two muscles tested in a limb (plus other 4 in other limbs) are enough to say there is not als.

(Muscles which I forgot is left abductor pollicis brevis; muscle tested were left first dorsal interosseous and left deltoid)
 

Vincent

Senior member
Joined
Dec 30, 2013
Messages
972
Reason
PALS
Diagnosis
08/2014
Country
CA
State
ON
City
Barrie
You need to lose about 70% of the nerve going to a muscle before it fails. Based on this an EMG would show changes well before you would notice symptoms. And it doesn't go one nerve at a time. PALS have both active and chronic denervation going on all over the place at varying levels,( some nerves are fine, others are at or above 70% loss, still others are 10%, 20%....). So all in all you are free, no ALS.
Vincent
 

Gorbos

Member
Joined
Oct 26, 2018
Messages
18
Reason
Other
Diagnosis
00/0000
Country
IT
State
IT
City
Milan
Sorry but what does "all in all" mean?
Can I be sure that this clean emg - also if some of my most suspected muscles were not examined - is ok to say that I don't have ALS?
 

KarenNWendyn

Forum Supporter
Moderator
Joined
Jul 29, 2017
Messages
3,388
Reason
PALS
Diagnosis
07/2017
Country
US
State
OR
City
Southern Oregon
Gorbos, you have been asking the same question over and over and have been answered here by multiple knowledgeable people.

Here is your previous thread, which I think should be merged with the current one (as previous one was still open), and this will show you and others how many times we’ve answered your question.

https://www.alsforums.com/forum/do-i-have-als-als/43479-emg-doubt.html

So yes, you are cleared of ALS once and for all. Take care and good bye.
 

Bestfriends14

Forum Supporter
Senior member
Joined
May 7, 2017
Messages
808
Reason
CALS
Diagnosis
05/2017
Country
CA
State
AB
City
CALGARY
Gorbos, why are you here if you have been told countless times it is not ALS? Get a grip and move on; stop pestering terminally ill people. At this point, it's messed up to keep asking the same question again and again. It's most likely time to seek therapy since you seem intent on bothering people with a terminal illness. It's mean and it's enough, so stop.
 

Gorbos

Member
Joined
Oct 26, 2018
Messages
18
Reason
Other
Diagnosis
00/0000
Country
IT
State
IT
City
Milan
I would never do something like that!!!
I was just asking if this EMG in the opinion of people of this forum has been done properly, because I had so many doubts. That's all!!

I'm sorry if my questions were so much bothering, I didn't want to bother anyone. Really.
just excuse me, really. I'll stop asking questions.
 
Last edited:

Gorbos

Member
Joined
Oct 26, 2018
Messages
18
Reason
Other
Diagnosis
00/0000
Country
IT
State
IT
City
Milan
I'm back: something's wrong

Hello everyone.
After some people in the forum reassured me about my irrational concerns, now I'm back because something changed.
Almost two months have passed since my 4 limbs EMG, which came out negative.
I have noticed that a dent in my left first dorsal interosseous muscle (which was there also before the EMG) has become much deeper and larger than before.
Also, trying to test my first dorsal interosseous on the left by myself, it's actually less strong than the one on the right.
(And I write with my left hand.)
Now. Last time I wrote, some people told me not to be worried because clean EMG means no ALS.
So, suppose that this is not ALS because my EMG was clean, how would you explain this difference in aspect (deeper dent over time) and strength of first dorsal interosseous?
How should I interpret this thing?
 

affected

Guru status reached
Joined
Apr 26, 2013
Messages
12,228
Reason
Lost a loved one
Diagnosis
05/2013
Country
OZ
State
AU
City
lala land
Re: I'm back: something's wrong

You must go and see a doctor - this is not a general health forum, nor an anxiety forum.

Get to a doctor, get examined and ask your questions. You cannot test yourself.

Dents are NOT ALS. But whatever is going on can only be figured out by hands on medical attention, not internet Q&A.

Please also go back and read the READ BEFORE POSTING section once again, read it slowly and remember we wrote this, we stand by what it says.

All the best.
 

Gorbos

Member
Joined
Oct 26, 2018
Messages
18
Reason
Other
Diagnosis
00/0000
Country
IT
State
IT
City
Milan
Re: I'm back: something's wrong

All I wanted to ask is this: could it still be possible that the EMG came out negative with ALS? it looks so strange that all these signs are exactly in the limb where I feel numbness.
It seems like everyone around me is trying to reassure me but I sense there is something wrong. I am extremely worried, and my general pratictioner will "throw" me out of his office without any hesitation after the EMG done. That's why I'm asking for some information
 

Nikki J

Moderator
Joined
Mar 22, 2012
Messages
8,423
Reason
PALS
Diagnosis
04/2014
Country
US
State
MA
City
Boston
Re: I'm back: something's wrong

As you were advised by Affected see a doctor. Really. There may be something wrong. We don’t know and can’t see you. There are many things it could be and the only way to find out is hands on medical care.

When you do to the doctor the correct approach is to say I have these symptoms, what is causing them. To focus on a disease especially one recently ruled out by asking is this ALS may well cause your doctor to dismiss your concerns.

What is wrong with me should always be the approach
 

Gorbos

Member
Joined
Oct 26, 2018
Messages
18
Reason
Other
Diagnosis
00/0000
Country
IT
State
IT
City
Milan
Re: I'm back: something's wrong

Thank you for your answer, Nikki.
With a clean EMG can I really say that ALS has been ruled out, in your opinion? Or maybe there's still a chance that it could actually be ALS?
This is what is concerning me and I am really worried. I sense there is something very wrong with me and I am very concerned
 

ShiftKicker

Moderator
Joined
Mar 16, 2015
Messages
2,826
Reason
DX UMND/PLS
Diagnosis
06/2015
Country
CA
State
BC
City
Vancouver
Re: I'm back: something's wrong

Please, ask your doctors what the trouble is. Each person who has replied to you has reaffirmed a clean emg rules out ALS and you keep asking anyhow.
 

Gorbos

Member
Joined
Oct 26, 2018
Messages
18
Reason
Other
Diagnosis
00/0000
Country
IT
State
IT
City
Milan
Re: I'm back: something's wrong

No, I don't mean to keep asking. I am fine if people confirm that a clean emg rules it out, it's just that looking around in the forum and on the internet I saw many cases of people with clean emg and after some months a second emg showed abnormalities. That's why I was asking. There are so many confusing information on the Internet...
At rest, the muscle is fine. When I contract it, there is this dent which seems to be deeper than how it was in the past months.
 
Status
Not open for further replies.
Top