EMG Signals for Neuromuscular Disease

[FreddieTheFox]

"For diseases that affect the neuromuscular system in general such as carpal tunnel syndrome or weakness/numbness related to trauma like a car accident or surgery, the rule is that nerve changes will not show up on the EMG until 3 weeks after the symptoms start. This is NOT true for ALS. Research is showing that there are very subtle changes on the EMG weeks to months before the typical symptoms of twitching (called fasciculations) occurs. What does this mean? Well, when a person comes in with weakness of specific muscles known to be affected early on in ALS like the hand muscles or the neuro exam shows things like brisk reflexes at the same time as weakness and wasting, then doctors tend to think, "This may be ALS, but I'm not sure because he doesn't have fasciculations." Then this person goes to get an EMG and they can see little changes that point to the diagnosis of ALS. However, if you already have true fasciculations whether it's ALS or benign fasciculation syndrome, then that fasciculation will show up on the EMG in the pattern of a fasciculation. If it's just twitching it will NOT show up as a fasciculation, which is a specific, well-described EMG finding that most neurologists should be able to recognize when they see it. So if you're having twitches and they're not showing up as fasciculations on the EMG, then it's probably not a fasciculation." I read this on the support forum , bfs in a nutshell: a twitch is something else then a fasciulation???? Idon't get it anymore. On my EMG they saw fasciculation but they said it isn't ALS. Are they wrong???? Could someone help me please I'm really starting to freak out!!!!F.

 

[inzTwoToneTunes]

W/O getting to technical I will try to explain. First I have to say that the confusion between twitching vs fasciculations has been made a bigger headache around here then it should be.It depends on what you are talking about. If someone has als, at some point they will have twitching. Twitching however in no way means you have als. I really don;t care what you call it, twitching, fasciculation, hyperexcitability, spasm.............If you don't have real clinacal weakness you don't have als. Als is not a disease of twitching, it is a disease of weakness.Some neuro's say their is a difference between als twitches and benign twitches. Speed, frequency, style........Some say there isn't. Trying not to scare anybody but please remember twitching w/o weakness is never als. Now when it comes to emg's and evoked potentials and sharp waves and all that mumbo jumbo, that is the muscle activity. If your muscle is struggling because the nerve supply is gone it has a distinct look on the screen and sound because it is sending out a distress signal. Think of it as muscle morris code for SOS.Some may argue with me but again is doesn;t matter what you call our jumpy muscles. It is not als.DD