EMG Test Results - Neuropathy Discovered

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rkeeli1

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I had my EMG test this morning. Strangely enough, while I was waiting for my test, there were announcements over the hospitals loud speakers stating the hospital was in "triage" mode. Whatever that means... more on this later.I was called back for my test. A little nervous, but wanted it done to move on with my life. Unfortunately, the neuro doing the test detected some neuropathy in my left lower leg. Huh? I asked him why this may be. While in my mind the thoughts of *** kept coming to the fore front. He said it could be caused by many different things, diabetes (which runs in my family), smoking, drinking, thyroid, etc. I told him about my concerns abot ***, and he told me to stop reading the Internet! He tested my right leg for comparrison, and everything showed normal.There was a knock on the door, and we were instructed to evacuate the building! What?!?! Apparently, there was a fire reported on the 5th floor (we were on the 1st) and the fire department wanted our area of the building cleared out. You've got to be kidding me...The Neuro said he would've liked to have done some tests on my back, but we needed to evacuate. He said he'd take the results, analyze them, and send them back to my GP, who ordered the test, and determine what the next steps may be if any.He could tell that I was a bit taken back by the readings and I was grabbing for any nugget of information I could get out of him. He said without knowing my medical history, he couldn't really speculate. He did send me on my way with the parting words of "it could be just that's the way you're made up".Anyhow... I'm waiting for the GP to call me back. My leg twitches, which have subsided a bit, have perked right back up after this. Maybe it's because they were shocked this morning, maybe its the nerves, maybe its something else.I have an appointment with a Neurologist on May 30th. It's going to be a long wait until then.Hopefully I didn't bring anyone down. I didn't mean to. I just wanted to share the results and hope for some words of encouragement.Thanks!
 
Golly!!! What an ordeal you had. Well I have been taking some supplements that I asked my GP/PCP about and he gave me the go ahead. The list is as follows:1. Lecithin (a natural from of Choline and can be found in many food sources such as; eggs) 1200 mg daily - Good for nerve and brain function2. Alpha Lipoic Acid (ALA) 600 mg daily – Good for metabolism and cell health 3. Omega 3 - 1200 mg daily – Good for heart, joints, and mind4. CO Q-10 Good for the heart – 400 mg dailyI had an okay EMG/NCS on my upper extrimites back in Feb. 08 It showed okay, not normal. It was because of nerve damage from the neck surgery I had last July. Family and medical history can SO play a big part of what is going on with you and are probably more likely than ALS. I tell you...The old saying "Take two asprin and call me in the morning" huh! I say "It takes two doctors to get an answer" ;)
 
After pondering this a while and doing a little more research, I come to realize it was the NCV test that was giving the abnormal readings. When the doctor did the needle *beep* (EMG) test, he was satisified with the results. I wonder what this means. I suppose I have all weekend to ponder it, while I wait to hear back from my PCP.
 
Hey Dbost-Hey that sounds like you had a fun exam. Atleast you heard some GOOD news. Ok so here is the deal with the NCV/EMG. These tests are done in tandem for several reasons. A few are (carpal tunnel, nerve block (I have it in elbow), neuropathy (can cause twitching) and a whole list of things. I am going to tell you something that will make you really happy...are you ready? In ALS the NCV is COMPLETELY normal and the EMG will show fibs, fasics, and PSW (positive sharp waves). Its ok to have fascics (a lot of us do that have emg's) but the other ones can also be other things than ALS). So basically your NCV was bad (man I wish I could show you mine) but having a BAD NCV and a GOOD EMG points away from ALS. The NCV can find other reasons (as your doctor said maybe neuropathy) for the twitching or the feelings you are having. Now its also good to have a good NCV and a good EMG....because that means everything is in great shape. But most of us dont have both of them perfect. My NCV showed focal conduction block, ulnar nerve slowing and "slowed latencies distally". Basically my right arm is in bad shape. But my EMG was completely clear and he told me I had a bad nerve in my elbow and was getting carpal tunnel. So dont fret, if you are having twitching and ALS was even possible the emg in ANY limb would have picked up fibs or PSW's. Again fascics are ok in an EMG as long as there are no other combination of findings and even then its most likely not ALS. So congrats! I had to ask these questions over and over again to two different neuros until they finally told me how everything works. Good to hear, make sure you take a list of questions to your next neuro visit and dont be afraid to say "ok so is there ANYTHING that concerns you". Get your $$$'s worth! Sean B.
 
