EMG for Diagnosing Bulbar ALS?

[professormentoradv]

how does a clean emg rule out bulbar. If bulbar is from the neck up and the emg sticks go into the arms and legs. Can an emg that does arms and legs determine bulbar.

 

[jamietwist]

While bulbar ALS most often presents with the speech and swallowing issues, (and not necessarily twitching), it also affects the upper limbs rather quickly. An EMG would likely pick up some mild fibrillations, and possibly a slowed NCV in the arms.