FuzzyScientistzInven
New member
I had a NCS and EMG done yesterday. The NCS was normal. The EMG was not. However, there were NO fasciculations found anywhere. He took 4 stabs in my calf and arch and then 3 in my arm and hand and 2 more in my back. Everywhere he poked, he found some noise. I asked him if anything was jumping out at him and he said "No, not jumping out.....hiding". He was extremely thorough and he spent over 2 hours with me. The NCS took another 2 hours by itself.
In the end, he stated that something is irritating the muscles and used the generic term channelopathy as a distinct possibility. That deals with the transfer of ions into the muscle cells. Ions such as calcium, magnesium, sodium and chloride ions. Basically, it could be a metabollic disorder and he's ordered a slew of blood tests. I went back and looked at my bloodwork done over the past few years and noticed that my sodium and chloride levels have been right on the border of being too low for several years. I mean the results were like 1 point above the low cutoff range. Maybe something finally changed?
Anyhow, we did get into the ALS discussion. He said he couldn't be 100% sure it wasn't but he said if it developed into ALS he would be surprised. He said there's just no signs of it. No signs of denervation, no fasciculations seen or picked up by the EMG, no wekness.....Nothing. He said he sees ALS all the time, even early stages of ALS and I just don't fit the mold.
Lastly, he told me he really didn't know what this is. (I'm reading that as he DOES know what it is NOT). He then went on to say that he has a feeling I'll be back to be retested in 6 months to a year for a followup.
a followup:
The doc didn't see any fscics in person or on the machine which is good. Today, my right calf (the one he didn't test) was twitching up a storm and I could see some of them quite easily. I have to remind myself that ALS is a systemic disease and he would have caught it no matter where he poked the needle. If I don't have in fascics, I guess I'll just call them twitches or contractions of small parts of the muscle. I dunno. In the leg he did test, he put the needle in extremely close to, if not directly in one muscle group that had been having some big visible twitches a few days before. So, he would have seen something if it had been fascics even though it wasn't moving yesterday.
About the EMG sounds: When he first put in the needle, all you could hear was static. When I contracted the muscle group, it made a loud machine gun sound and then when back to static when I relaxed. Then, a few seconds later, I could hear a faint "click, click, click" that was rythmic and incresed in speed. He did a bunch of playing with needle after that. Those same sound happen everywhere he poked on my body. In many places, there was only static after I relaxed the muscle but he would keep turning and positioning that needle until he would hit an area gicing off those same clicks. I asked him at that time if it was looking like ALS and he said "No, there are no fasciculation potentials".
The doc who did the EMG was the chief scientist / neurologist at the Mississpi Methodist Rehabilitation Center in the state capital of Jackson. I think he's a pretty well recognized guy in his field and specializes and has written a book on the EMG.
I think it's called "Atlas of Electromyography" by Dr. Arturo Leis in case anyone has $70 they'd like to get rid of.
In the end, he stated that something is irritating the muscles and used the generic term channelopathy as a distinct possibility. That deals with the transfer of ions into the muscle cells. Ions such as calcium, magnesium, sodium and chloride ions. Basically, it could be a metabollic disorder and he's ordered a slew of blood tests. I went back and looked at my bloodwork done over the past few years and noticed that my sodium and chloride levels have been right on the border of being too low for several years. I mean the results were like 1 point above the low cutoff range. Maybe something finally changed?
Anyhow, we did get into the ALS discussion. He said he couldn't be 100% sure it wasn't but he said if it developed into ALS he would be surprised. He said there's just no signs of it. No signs of denervation, no fasciculations seen or picked up by the EMG, no wekness.....Nothing. He said he sees ALS all the time, even early stages of ALS and I just don't fit the mold.
Lastly, he told me he really didn't know what this is. (I'm reading that as he DOES know what it is NOT). He then went on to say that he has a feeling I'll be back to be retested in 6 months to a year for a followup.
a followup:
The doc didn't see any fscics in person or on the machine which is good. Today, my right calf (the one he didn't test) was twitching up a storm and I could see some of them quite easily. I have to remind myself that ALS is a systemic disease and he would have caught it no matter where he poked the needle. If I don't have in fascics, I guess I'll just call them twitches or contractions of small parts of the muscle. I dunno. In the leg he did test, he put the needle in extremely close to, if not directly in one muscle group that had been having some big visible twitches a few days before. So, he would have seen something if it had been fascics even though it wasn't moving yesterday.
About the EMG sounds: When he first put in the needle, all you could hear was static. When I contracted the muscle group, it made a loud machine gun sound and then when back to static when I relaxed. Then, a few seconds later, I could hear a faint "click, click, click" that was rythmic and incresed in speed. He did a bunch of playing with needle after that. Those same sound happen everywhere he poked on my body. In many places, there was only static after I relaxed the muscle but he would keep turning and positioning that needle until he would hit an area gicing off those same clicks. I asked him at that time if it was looking like ALS and he said "No, there are no fasciculation potentials".
The doc who did the EMG was the chief scientist / neurologist at the Mississpi Methodist Rehabilitation Center in the state capital of Jackson. I think he's a pretty well recognized guy in his field and specializes and has written a book on the EMG.
I think it's called "Atlas of Electromyography" by Dr. Arturo Leis in case anyone has $70 they'd like to get rid of.
I know excatly what you mean. I twitch all the time but every time I'm at the neuro (3 times now) not a ONE showed it's ugly face !!!