Thanks, Sean! That sould help ease the mind a bit until I hear what the final results are.I do, however, feel like I wasn't treated to a fair test as we had to evacuate. I could tell he wanted to do more testing, but we had to leave. He said he would've like to have tested my back (that has to feel weird), but will go over the results with my PCP. If my PCP thinks further testing is needed, I'll have to go back in.What has me thinking it how this all relates to my initial symptons. If you've read my long diatribe (Yeah, me too - ), you'll see this all started with an eye twitch that turned into some face pain with sinus and face pressure. I always thought the leg twitching was anxiety/stress related due to what was going on in and around my head. Maybe it's related, maybe it's not. I will certainly start collecting a list of questions. I also started a "what am I feeling now" journal, which I should've started a long time ago.Thanks again for the encouragement. It HELPS!~ db
 
Sounds like Sean B. gave you good advice! I think that's why I avoid getting an EMG (my symptoms started before the internet) and I wasn't offered one due to normal neuro exams. Had I known about an EMG back then I would have insisted on one like most of you. Now, I know something would appear, carpal tunnel, arthritis, etc. and I just don't want to start worrying, (I've been twitching for decades, so I'm pretty sure it's nothing sinister!) My husband had an EMG a couple of weeks ago. His neurosurgeon thinks he may have neuropathy in his feet. The dr. kept asking about diabetes, etc. & said that his tingling and numbness couldn't be caused from his back problems. He doesn't have diabetes, is in good physical shape, etc. His mother is 90 and has had "neuropathy in her feet of unknown cause" for at least 30 years that I can remember! She still lives alone out in the country, teaches painting classes, etc. (also walks normally). I'm betting that's what my husband has--some form of heriditary neuropathy. I could tell that there were some abnormalities when the neuro was performing the test, just by the questions he asked afterwards, his failure to give us any info regarding the results, etc. (we'll get them Monday from the neurosurgeon). I'll let you all know. The EMG's test for alot more disorders than what we all worry about. Best Wishes, Denise
 
Sounds like Sean B. gave you good advice! I think that's why I avoid getting an EMG (my symptoms started before the internet) and I wasn't offered one due to normal neuro exams. Had I known about an EMG back then I would have insisted on one like most of you. Now, I know something would appear, carpal tunnel, arthritis, etc. and I just don't want to start worrying, (I've been twitching for decades, so I'm pretty sure it's nothing sinister!) My husband had an EMG a couple of weeks ago. His neurosurgeon thinks he may have neuropathy in his feet. The dr. kept asking about diabetes, etc. & said that his tingling and numbness couldn't be caused from his back problems. He doesn't have diabetes, is in good physical shape, etc. His mother is 90 and has had "neuropathy in her feet of unknown cause" for at least 30 years that I can remember! She still lives alone out in the country, teaches painting classes, etc. (also walks normally). I'm betting that's what my husband has--some form of heriditary neuropathy. I could tell that there were some abnormalities when the neuro was performing the test, just by the questions he asked afterwards, his failure to give us any info regarding the results, etc. (we'll get them Monday from the neurosurgeon). I'll let you all know. The EMG's test for alot more disorders than what we all worry about. Best Wishes, Denise
 
