Unexpected EMG and foot drop

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odysseussssssss

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Learn about ALS
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Izmir
Thank you for your time. I am a 19 year old male, in 6 months i'll be 20. So about 3-4 months ive been suffering from drop foot in my right foot. I've decided to have EMG and doctor asked me if i experince twitches and if i am into sports or exercising (which i am not) and said results are unexpected so she suggested me to see a much more experienced doctor. The reason why i am concerned about ALS is that i've been experiencing some twitches, i have a drop foot and 'unexpected emg results'.
For twitching i can say that i am having those small twitches for a long time (3 or 4 years maybe?) and the moment i touch or move my twitching muscle it dissapears. I've been extremely anxious for the last hour so twitching is happening much more often, especially at a localized area that have been twitching for years.
The drop foot issue is concerning me even more. I realized i cant quite tighten the muscle in my calve but when i somehow can i can feel it is as tight as my left calve. I can't say i am experiencing weakness or having difficulty in walking, i can walk with my toes.
Now i am extremely anxious. What is your opinion?
 
That you need more information. Specifically the emg report. There are many causes of foot drop and many causes of abnormal emgs. The chances of ALS at your age are exceedingly low.
 
Who diagnosed you with drop foot? If you can go on your toes, I'm assuming you can walk on your heels, as well? Are you able to post your EMG results with identying information removed? Please include the summary/conclusion part. You do need more information and, as Nikki said, ALS at your age is extremely, extremely rare.
 
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I can't walk on my heels.
My family decided to show me the report. The conclusion part suggests to watch for motor neuron disease, says it should be tracked (i am sorry it is in turkish so i can't translate it well.) It also says i have neurogenic changes. No diagnosis but doctor definitetly wanted another opinion, and did not talked anything about the ALS itself. Could it really be ALS, near future or now? I am scared...
 
That is still very vague. Do you have a chart with columns? Does the report discuss denervation. If so what does it say? Does it mention spontaneous activity?
 
I would like to update. No spontaneous activity or denervation. But there is neurogenic changes in all of my muscles. Wasting seems to be symetrical, but in contrast my rigth foot wasted more severly than my left foot, which i think led to foot drop. My physical examination showed no signs of ALS, but doctor said that he can not comment on future results, what this condition might be and that worried me. My doctors are considering SMA type 3, since i have been experiencing fasuculations for nearly 5 years and i have relatively severe scoliosis and showing no other signs. And the weakness seems to be symetrical, especially in my arms. My dropped foot shows no pyramidal signs even though it wasted severly so i think that is a good sign, right? I am still worried if this is some sort of 'early onset' ALS. I would like to have your opinions on this, i value your opinions. This website has been a great help to me, just by reading. Thanks in advance.
 
From what you have said, there is no reason at all to consider ALS. I would make sure you get a spine MRI, because problems there can lead to the problems you describe.

Best,
Laurie
 
So i've had my second emg, a long and more comprehensive one. Things turned out to be unexpected and worrying. Nothing you want to hear as a 19 year old. It seems i have denervation in my right leg. MUP changes are present in all of my muscles as well. Emg shows asymetrical denervation and wasting which is concerning but whatever this is, it spread to my left leg as well. Strangely enough, there is no clear findings in my upper body, escapically no findings at face or intercostal muscles, triceps, et cetera. My doctor said it is a clinically probable ALS so there is probably more patterns observed that i do not know. Conclusion states clearly that patterns show probable anterior horn disease and it requires further examination. I know there is a long way before a diagnosis but it is quite scary at this point, i am about to lose hope. What other diseases are possible? What causes asymetrical denervation and severe wasting with MUP instability and drop foot which seems to has no reason to be observed (nothing showed up in my mri scans) other than the natural progression of the mnd, loss of function?
 
I am sorry this must be very hard Are there other possibilities for your symptoms? Without seeing the emg the answer is yes there are many things including some very rare that could cause them. Mup abnormalities can happen for many reasons and as for denervation you need more details.

is your doctor an ALS specialist? Can you get a second opinion?
 
I'm not a doctor so I have no first hand information on what it might be. But my friend's teenage son just started having foot drop, and the doctor determined it was because he was crossing his legs for hours every day while doing online school. The leg crossing was compressing the nerves and eventually led to foot drop. I may be totally off-base (so please disregard this if it sounds ridiculous), but could there be something like this that you are doing that might be causing issues?
 
Can you post the tables and report, with identifying information removed? We could be more helpful. Even in Turkish, it would shed more light.
 
yes i do cross my legs for hours, thanks to quarantine, for a year now. i am on computer all day because of my online classes. that was our initial thought on reason for drop foot but mri scans showed nothing. we had second opinions but all the doctors we've seen recomended the very specialist who is now reasearching on my condition. btw i would like to correct myself. my doctor said that it is suspicious als, not probable als (which indicates pure lmn syndrome according to studies i've found online.)

my latest emg report, with translations

e1db765e-3f41-4601-a037-829cc21849be.jpg


translation for conclusion: Findings consistent with l4-s1 radiculopathy were detected, bilateral prominent on the right. Because of the precense of fasiculation (observed in edc muscle as well) and the distribution pattern, monitoring (or tracking, watching etc.) for anterior horn diseases is suitable.
motor verileri: motor data
duyusal verileri: sensory data
süre: time
alan: area
mesafe: distance
(data is on metric system)


2f79897f-d168-44a9-9839-2b199f40cbcd.jpg


trasnlation for emg findings
seyrelme: wasting
hafif seyrelme: mild wasting
parsiyel denervasyon: partial denervation
submaksimal: submaximal
sağ: right
sol: left
 
Well this is much less dire than it sounded. If your translation is accurate monitoring for anterior horn disease is not the same as probable anterior horn disease. Your findings are confined to one area that it could well be a local issue. Not everything shows on mri.
 
It reads to me, like you asked "do I have ALS, I think I might" and so they wrote that they will continue to monitor.
As Nikki says, it does not read as though the doctor thinks you have ALS.
I do hope you can find the cause and treatment for the issues, it does sound more possible it is something treatable.
 
thank you for your hopeful comments, i hope it is a local issue that can be treated. i would like to ask one more thing. is polyradiculopathy and als related? as far as ive read online polyradiculopathy conditions mimic als and they are two different things. report states that i have polyradiculopathy and it is bilateral so i think these are indications that in fact what i am having is not mnd but something different, maybe? these are my speculations btw, not that ive had a second opinion, which i will.
 
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