Carpal Tunnel - EMG Differences

Usually, carpal tunnel and A/L/S appear different on an EMG and NCS (they typically do both tests). Carpal tunnel (CTS) will often show slow nerve transmission on an NCS in both motor and sensory nerves; since A/L/S doesn't affect sensory nerves or (at least in the early stages) slow nerve transmission speed, this can be used for a differential. In addition, A/L/S will typically have signs of denervation (positive sharp waves and fibrillations), while CTS doesn't unless it's really bad.

Typically, the only time CTS and A/L/S are confused is during the neuro exam, when weakness in the muscles of the hand is noted. If there's no weakness, there's no A/L/S. If there is weakness, it's still far more likely to be CTS, which is present in (by some estimates) 2–3% of the population. That's a lot more people than have A/L/S.

BTW, CTS was on Jeopardy last night. They showed someone using a segmented keyboard (appears to be the one I have in my office) and asked about the syndrome that causes pain in the wrist. If you've got pain, it makes it even less likely you have A/L/S.
 
After all those clean emgs and visits..you are fine. Something would have been picked up.

Even after almost 2 years of this, I still twitch, not as much but still do. There are times when I exercise and I am fine afterwards, but other times as soon as I stop and rest, the twitches are back big time, usually from my waist down, that is after power walking or just brisk in home walking. (I don't do much upper exercise).

I am sure you are fine. :)
 
Hello Dear Friends!

It seems that I am now within the bulbar stuff:

After passing another Neuro Exam+additional EMG (left arm+leg, 3 needles)+NCV without the sligthest sign regarding anything sinsiter, I found myself developing the following since last Tuesday:

- excessed felt saliva, but sometimes dry throat
- shortness of breath, ongoing whistling/talking e.g. gets harder or feeling that breathing is laboured
- uncomfortable and heavy tongue when talking
- more or less shortness of breath (feeling as if somebody is sitting on my chest/globus!)
- from time to time humid speech
- more and more avoiding to talk because of being afraid to loose saliva
- talking is being observed from my mind all the time which makes the situation worse and everything more difficult
- fear of bulbar ALS-onset

By the way I do not experience any fascicullations on tongue so far, tongue is absolutely quiet when examined relaxed within open mouth, yesterday I had been able to ride my bike for 40 km with my family without any problems, twitching has decreased and arm/leg condition has been totally improved so far!

It seems that I am now on the Bulbar-Trip! But I cannot help myself as "it" is always telling: Limb-EMG is not sufficient for the Bulbar-stuff!

In addition to that, maybe I have also got a slight infection of the globus as some of my colleagues had been suffering from that during the last week?!

Anyway, I had read on a German site that shortness of breath is only the initial sign for 3-4 % of any ALS-afflicted person.

Do you have any additional striking argument to rule ot this nasty desease for me?

Thank you so much, this community is a gorgeous thing!

Astro
 

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