My GP called me with my EMG results. Unfortunately, the report wasn't spelled out well enough for him to give me any good news. It was reported that I have 2 nerves in the left lower leg (motor portions) that showed abnormalities. 2!?!? Sensory, fine. Muscle function, fine.There apparently was only diagnostic data in the report. Nothing on what level these "abnormalities" were at (minimal, moderate, sever). He wants a neurologist to interpret the results, however I don't have an appointment until May 30th!!!Do you ever have the talk with you doctor where you get a bad feeling just by his tone? It wasn't a comfortable conversation. He wasn't possitive, but he wasn't overly negative. There was concern in his voice, but maybe that was just me reading to deep into it.He'd like me to go get the further EMG tests done (back? neck?) that the Neruo wanted to do during my visit before the evacuation. Now I'm struggling with the hospital trying to get in ASAP because, according to them, the test was complete and they need a new order. Ugh!My doctor is also trying to help get my Neuro appointment bumped up earlier. I can't wait until May 30th. This is really freaking me out now. If it was a abnormality in the sensory, I'd say fine. From what I've been reading, the sensory points away from ***, but the motor... well.I'm not experiencing any weakness, from what I can tell. I don't see any atrophy, but how would I know, I'm not trained in this stuff.The toes on both of my feet have been burning since yesterday. The twitching is there every now and then, but no where near what it was a few weeks ago. I don't know what it all means.I'm scared. I'm nervous. I don't know what to think anymore. I want to see the neurologist ASAP but I'm also afraid of what he might tell me.
 
dbost, my GP told me he thought I had ALS before I even went to the neuro. Don't try to read anything into his tone. You might read correctly and freak yourself out. GP's don't know anything about neurology.Do you have any idea how many people have neuropathies in their legs, twitching, etc? The number is staggering. You are going to be really disappointed when you go to the neurologist. With no other problems, your diagnoses is going to be..."Mild neuropathy. Nothing to worry about. We'll check you in six months."I feel badly for you, though. I went through all the same emotional turmoil. I told everyone my doctor figured I had ALS. If someone mentioned Christmas, I wondered if I'd still be able to walk.Hang in there. My thoughts are with you.
 
Neuropathy does not mean ALS.The neuro that gave me my 2'nd EMG had a neuropathy in his hand, no big deal. Sensory nerve issues are not a sign of ALS either. Motor nerves, denervation, weakness, muscle wasting may point that way but you had a normal needle exam so it sounds like no denervation was present. So if you had some issues on the NCV, no big deal. I had a slowed sural sensory response in my EMG test and it was actually just because it was cold outside and my skin temperature caused the response to be slower. I think you're too worked up. As long as there was no denervation on the EMG and you have no debilitating weakness with muscle wasting, you're just fine. All of that has to be in place:* Failed physical exam* Severe debilitatiing weakness* Denervation on the EMG* Wasting musclein order for a potential diagnosis of ALS. You don't meet the criteria.I'd just relax and be happy :)God bless,Troy
 
Thank you all for the replies. You have truly helped. I called the doc's office today to get the EMG report faxed to me. Here are the highlights (or lowlights):*** Report (Summarized) ***The patient has evidence of an axonal neuropathy of the bilateral motor portions of the peroneal and tibial nerves. The sensory portion of the lower extremity sural nerve was intact. EMG portion of the exam for left upper and left lower extremity was normal with no signs of of acute or chronic denervation. The cervical and lumbar paraspinals were unable to be performed due to a **** hospital emergency evacuation ****.... (stuff about sensory tests) ...Motor studies were performed for the left lower extremity. The left peroneal was unable to be obtained (???) either distally or proximally at the fibular head. F waves could also not be performed due to this lack of waveform production. For comparison, a right peroneal nerve study was done. Latency at the ankle was 3.9 msec and at the fibular head 12.6 msec. Amplitude was diminished at 2.0 mV and 2.7 MV respectively. The distance was 390 mm and velocity was 45 m/sec.Left tibial nerves wer then performed for motor studies. Latency at the ankle was 3.7 msec and popliteal fossa 16.6 msec. Amplitudes were 2.4 and 1.6 mV respecitvely, both diminished. Distance was 510mm with a velocity of 40 m/sec.F wave studies were then performed for the left tibial nerve. We were unable to obtain an F wave response adequately. Left peroneal also obviously could not be obtained due to lack of any initial motor response.The needle EMG portion of the test was then performed for the left lower and upper extremity. Left extensor hallucis longus, tibialis anterior, and medial gastrocnemius were performed with normal insertional activity, no abnormal spontaneous activity, and normal amplitude, duration and recruitment pattern for those muscles.*** End Report ***So... the questions I have are, Where the H*** is my peroneal nerve in my left leg???? And what does diminished mean??? What about the levels of "diminished"??? Two more weeks until I see the neurologist! As I said, I can't wait, but then again, I'm nervous as to what he might tell me.
 
