Clean EMG, Normal Polyphasics: Seeking Reassurance

[nameyisyBoby]

Background - 2 years 8 months of twitching with no weakness. Finally went to a general neurologist to ease my mind. He gave me a clean exam (besides brisk reflexes which he said were not an issue since the rest of the exam was normal), and EMG (just on right side). The EMG included some polyphasics that were in the normal range, besides that everything was perfect. He called it clean, but he referred me to a neuro-muscular specialist for a second opinion.
The specialists gave me a clean exam, again with brisk reflexes that did not concern him. Then a Nerve Conduction Study that revealed mild to moderate Carpal Tunnel Syndrome. Then the most complete needle EMG I ever heard of. Both legs, both arms, both hands, back, neck, and tongue. He said the needles also showed Carpal Tunnel Syndrome (some polyphasics in hands), but the good news was no denervation anywhere. He said denervation on the EMG is the key. He said an ALS diagnosis would require three of the five body regions (head, thorax, arms, legs, and neck I think) to show denervation, and that I had zero denervation. I have to go back to him in two weeks to review all the data, but he said I have nothing to be anxious about.
Of course, having health anxiety, I recall someone mentioning that sometimes Carpal Tunnel is misdiagnosed, and it turns out to be ALS, but I am not sure if those instances included such a detailed EMG. Anyone have any info on that?
God Bless,
NoraFL

 

[nameyisyBoby]

Were polyphasic waves there both times in the same hand CTS is ?

Since the first EMG was nearly clear, why was the second one done ? (what was your original neuro.'s rationale for sending to the NM doc. and why did the NM doc. do it with two normal neuro. exams. and one clean EMG)

How long did the needle part take on the second one ?

CTS can be misdiagnosed but not if there is abnormal NCV test and certainly not after this long.

 

[ydav3yat3s]

Were polyphasic waves there both times in the same hand CTS is ?
Yes, the first EMG was on only one hand though. The CTS showed up in both.

Since the first EMG was nearly clear, why was the second one done ? (what was your original neuro.'s rationale for sending to the NM doc. and why did the NM doc. do it with two normal neuro. exams. and one clean EMG)
The general neuro sent me to the Neuro-muscular specialist because he is a general, and always sends patients to a Neuro-muscular specialist after a clean exam by him

How long did the needle part take on the second one ?
about 20 minutes

CTS can be misdiagnosed but not if there is abnormal NCV test and certainly not after this long.
My NCV test showed CTS

NoraFL

 

[nameyisyBoby]

My recommendation : Change your neuro. - no good doc. first does EMG on a patient after 2.5 yrs. (unless you requested it) and then sends to someone else after a clean exam. (I can understand that if there was an abnormality so that there can be a second opinion). The two seem to hand-in-glove to me.