I ve had my blood work done and everything is in the normal range except my cpk level was elevated.so umn is clinically diagnosed by reflex tests,nuero exam etc.i ve done some of those tests myself.my patella reflex seems brisk but im no dr.babinski tests neagtive performed by a friend,negative hoffman tested at home and negative rohmberg as well just brisk knee jerks...that what makes me think maybe the emg might have missed it due to umn instead of lmn. thx. guys.
Sporty, I gotta tell ya--you simply can NOT do reflexes on yourself. You wouldn't know brisk if it hit you in the head, hon. That's what a neurologist is for.
Your EMG showing no pathology in the lower legs where you're having symptoms, as several of us said--pretty much means ALS isn't the issue.
Carpal tunnel usually has associated symptoms--hand pain being a biggie. But not necessarily in mild stages.
UMN AND LMN both have clinical signs--spasticity, positive babinski, brisk reflexes, fasciculations, weakness, atrophy, loss of use
Your friend can't be doing the reflex tests, either. And honestly, if not done properly--you may seem to have no reflexes at all even.
Let me tell you a little story--I have UMN and LMN clinical signs as determined by a very good ALS specialist. Spasticity, fasciculations, major atrophy in my hands, CTS, and, here's the biggie: LOSS OF USE OF the affected part. I have hyper reflexes in my legs and absent or slight reflexes in my arms.
There is a difference between what we feel as being weak--and falling down the stairs because of foot drop. There's a difference between a hand feeling weak--and not being able to push a can of hair spray with good ole index finger. The symptoms are just too obvious to be ignored by that point.
I feel weak all the time--I fall all the time--and there is still a good possibility even with ALL these issues that say "ALS" that I don't have ALS. I fit a crap load of the symptoms and signs. But there are a TON of things that mimic ALS.
If you do in fact have brisk reflexes and increased tone in your legs--but still feel weak in them--that they might consider MS. If muscle weakness gets better, it could be something else. See where I'm going here?
CLEAN EMG in a limb that has the signs you have MEAN NO ALS. The EMG would have shown SOME abnormality in a limb that seems to have lost muscle and continually twitching.
Of course mistakes happen and ALS is misdiagnosed as other things--but what really points to ALS beyond all the signs and symptoms in the world is progressive weakness and atrophy.
Spend some time researching some of the treatable things: MS, MG, MMN, CIDP --and those are just a few.
Can I say for absolute certainty you don't have ALS? Unfortunately, no. But I can feel pretty confident saying it's very unlikely with a clean EMG.
If the doc had noticed brisk reflexes and you showed other clinical signs of LMN AND UMN, they'd have done an EMG in MANY regions. Not just the legs and arms. If it had been "iffy" they'd have told you to come back and be retested in 3-6 months most likely.
To ally your own fears--if we can't make you with our comments--please see an ALS neuro and put the question to rest once and for all. Honestly, I wouldn't trust an EMG not done by a neurologist who knows ALS when he/she sees it. But--you have a lot of symptoms that just don't sound like ALS.
Your 4 months of twitching all over even leads away from ALS. With that much twitching all over for that long--there would be some very obvious muscle loss (you wouldn't have any doubt, believe me....real muscle loss is very obvious)
Does that help? Or are you still convinced they were wrong?