NO SIGNS OF ACUTE OR CHRONIC DENERVATION.NO ABNORMAL SPONTANEOUS ACTIVITY AND NORMAL AMPLITUDE, DURATION AND RECRUITMENT PATTERN (FOR THOSE MUSCLES).These two sentences confirmed that you do not have NMD.You are pretty much O.K.Greetings from Europe.
 
EMG portion of the exam for left upper and left lower extremity was normal with no signs of of acute or chronic denervation.Translated... NO ALSCongratulations on the excellent EMG results :)no denervation means that you do not have any sort of Motor Neuron Disease, or ALS.Fantastic news.You don't need any more EMG pokes. Having one side of your body completed with no signs of denervation sums it all up. You're OK. You might have a damaged or pinched nerve somewhere but who cares?? :) IT'S NOT ALS and that's awesome news. Hope you can put your mind at rest now. :)
 
Thank you everyone for the words of encouragement. I can accept that I may have a pinched nerve (boy, I hope I do and that's what's causing all this), but I still want to know why they weren't able to find my peroneal nerve. Faulty equipment? Maybe. Could the nerve be so entrapped that they couldn't detect the peroneal in my leg???Along with the weird twitches here and there, and the burning toes from last week, the malaise feelings, the shakiness, I'm still concerned about what's going on in my face. It seems to come and go. The past couple of days have been strange for the facial area. Minor twitches (nothing jerky like other areas). Eye twitching. Tightness around the eyes, and now right cheek (used to be left). Muscle vibrations when I squeeze the facial muscles. There has been days when the pressure in my forehead and temple areas has been so bad, I could feel my pulse beating in my temples.Could this all be stress related? I guess anything is possible. It does seem that I have symptoms that come and go. Day after day, it's something else. The other morning I woke up with the worst stiff neck. The pain was so bad when I turned my head, I could feel it shoot up the right-side of my skull to the point of where the area to the right of my right eye hurt. Through the day, it felt like it turned into a migraine. Is that possible? My neck is still stiff but no where near as bad as it was on Saturday.Maybe I just need a good chiropractor, a good masseuse and an enjoyable round of golf on the most peaceful and serene course I can find.
 
Ok... so the hospital was able to finally squeeze me in to finish up the EMG test, because the dr. "saw something" before we had to evacuate. He's going to zap my lower back and cervical. I sure hope he comes and says, "oh yeah, its a back thing", instead of "hmmmm" again. I'm glad its tomorrow so I don't have to stew on this too long. Although I'm starting to buzz again. I should pop a Xanax but I'm trying to go med free.Any questions I should ask tomorrow? Anything I should look for?Your help, guidance and encouragement are GREATLY appreciated!
 
I have similar facial symptoms and I'm pretty sure that mine are related to BFS. I think I posted somewhere that I had two CT scans of the sinuses over the years b/c of all of the pressure, pain, etc. They were both okay, (just subjected me to a lot of unnecessary radiation!) I still get a lot of pressure, pain and TMJ symptoms and they coincide with a BFS flare usually. My right eye is a pretty good indicator of a flare, (it was my 1st area to twitch and it's still a major hotspot during my flares.) Best Wishes, Denise
 

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