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Question about EMG


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Old 12-07-2016, 12:23 PM   #1
Mrwrong
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Question about EMG

I have been under investigation in a few years. I will try to keep my story short. I have made four EMG in four years. The first two were normal but the last two shows inactive neurogenic changes in three muscles of the left calf. Now I have started getting the same problem in right calf and what it feels like the muscles in the left but made no EMG since these problems began. My neurologist dismissed my suspicions on ALS and says that it will find other anomalies than I have. Now to my question. I know that one must present both chronic denervation as active denervation in ALS. Is it correct that that in ALS as presented first active denervation that lasts until the "contact" with the affected muscle stops, and then it is chronic denervation?
I have tried to get answers from my neurologist but has no clear answers. I have other problems also and especially the left arm but no abnormalities presented at clinical examination nor the EMG.

 
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Old 12-07-2016, 03:07 PM   #2
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Re: Question about EMG

Hello mrwrong,

I don't have an answer to your specific question, but it sounds like you have been through a lot with that many tests. Are you seeing a neuromuscular specialist? I saw several neurologists before finally meeting with a specialist.

Four EMG's seem very unusual. Is your neurologist recommending one every year? As I am sure you know, a "clean" EMG almost ensures that the underlying cause is not ALS. Four years with very little progression not exactly how it goes for ALS.

Do they have any other ideas what may be the cause?

Thanks,

James

 
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Old 12-07-2016, 11:28 PM   #3
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Re: Question about EMG

This will be a long post and hope you bother to read it :-). First, my mother tongue is Swedish, so I apologize in advance for typos and more.

Yes, it started about 4.5 years ago and nothing that initially pointed to neurological problems. Started to get sinus tachycardia episodes in and especially when I slept, but even otherwise. Later they managed to catch the episodes and is very well established cardiology and wears today a revealbox that is implanted under the skin. Nowadays, the heart is very calm and rarely gets these attacks.

Shortly thereafter began the muscles in the neck and shoulders become very stiff, but today is better. Then the problem began with my left leg became weaker. Got to do MRI on the skull, thoracic spine and lumbar spine, and was found when the disks that bulge at L5 level. At the same time I started to get muscle spasms in the left leg. Then I started to get muscle spasms throughout the body.

In November 2015 I started getting significantly sore left calf and the pain subsided but got cramps and foot and what suffered constant muscle spasms and vibration. Then right calf also started twitching and more.
Diffuse pain in both arms at the height of the elbows. Feeling generally weak in the legs and especially the left arm.


Unfortunately we don´t have neuromuscular specialists in Sweden so neurologists have to manage neuromuscular diseases. Neurologists do not themselves EMG, but this is done by neurophysiologists. Regarding the number of EMG, it is myself who pushed to get them to do.

The man then observed under these years:
* Supraventricular tachycardia
* Chronic denervation in the three muscles of the left calf.
* Slightly decreased muscle mass in the left calf.
* Reduced reflexes in both arms.
* Reduced reflex in the left leg.
* Muscle twitching.

Understand that no one here can put a diagnosis on me but would really appreciate your thoughts and concerns. My neurologist is very helpful but she has no suggestions on what's wrong with me. And it is this that is the problem for me. For without the diagnosis begins myself playing Dr. Google.



Feeling extremely tired mentally since I run on these investigations. Moreover, I feel alone in the situation ....

 
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Old 12-08-2016, 12:09 AM   #4
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Re: Question about EMG

I read your entire post. I don't recall that you posted your age. Also let me ask what if any medicines are you on for muscle spasms?

Have you had any viruses, or have you had a flu shot preceding yiur spasms and twitching?

I suspect that you have done much research on doctor google. I did not begin twitching until i read about it. Stay away from him.

I am quite familiar with ALS. Can you more information once I have more information.

Thanks,

James

 
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Old 12-08-2016, 12:54 AM   #5
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Re: Question about EMG

Hey James,
Thanks for the input! Have you been diagnosed with ALS? I am 42 years old. I wrote wrong earlier when I wrote muscle spasms, but I have not. What I have is muscle twitching, sore muscles, vibration and more. Medications I stand on today's metroprolol and Sobril. Unfortunately wrote cardiologists out Sobril few years ago in the belief that tachycardia episodes would end and then have continued neurologist so I'm slightly addicted to them. However, it is in a small dose. Can not recall any infection and are no blood tests that indicate this. Have not had a flu shot. However, as I convinced neurologist print Doxy for a period but I was much worse and had to quit.

 
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Old 12-08-2016, 03:59 AM   #6
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Re: Question about EMG

Hey James,
Have just read all your posts and understand that you do not yet have ALS diagnosis. When I read your posts so I recognize very many of your symptoms other than muscle spasms.

Last edited by moderator2; 12-08-2016 at 04:01 AM.

