Questions about the process...

[Leffty99]

Hello everyone, I am a new member and supporter of this very insightful and helpful forum.

Thank you to all of the moderators, caregivers and Loved Ones that take the time to educate us about MND. I have read the suggested “Answers to Common Concerns” and “Getting a Diagnosis” prior to making this post. I have also taken the time to read many of the recent posts and replies within the “Could this be ALS” segment of the forum.

Like many other people that have posted within this particular segment, I too have been chasing down a diagnosis for a set of symptoms that seem to be progressing over the past 9 -12 months. I am a 59 year old Caucasian male.

My original Chief Complaint to my PCP was a distrust of the function and support of my right leg in the sense that it not functioning well under normal daily tasks. The physical exam, blood work and diagnostic images that were made came back negative. I was referred to a neurologist when I returned to my PCP with an update of continued concern about the functionality of my right leg with localized fatigue, stiffness and fasciculations in the right leg. Two months after my initial meeting with my PCP, I met with a Neurologist who performed a thorough exam and EMG. The neurologist told me “at this time I do not see concern for MND/ALS.

Today, 6 months after my EMG, my symptoms/issues are progressing. With the general knowledge the MND can be difficult to diagnose and take up to year or so to diagnose, I have few questions that hopefully this forum can answer to help any of us that have continued symptoms progressing beyond the EMG test.

• Once a person, has an early clean EMG is it unlikely that a second or third EMG will be different?
• Are EMGs diagnostic in the early symptomatic phase of MND? Before weakness and atrophy are present?
• With the understanding that MND/ALS itself is painless, can muscles affected by the MND be painful under load and function or do the muscles just fail in their ability to work correctly without pain?
• Are there any sensory concerns that are secondary to the disease process itself that should be expressed to the overseeing physician?

Thank you for addressing these questions.

L

 

[KarenNWendyn]

1) If the EMG was done on a symptomatic area and was clean, then it was not done too early, and subsequent EMGs are unlikely to be helpful.

2) Yes, if there are symptoms, they can suggest the diagnosis. Clinical correlation is always important as well as ruling out ALS mimics.

3) It’s painless when the muscle fails, even lower extremity muscles.

4) Sensory concerns should always be discussed with the physician since his/her job is to try to find out what’s wrong with you, not just to possibly diagnose ALS.

 

[lgelb]

Since generalized neuromuscular disease has been ruled out, I would ask your PCP about a PT evaluation.