weakness after EMG

[worried27]

Hello everyone
this is my first thread which was closed

My first thread

Hello everyone. First of all, thank you for your efforts to help other people I am a 27 year old man and I read in this forum for almost 5 months, it is the moment when my first symptom appeared, it is about the generalized fasciculations notament to my left eyelid (I was convinced before that '...

www.alsforums.com

A small update: the fasicuclations worsened these two weeks and I feel heaviness in my feet when I walk and unfortunately cannot maintain going to the neurologist because of what is going on in the world.

I read in the pinned thread, that the EMG detects the changes before the weakness is evident
and I have read elsewhere that the fibrillations are not found enough at the beginning, (just the chronic changes) and I want to confirm this.

I also read that many people feel perceived weakness before clinical weakness sets in over time. I wanted to know is that among you, who in this evolution scheme (EMG change then weakness).

I think I can no longer control my anxiety even with the anxiolytic and the anti depressant.

 

[affected]

You were asked to come back after 3 months and tell us how you went with your doctors. You don't have any progression beyond feeling things and reading lots online. You can read all you want elsewhere, but you know already that the below link is our official position and we won't sit and argue back and forth with what you choose to read online.

Please get help from doctors, televisits are probably available to you. Read the below link again - it answers all your questions. We have not found perceived weakness happens with ALS, and you have read us saying this over and over. Again we aren't here to argue these points, we wrote the pinned post linked below so our paralysed members, breathing with machines won't have to do that to reassure people with no ALS symptoms. Please go get help we are not anxiety managers, I'm sorry you are suffering.

Important - READ BEFORE POSTING! Answers to common concerns about possible symptoms

We will try to answer reasonable questions. We are not here to argue with you. If you announce that you ”know” you have ALS when the doctors say otherwise, or you have not bothered to see a doctor, your thread will be closed. It is not our place to try to convince you you are wrong. Neither...

www.alsforums.com

 

[KarenNWendyn]

Feeling heaviness and feeling weakness is not part of ALS. In ALS, muscles don’t work. There’s no feeling of weakness associated with that.

An EMG detects changes in a muscle before the muscle loses function because a muscle has to lose about 70% of its innervation (nerve connections) before clinical weakness is detectable in that muscle. The EMG can show the denervation at an early stage.

 

[worried27]

thank you for your reply
I have read this thread several times, and I know that for some people it is very difficult to write a small paragraph, I am sorry if I disturb you
but I don't know what to do I'm really upset, I just give you advice and answers to clarify things
sorry, one more time

 

[affected]

The thing to do is go back to your doctors, that is the only possible advice.

 

[worried27]

Thanks Karen
I wanted to answer but I couldn't for 3 days
what I understand from your reply that it is common to find changes in EMG before clinical weakness sets in
then I am strongly concerned because my EMG showed chronic changes (what I understand from the conclusion)
then it is a matter of time that the weakness will be clear ...

 

[KarenNWendyn]

Umm... that’s not exactly what I was saying. Best to discuss with your doctor.

 

[lgelb]

It is NOT true that "many people feel perceived weakness before clinical weakness."

As Karen said, weakness isn't something you feel. It is being unable to do things that you used to.

Imagine you stayed up all night. Would you feel weak? Tired? Not quite able to do everything you wanted?

That is NOT what ALS feels like.

ALS causes muscles to not work any more. They don't feel different. They just don't work.

Did you consult Dr. Imounan as I suggested?

 

[worried27]

Ok thank you.
Unfortunately there is not a neuromuscular specialist, I think that the only choice available at the moment is to wait and see even it's very expensive in terms of mental health, but it is the only solution because it's difficult to take a appointment even if at a general neurologist or a specialist in another disease at the moment and I don't know which doctor I must believe
thank you for your time spent answering the questions.

_____________________________________
Thanks Igelb
no I could not make an appointment with another neurologist or with the doctor that you recommended me, I wanted to wait some time before taking a 3rd opinion, but unfortunately the current circumstances prevent me from making what I planned to do

sorry i can't write new comment for 3 days

 

[worried27]

Good evening All
if you allow I want to ask a quick question about denervation, does active denervation happen before chronic denervation or vice versa
I saw a few stories of people who had their first EMG with poor concussion at the start (I don't know the details) and who did not have clinical weakness at the start
I feel the same with these cases,

thank's in advance and sorry for my english

 

[KarenNWendyn]

Active denervation means denervation happening presently. After it’s been there a while, it’s chronic.

Is there anything you can’t do now that you could do a year ago? If not, don’t worry about ALS.

If you’re still worried, see a doctor. No point in speculating or posting further until then.

 

[worried27]

thanks Karen
I have generalized chronic changes and intense fatigue and a feeling of blocked food in the throat, but for the moment there is no clinical weakness
my 1st doctor who is a general neurologist told me before recovering the results that everything was fine, but I discovered the opposite in the file
the 2nd neuro who is also a general neurologist told me that as long as there is no clinical weakness it is benign despite the dirty EMG
I joined a BFS group but all members who had EMGs, have claen EMGs
i don't really know what i should do
, I feel like I'm following a false hope
sorry for the inconvenience

 

[lgelb]

If you have an EMG to post, with identifiers blacked out, by all means post it. We will be much better able to comment.

 

[worried27]

unfortunately I do not have a detailed EMG report as you often see here, there is just the comment and conclusion part there are tables but in the nerve conduction part which returned to normal but the EMG part
absence of spontaneous activity in the muscles tested and for maximum contraction
neurogenic traces on the bulbar stage and intermediate traces in the four members
conclusion: EMG signs which may be compatible with involvement of the anterior horn
that's all that writes there
I didn't want to come back to the 1st neuro, because I think he lied to me, he told me that everything is normal and that I have to repeat the EMG in 3 months, the 2nd neuro gave me a little peace of mind but I think he doesn't take me seriously, because EMG results like mine should alarm any doctor
I try to accept the diagnosis of a motor neuron disorder but I do not arrive for the moment I feel weak day after day and I have aches with the least effort and I do not know if I have a real clinical weakness or not, because my last clinical examination was 6 months ago and I doubt that it was detailed and complete I saw several stories from people like me who had fasciculations and after a period of a year or more have progressed to clinical weakness

sorry if i was longer but i don't have another place to express myself i don't know what i want by writing this but i do it while waiting for the verdict

 

[KarenNWendyn]

It does not sound to me that your EMG is diagnostic of a motor neuron disease, especially as it needs to be interpreted within the clinical context. And it is not clear that you have true weakness.

so there’s really not much more we on this forum can tell you. You will need to follow up with a neuromuscular specialist.

You can’t diagnose yourself by comparing your symptoms with others.