EMG Results, Twitching, and ALS

ListlessOne

Well-known member
Hi, I posted jubilantly a few days ago about how my emg was clean and I was free to go on with my life. FOr some reason (due to being trapped in the house during this massive east coast storm) I started googling again. I came across something which suggested that a clean emg in the presence of twitching could just mean the beginning stages of ALS- i.e, the first six months of nerve hyperexcitability - which is why people go for repeat tests at 6 months. My dr. basically looked at me like he did not want to see me again or invite me back in 6 months. KInd of like go away and get on with your life. Have all of you gone back in six months for a repeat if you were still symptomatic? In that case I don't know how anyone with a clean EMG in the first six months could relax at all! I am only 1 month into the twitching so maybe I went TOO EARLY to be conclusive? Just for reference, I was poked in 3 limbs, the cheek and the mid spine which I thought was unusual. Anyone else poked in the mid back/spine?"
 
Well, I was assigned for consecutive 3 month followups after more or less clean EMG also on 4th week after twitching onset (with extra rythm on the background). Which were primarily to see if my twitches (supposedly lower motor neuron signs) would not become accompanied with upper motor neuron signs (like spoiled reflexes, hyperreflexia etc). In that case I might have another EMG to check if MUPs are changed etc.Clean EMG with twitches and subsequent ALS usually mean that process started not from central brain but from anterior horns first. and anyway, those people usually have SOMETHING else, like so called horn reflexes change (have no idea what it is but my doctor got me ticked with the needle in my belly and wrote in my history - "horn reflexes normal", suppose to check my anterior horns status before emg. So it is hardly unlikely that one may have NORMAL CLINICAL PLUS CLEAN EMG PLUS TWITCHES and then ALS. Something should be wrong in this triade.please do not google for als. it does not help you. you are very lucky to have official diagnosis of BFS, enjoy it. See, there is a guy here nicknamed Derek. He has a diagnosis of possible ALS, and he says that he does not see any weakness but doctor on clinical had found a bit of weakness in his finger! he also has a bit of FP on EMG - and combination of this subtlest weakness he even could not notice by himself and ONLY FP - those two subtle signs were anough to get him suspected for ALS.IF you are not suspected and have clean clinical and clean emg, then it is bfs.
 
Thanks. I keep reminding myself he did this test to put me at ease to. He said "completely normal exam." And he is not only a neuro but a fellow in neuromuscular disease and neurophysiology - not sure if that makes him an ALS specialist but I would imagine he is pretty good at looking at EMGs and clinicals. And I do have to say since the test the twitching has diminished a lot....You are right time to stay off ALS boards and seeing all the contradictory answers.
 
Don't give in. This need to have more and more EMGs for reassurance will never ever stop unless you put your foot down. I know someone who's twitched for 4+ years, had 3 EMGs (the first two being 2 years apart and being basically the same, not completely clean, but no ALS, and the most recent one being a year ago, completely clean) and still says he might want another EMG. For what? It's a cycle that you have to break.
 
I agree its a self perpetuating cycle. Here's the thing- its all so contradictory- On the one hand the guidance is if you are twitching, you must be so far into this disease that for sure a clean EMG - no matter how soon you test - means no ALS BUTWait, twitching could just be the INITIAL nerve excitability so a clean EMG after 6 months of twitching is what is most reliable. I just want some darn peace of mind and waiting another 5 of so months in my state of mind ain't gonna be good. I gotta just let it go.
 
The second condition is a very, very, very tiny subset of the first.The first is a very tiny subset of a very rare disease.So there isn't a contradiction, just different levels of risk. What matters to you now though is that all those various "rares", and how relatively common BFS is, mean that the probability that you have ALS is bugger-all :)Go outside*, enjoy life!GlowGreen* Once the storm clears!
 
