Questions About EMG

[sammy]

I have read alot of these posts regarding diagnosis and EMGs. I have been one of those from Dr. to Dr. I have one Dr. who gave me a possible ALS diagnosis, the other
Drs are not sure what is wrong. I have bilateral frozen shoulders, general fatigue, some weakness in arms, my arms have become flabby, some twitching not as much as I have seen on some of the posts here. I have had several MRIs and bloodwork done.
The only issue that arose was low Vitamin D. I had 2 Emgs and am not sure if this would be a clean Emg or not.
The report states: Evidence of electrical instability in all examined muscles, Prolonged distal latency . conduction velocity is reduced. Fasiculations in right and left deltoids.

I know that you are not all Drs. but I was hoping that maybe someone could tell me if
this is in line with anything they have seen or know.
I really doubt the probability of ALS, I am not falling, I have lost some strength but can still do things, and I have not had any speech or breathing problems. My primary complaint was my shoulders and upper arms, My long time dr was the 1st one who mentioned muscle wasting in my arms and chest. Any input would be appreciated.
Thanks,

 

[sammy]

Sorry one thing I left out is the neuro said I have brisk reflexes and Hoffman's sign
bilaterally

 

[Erica]

It would be a question for Wright, who is a member here and able to interpret EMG's.
He is very kind; send him a private message asking for his help. Erica

 

[hopingforcure]

Did you see a neuro-muscular specialist? Your emg report could be evidence of a number of things. Myopathy maybe? what did the doc say? please write back..

 

[sammy]

I have been to 3 neuros, the 1st neuro after a year of seeing her mentioned possible ALS,
she saw muscle wasting. I went to another neuro not mentioning ALS at all, after he examined me and ordered more blood work, he also did an EMG and felt that ALS was a possiblility also. He sent me to a movement disorder specialist who did not seem to agree that it was ALS, he felt that wait and see might be best. I do have pain in my arms from the frozen shoulders, he said pain is not part of ALS. He did say my reflexes are brisk and that I have hoffman's reflex bilaterally, which was in agreement with the other 2 docs.
At this point I am very confused. I never imagined it would be like this, however I do doubt ALS because it has bee going on for a year, and although I am fatigued and have some more muscle loss, I don't have any breathing or speaking problems. There are some days that I feel a little better than others especially if I get some sleep.

 

[hopingforcure]

Who have you seen? I really like Dr. Simmons at Hershey Med Center ALS clinic. Did you go to U of PA? we have quite a few patients that go there. Did they mention any other differential diagnosed? I do not mean to scare you but many of have pain from MND. I think that is a real divided issue. Some do not have pain, some do..

 

[Zaphoon]

Hey Sammy!

You have some things in common with me. I have bilateral frozen shoulders and can identify with your pain. My shoulder muscles have atrophied and I am seeing if I can build them back up. Some of the doctors I've seen do not believe the PLS and frozen shoulders are connected. There is one, however, that believes there is a connection and that PLS is causetory.

The Babinski and Hoffman signs indicate upper motor neuron trouble. Muscle atrophy usually isn't seen until late in PLS and it is normally attributed to disuse (as it is with frozen shoulder syndrome).

I'm no doctor and even have trouble spelling biologee (my disclaimer). Hang in there! Sooner or later, a neurologist out there will figure things out for you with a better degree of certainty.

Zaphoon

 

[katmomma]

If you don't mind me asking, what exactly is frozen shoulder? I looked it up online but am still confused. What do your shoulders feel like? Does it come and go?

 

[Zaphoon]

Frozen shoulder syndrome has 3 stages: pain, freezing and thawing. If you ask me, stage one really never disapates during the whole thing. It can take a few years for the syndrome to go away but it can also relapse. Medical professionals don't know the how's and why's of it all. I have communicated with other PLSers that have it.

I have bilateral frozen shoulders which is sort of rare but then again, so is PLS.

The syndrome inhibits range of motion and causes weakness and atrophy in effected muscles. Mine was so bad, I couldn't lift anything over my head or even turn the car radio on. It took both hands to manipulate the gear shift lever on the steering column.

I have regained some lost motion and some strength but still have a long way to go. I kind of doubt that I'll ever get back to 100% (I think the PLS is inhibitting that goal).

 

[pammy621]

Zaphoon, thanks for the information, did you have fasiculations in your arms, I also have bilateral which I was told is rare. I went to a pain Dr. who gave me some minor excercises to do, such as walk my fingers up the wall the highest I can. He also told it could take up to 4 years for it to resolve. I do think that the frozen shoulder issue is not helping me get a diagnosis. I do appreciate everyone's input.

 

[Zaphoon]

I have fasciculations in my legs constantly. They are non-stop. I have occasional heavy-duty twitching/jerking in my arm and shoulder muscles.

You are probably correct when you say that the frozen shoulder business is hampering a diagnosis. It kind of muddies the mix. My personal opinion is that I probably have shoulder onset PLS vice leg onset and if this is so, I've had PLS for about 4 or 5 years. It is my opinion that PLS is the cause for my shoulder issues.

At any rate, I'm right at the mean age of onset for both PLS and Frozen Shoulder Syndrome.

Zaphoon

 

[katmomma]

Here's what Ive been experiencing as far as my shoulders go, and I had a normal emg 2 months ago : My shoulder muscles feel tender to the touch, like when I touch the muscle and press a little, it is painful. With this, it feels like my whole arm is weak. Its weird because it comes and goes. Usually when I wake up in the morning, my shoulders feel fine, but as I start doing things, is when I have this feeling. It gives me the feeling that my hands are weak too. Also, it seems to switch sides, from shoulder to shoulder. I have no idea what this is. My neuro said he thinks its hormone related cause I'm pregnant, but Ive been pregnant before, and I know its not. My obgyn also said its not. Also, I get twitches in my shoulders and arms, and I know when I had my emg done, Ive had twitching where the needle was stuck but it showed normal. Any input? Does this sound like frozen shoulder? Also, I just turned 27, so I feel like Id be too young for frozen shoulder...but then again who knows?

 

[Zaphoon]

Its been a while since I've done my research on frozen shoulder but if memory serves me correct, it can strike an adult at any age although it is more common to hit in the 4th and 5th decades and up. About 15% of cases will experience a bilateral case.

The tenderness you described is something I've experienced as well. The weakness can be profound enough to throw the doctors a little off course if you are experiencing other nervous system disorders (as evidenced by Babinski & Hoffman signs). In my case, the shoulder/arm weakness was terrible and tough to work with but I've made some improvement through physical therapy, the help of a chiropractor and range of motion exercises.

Zaphoon

 

[katmomma]

Is it related to als from what you know? Did the pain get worse over time or was it pretty bad from the beginning? Also, what do you think of the coming and going part that I experience? Does it sound like part of it?

 

[Zaphoon]

When ALS does damage to, the damage done is not reversable. For instance, once the muscles get weakened, you cannot make them strong again. So, there is no coming-and-going strength wise in ALS.

With frozen shoulder, in my case, the pain was there if I tried to take the arm beyond the frozen zone or if I tried to lay on my side.

Zaphoon