 
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Old 12-08-2016, 06:57 AM   #7
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Re: Question about EMG

You are correct. I have not been diagnosed with ALS. I have twitching bodywide, vibrations and muscle cramping 24/7.

Has bee 20 months since my first visit to a neurologist. I am on Gabapentin with a low dose effexor for sensory symptoms as well as the cramping.

Do you have any neutomuscular disease in your fanily history? Do you have weskness or just peeceived?

Take care,

James

 
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Old 12-08-2016, 08:18 AM   #8
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Re: Question about EMG

No, no one with mnd. Father has ms and I know that there i parkinsons and alzeimers om my mothers side. When I read your symptoms I come to think about FND.
Do you suspect als for your self?

 
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Old 12-08-2016, 08:55 AM   #9
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Re: Question about EMG

Yes I am undiagnosed. Up to one half of patients are never diagnosed here.
I am done with tests. No more. I go in once a year for medicine refills and just live every day.

It sounds like you have no clinical symptoms. Do you see any real atrophy or weakness?

Take care,

James

 
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Old 12-08-2016, 12:18 PM   #10
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Re: Question about EMG

The clinical symptoms that they have found are:
* Weak reflexes in the arms and left leg
* Muscle twitching
* A little weakness in his left leg. In particular, the foot and calf.

Some visible atrophy on the outside of the left calf. Have involuntary muscle movements in the index finger of the left hand and the big toe of the left foot.
Does my description sound like als to you?

What have you found in your EMG? Chronic denervation and / or acute denervation?
You seem very calm about your own situation, which I admire.
Have your symptoms worsened over time? Do you have any clinical weakness?

 
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Old 12-08-2016, 01:00 PM   #11
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Re: Question about EMG

Quote:
Originally Posted by Mrwrong View Post
The clinical symptoms that they have found are:
* Weak reflexes in the arms and left leg
* Muscle twitching
* A little weakness in his left leg. In particular, the foot and calf.

Some visible atrophy on the outside of the left calf. Have involuntary muscle movements in the index finger of the left hand and the big toe of the left foot.
Does my description sound like als to you?

What have you found in your EMG? Chronic denervation and / or acute denervation?
You seem very calm about your own situation, which I admire.
Have your symptoms worsened over time? Do you have any clinical weakness?
My first EMG was 18 months ago and clean. I had one 6 months later by another doctor and the results showed many fasciculations. I never got a copy of the report. It was a doctor I went to on a whim. I scheduled an appointment with a neuromuscular specialist and she did a thorough clinical and declined to have another EMG performed. Said not ALS, but recommended lumbar puncture. I never had it done.

My reflexes are dininished or nonexistent in my ankles. That is what neuropathy does they explained. The heightened reflexes are the scary ones that almost always indicate a serious disease. I do not have those.

They said that sensory symptoms even more of an indicator that issue is not ALS.

Your symptoms do not sound like ALS. What day to day functions are more difficult or impossible? Is the atrophy very pronounced?

Take care,

James

 
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Old 12-08-2016, 08:45 PM   #12
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Re: Question about EMG

thanks so much for your answers. But if muskeltwiching was the only one found in your EMG it means absolutely nothing unless there was also denervation. There is nothing I can't do but my calves are quickly becoming tired. Have diffuse aching in arms that are a little burning. The atrophy is quite visible. In one of your topics, you write about your lumps and these I have too. These are small and get them past the ribcage, but also in other places

 
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Old 12-08-2016, 09:53 PM   #13
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Re: Question about EMG

What you are describing is not how it works is it. Supposed to be a sudden failure of a muscle. Also the progression is rather rapid.

I just got back from working out. I go five days a week. As I sit here almost every muscle is sore to the touch. I have no failure. Do I see atrophy? I believe I do, but who knows. I am 52 so mainly do cardio. I can still grab 35lb dumbbells and curl them as usual...so I have no idea.

I am going to live every day. If I don't have anything serious then great. If I do there is no treatment so who cares. At least I didn't waste time worrying.

Take care,

James

 
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Old 12-09-2016, 12:32 AM   #14
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Re: Question about EMG

Quote:
Originally Posted by TimAlley View Post

I am going to live every day. If I don't have anything serious then great. If I do there is no treatment so who cares. At least I didn't waste time worrying.
Wish I had your attitude. Must say that I don´t have exaggerated anxiety but I will continue to require investigation of the investigation. The worst thing is that I lose precious time with family and my wife has a little difficult to understand what the problem is because I look "normal" out.

 
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Old 12-10-2016, 12:18 AM   #15
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Re: Question about EMG

You just need time to pass. As each day goes by and you can still do everything you are used to yiu will slowly realize that you do not have ALS.

Over 605 days since my first symptom here.

Take care,

James

 
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