These 'storms' are very real, but you must also realize that they of our very own creation. When the wind is blowing and the seas are choppy breath slowly and deeply, close your eyes and visualize the storm as your mind presents it to you. As you continue to breath slowly focus your mind on seeing the winds die down and the seas calming. Watch the storm clouds dissipate until the sky is clear and cloudless. Take your time but you shouldn't need more then 10 minutes. Visualization exercises like this are incredibly powerful. You have the power to break the storm, just as you had the power to create it. We are not helpless victims to our thoughts. When you learn the proper tools and techniques you can steer your course in a positive direction at will and you can learn to recognize when you are steering it into a negative one (so that you can stop it before it is too late). Reassurance from this board is helpful, but it is a crutch you need not rely on. You are the answer you have been looking for. We all have that within us.
 
Yes storming all over inside and outside. Honestly, I cant even say for sure that I have BFS, right - don't you need to be twitching for a certain number of months? Mine has been only one month? It seems premmature a bit. For those of you diagnosed early, did you still continue to worry or pray that the twitching would go away? Even though the EMG was clear I still want this to go away so I don't have to worry for the next few months. This is the second time in my life I've had to move past something. Fifteen years ago, 6 months after I gave birth to my oldest, I had all sorts of weird symptoms and parasthesias (similar to BFS but not quite, no twitching). I was in a bad way and every test was done, even a bone marrow biopsy. Everything came back negative and of course everyone said, 'see honey, you just have post partum depression." Then I got a phone call 2 months later, when I was feeling better and symptoms clearing, from the dr saying that the cytogenetic test done on my bone marrow showed chromosome deletions that showed lymphoma. However, they could find no active evidence of any cancer in my body with all the other tests. He told me I was one of 5 in the genetic database that had this deletion and there was no way it was a mistake- it was a deletion associated with lymphoma. They couldn't say whether it meant that I had the disease, would get the disease in 5 yrs, 10 yrs, etc. or if several factors (environmental, genetic, etc) had to happen in a cascade to set it off. So the advice was to put it "out of my mind" and go on on with life unless I had any symptoms. Easier said and done with a new baby, but here I am now 15 yrs later and knock on wood no evidence of that disease and believe it or not I did put it out of my mind b/c how else can you go on? So everytime I get something weird going on my mind goes back to that scare. And here we go again, a bunch of weird unexplainable symptoms with no diagnosis. Why can't I be one of the easy ones who twitches and they take a blood test and say, oh, Lin, your thyroid is off or you need more B12. UGH! I always have these weird extended undiagnosed conditions that take up months of testing and anxiety and have no easy answer!!!!! Thanks for all your help. I've got to chill. This was all created in my mind too. Neither of my neuro's ever suggested or suspected ALS. I brought it up to them after exhausting all other serious causes for my weird symptoms (neck issues, head rushes, back and trap spasms, twitching). I am normally a very composed person and even in the face of real medical crisis cope very well (I had open heart surgery to correct a bad mitralv valve and didn't sweat it or google it one bit because it was straightforward, no health anxeity about it at all). HOwever, I fall apart when symptoms fail to have a diagnosis. Okay, enough of me tonight. For those of you on the east coast, stay safe. Thanks again, I will stop reading the Dr. C's hypothesis and start practicing secretagentman's deep breathing exercises ....
 
ListlessOne,If it helps at all, my nm specialist did my emg at one month into twitching too. He specifically said that if a person has anything sinister, it should already be running its course for 6-9 months in a person's body before twitching starts. Therefore, it should be detected on an emg. I am not sugar coating anything; those are his exact words. The said one clean emg is a good thing and a second is a really, really good thing which is why I am going back for a follow up at the four month mark. I am scared too and I've seen the exact reports you are talking about, and there is a lot of contradictory information out there. It sounds to me that it would very, very unlikely to be something sinister. I did the same thing as you did: I was fine for a few days after my emg and then I began to doubt it and worry again. I would trust in your doctor though- he/ she knows your personal history better than anyone. On another note, I am in Northern Virginia and got snowed in today too. I am afraid it is going to be back to work tomorrow though.Peace,ristinaL91
 
I've been twitching for 7 months now. I haven't had 1 EMG. I've been to the neurologist about it, and they felt no need to do an EMG after everything else checked out (reflexes, strengths, etc...). If the neuro's feel no need to do an EMG, than neither do I. Btw I've been to 5 different ones, but that's generally for the parasthesia thats been affecting me, as i've been trying to get to the bottom of everything.
 

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