Second EMG Appointment

Andrewsj

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I had posted here in April after I had been twitching for a couple months. I had got a clean EMG of my entire left side of my body.

Over the last 3 months my twitching has mostly gone away but i have gotten some strange mouth related symptoms

1) I feel like my tongue has Atrophy now (Although on the first clinical in April the doctor noted no atrophy)
2) It is becoming increasing harder to hold conversation. I find my self slipping up words and hard to articulate. Almost like i get tongue tied No actual slurring of my words and no choking.
3) I feel like when I speak a lot I get emotional quickly and almost on the verge of tears.
4) I have tightness in my throat and face
5) I have been drooling and yawning a lot more lately.

I saw neurologist about a week ago and have a second EMG scheduled for tomorrow (she did give me a clincal, but did not look at my mouth or neck). She knows about my first one and is only going to do my right side (arm and legs)

I have a couple questions.
1. I don't understand why a neuro would give me a right sided EMG when I told her that all my concerns were in my mouth region? Does anyone know why? I am going to ask tomorrow if they will do my tongue or chin as well.
2) I read that some people with ALS involuntary cry or laugh. I feel very emotional when I talk but haven't started uncontrollably crying yet. I can still stop myself. I was wondering if this is normal with someone PBA.


Sorry to post again.
Thank you for your time.
 

affected

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1. Your neurologist went through years and years and years of training and experience, so she likely has a pretty fair idea where to test on your body. It is often not where a non medical person expects. How about asking your doctor for more information?

2. nope people with PBA don't match what you describe at all

Get help from your doctors and let us know once you have results.
 

Andrewsj

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Got my Second EMG on my right side this time. All clean. The tech said he didn't see any reason to do my tongue because i wasn't slurring my words and my whole right side was clean and my left side was as well in April. He said if I had ALS it would have most likely progressed a lot in 3 months. He says he does EMGS every day and only gets someone with ALS around once every 6 months or so. Got some follows up with the neuro to go over some other things. But with a full body EMG clean I am in the clear and can move on.

Thanks again. you guys really helped me out a lot
 

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That is fantastic news. Hold on to this and see your doctor if fears return.
 

Andrewsj

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Went to the neuro as a follow up today to go over the EMG . She told me it was clean. However I asked her to look at my tongue and she said it looked weird and deviates to the right. She also said it looks like their could be Atrophy (although she didn't seem sure). She sent a picture of my tongue to the lead Doctor there and he said it also looked strange. I am getting a MRI of my spine to rule out MS. She did say that it might be worth getting a second opinion at John Hopkins, although she said a repetitive nerve conduction and a EMG should have picked up ALS (although i never had one in my tongue region.). Freaked me a little. The think that confuses me is that I do feel like Its hard to speak and I mispronounce words sometimes but I am not slurring my words. Atrophy would normally come after correct?
 

Nikki J

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Atrophy is after weakness / dysfunction yes.

did your emg include the trapezius or the sternocleidomastoid? Both of those are considered at least as good as tongue for bulbar.

you should follow the advice of your doctor though so if they want a second opinion get it
 

Andrewsj

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I had my middle traps done in April (both right and left) and they were clean. however in April on my clinical my doctor put down that my tongue had no atrophy and protruded in midline. I will ask for it after i get this MRI. just for peace of mind.
 

Andrewsj

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Got my Second opinion, not at Hopkins, They did EMG under my Chin (pretty sure that's for bulbar) It was quiet and he said that was good and it only got loud when he told me to move my tongue. He said everything looked good on his end. I am in the clear now :) Interesting enough he asked me if I would be willing to get a Covid anti-body test. He says he has been seeing a bunch of new patients who have been coming in with almost the exact neurological symptoms I have who are long haulers with Covid. He said the more Journals are being published the more we are going to see this neurological side effect of Covid
 

Nikki J

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Under the chin is indeed one of the sites for bulbar. It is the examiner preference which site they use. One of the researchers I used to see preferred that one

the post covid issue is one we are seeing here and in other online groups as well. I hope you chose to get the test

best of luck
 

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Please do believe this time and don't allow yourself to go around a third time.
I would suggest you do investigate covid, the long covid is a serious issue and I hope if this is the case they can really help you recover well.
 
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