Worried about my Mom

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Rio20

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Hi,
Thanks for reading my post. I never heard about ALS until my mom has been suspected with a possible ALS. I still don't believe she has ALS. She is 62 years, She has some weakness on her right hand and right leg and twitching. She has seen a neurologist and took an EMG.
EMG conclusion is :
EMG was done in right quadriceps, left quadriceps, right tibialis anterior, first dorsal intereossei, tibialis anterior and right biceps.
Insertional activity was normal. Spontaneous activity in the form of fasciculations.Positive sharp waves and occasional fibirillations were noted in all the muscels tested.
MUAP were moderately high amplitude and showed increase in polyphasia with increase in recruitment ratio.
NCS & EMG study showed evidence of chronic denervation and renervation changes suggestive of anterior horn cell involvement.

Can this be ALS? I know ALS symptoms can mimic other conditions too.She has no progressive symptoms, she is able to do all her daily activities except little stiffness on the right arm and right leg. She is out of the country and coming to US next month to have a second opinion. I cant sleep thinking about her... she is my everything...
 

Nikki J

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It could be. There are other tests to be done if she only had an emg. Where is she getting the second opinion? It definitely should be with an ALS specialist. Make sure she brings copies of all her records and discs of any mris or other imaging
 

Rio20

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Thank you Nikki for responding. But i don't want to believe it could be ALS.
She had blood tests and MRI's and it came out normal. What are the other tests?
Yes, trying to schedule an appointment with an ALS specialist. She is going to be new patient(from another country) so i have to start from the scratch. Meet with Primary, then referral and then specialist.
 

Nikki J

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There are blood tests for so many things. She may not have had them all. She should not have to see a pcp. The major medical centers certainly see international patients in their specialty clinics. Where will she be geographically and are you willing to travel from there?
 

Rio20

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We are currently located in Albany, NY. Do you have any suggestions on the medical centers? Blood test she has taken was general blood test. Then MRI - spine and MRI- Brain. These are the 3 things she has taken along with EMg. Let me know if you want me to post the eMG tables. I have pdf copies with me. Thanks again for your help.
 

Nikki J

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Yes posting the emg would be helpful. Remember to block her name / identifying data first

I would consider the ALS clinics at Columbia, Hopkins, or Mass General or Dr Heiman Patterson at Temple
 

Rio20

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Thanks for the ALS clinic list.
Here is the EMG copy. Is this too bad?
Screen Shot 2021-04-09 at 3.18.12 PM.png
 

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Nikki J

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That is not the emg. Is that all you have?
 

Rio20

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That is not?? This is all i have got for EMG. And a conclusion report which i have posted the content in my first thread. I will attach that too here. Nothing against the doctor, but I am not really convinced with the entire diagnosis process in my country of origin.
 

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Nikki J

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It is the nerve conduction test. Usually for the emg as well as a summary we get a table. The muscles are listed vertically and the various categories are horizontal
 

Rio20

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I think this is what she got from the hospital. but I will check with my mom again. How is her nerve conduction result?
Nikki... I appreciate your time.
 

Nikki J

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I don’t know how to evaluate the numbers without looking them up but ncs is not an ALS test. It is usually normal in ALS
 

Rio20

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I just checked with my mom and she said, there is no EMG table in her report only ncs. Not sure how they come up with this interpretation without providing proper EMG results.
 
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