- Joined
- Sep 17, 2022
- Messages
- 4
- Reason
- Learn about ALS
- Diagnosis
- 00/0000
- Country
- US
- State
- CA
Hello,
Many thanks to the CALS/PALS who provide insight in this forum. I can only imagine the hardships you endure and my thoughts are with you all.
I am a 40 year old male, firefighter, married with 2 young children. I have had back problems for years and recently got an MRI indicating some disc dessecation in L4/L5 and L5/S1. Mild concentric disc bulge with posterior annular fissure affecting left L5 nerve root. At L5/S1, I have symmetrical disc bulge with right paracentral protrusion with mild right foraminal recess stenosis.
I am here, concerned about ALS due to twitching I noticed in both calves while sitting at work. This began almost 2 months ago. Didn't think much at first, but they picked up and would appear pretty much everywhere including forearms, shoulders, back, and stomach. Shortly after, my right calve began to ache (like the feeling after a cramp). It was intermittent at first, then became a 24/7 thing despite stretching and massaging. Same has now occurred in the left calf. I have read the sticky (many times!!). I do NOT have clinical weakness. I do NOT notice that anything has become noticeably more difficult. I do have some burning in both feet which I now understand points away from ALS. Routine blood work and electrolytes are normal. I do have Reynauds so maybe an ANA might be in order?
I had an NCS and EMG done today and I have attached the results. This was done at kaiser based on my recent back injury (work related). The NCS was totally normal so he decided he wanted to do the EMG and unsolicited he mentioned ALS. This of course freaked me out, but I tried to stay calm. However, I could tell he was finding some things during the EMG. After doing the legs he wanted to test my right arm too. He was making me a little nervous so I asked him what he was seeing. He told me he saw my fasiculations and noted some fibrillations. He said "I was only checking things based on your back injury, but I do not think you have ALS RIGHT NOW. If you develop foot drop or wrist drop we can do another EMG." He was rushed and didn't have time to discuss further. His interpretation is as follows
Impression:
This is an abnormal study with electrophysiological evidence for a right L4-5 radiculopathy. There is no evidence for peripheral Neuropathy or myopathy. Multiple fasciculations seen on this EMG exam are likely benign at this time , but in case of any future focal weakness please consider repeating the EMG test to rule out a motor neuron process.
My question: I have 2+ fibs, few fasc's, and 1+ PSW on both my R tibialis anterior and R gastrocnemius. This is a bit alarming to me. He did not use the words denervation at all. Should I be concerned about this EMG? Does this look "dirty" to you based on your knowledge and experience? Regardless of weakness, should I repeat this in 3-6 months anyway?
I apologize for the length, I was really hoping for a clean EMG.
Many thanks to the CALS/PALS who provide insight in this forum. I can only imagine the hardships you endure and my thoughts are with you all.
I am a 40 year old male, firefighter, married with 2 young children. I have had back problems for years and recently got an MRI indicating some disc dessecation in L4/L5 and L5/S1. Mild concentric disc bulge with posterior annular fissure affecting left L5 nerve root. At L5/S1, I have symmetrical disc bulge with right paracentral protrusion with mild right foraminal recess stenosis.
I am here, concerned about ALS due to twitching I noticed in both calves while sitting at work. This began almost 2 months ago. Didn't think much at first, but they picked up and would appear pretty much everywhere including forearms, shoulders, back, and stomach. Shortly after, my right calve began to ache (like the feeling after a cramp). It was intermittent at first, then became a 24/7 thing despite stretching and massaging. Same has now occurred in the left calf. I have read the sticky (many times!!). I do NOT have clinical weakness. I do NOT notice that anything has become noticeably more difficult. I do have some burning in both feet which I now understand points away from ALS. Routine blood work and electrolytes are normal. I do have Reynauds so maybe an ANA might be in order?
I had an NCS and EMG done today and I have attached the results. This was done at kaiser based on my recent back injury (work related). The NCS was totally normal so he decided he wanted to do the EMG and unsolicited he mentioned ALS. This of course freaked me out, but I tried to stay calm. However, I could tell he was finding some things during the EMG. After doing the legs he wanted to test my right arm too. He was making me a little nervous so I asked him what he was seeing. He told me he saw my fasiculations and noted some fibrillations. He said "I was only checking things based on your back injury, but I do not think you have ALS RIGHT NOW. If you develop foot drop or wrist drop we can do another EMG." He was rushed and didn't have time to discuss further. His interpretation is as follows
Impression:
This is an abnormal study with electrophysiological evidence for a right L4-5 radiculopathy. There is no evidence for peripheral Neuropathy or myopathy. Multiple fasciculations seen on this EMG exam are likely benign at this time , but in case of any future focal weakness please consider repeating the EMG test to rule out a motor neuron process.
My question: I have 2+ fibs, few fasc's, and 1+ PSW on both my R tibialis anterior and R gastrocnemius. This is a bit alarming to me. He did not use the words denervation at all. Should I be concerned about this EMG? Does this look "dirty" to you based on your knowledge and experience? Regardless of weakness, should I repeat this in 3-6 months anyway?
I apologize for the length, I was really hoping for a clean EMG.