a post in addition to the negative emg als post

General Topics

Moderators: JohnV, Arron, garym

a post in addition to the negative emg als post

Postby Kerri29 on April 21st, 2004, 6:36 am

Please do not do this, I have had probably 9 emgs at this point because of people saying crap like this. I will have you know meg had an emg in the begining of her symptoms, and NORMAL emg does not mean it was completely normal, it just means it was within normal limits, you may want to take a look at your emg report.

I have my doctors ready to choke me because I read stuff like this.

Kerri
Kerri29
New Member
New Member
 
Posts: 5
Joined: April 20th, 2004, 11:55 am

Curious about Normal Limits?

Postby Bradford on April 21st, 2004, 9:26 pm

I wasn't aware that EMG had normal limits. This doesn't make sense because in an EMG the doctor looks at the muscle at rest as well as the action potential (muscle contracting). In normal muscle at rest there should be "zero" electrical activity. In other words there isn't necessarily a "range" that we fall into as being normal.

If the EMG is clean, it most likely means that at rest there isn't any abnormal electrical activity that is seen compared to abnormal electrical activity in diseased states. Likewise, when the muscle is contracting the doctors look at how strong the action potential is compared to diseased states where there is a decreased action potential and poor recovery
time for the muscle. In otherwords "electrical confirmation" of weakness.

Twtiching is seen as large random amplitudes that are differentiated from things like fibrillations (low amplitude) when a muscle is de-nervating. With benign twtiching, action potentials remain high and there is good
recovery time for the muscle. In other words the neuromuscular system
is functioning properly in spite of the twitching.

Having said this can you clarify what normal limits are in an EMG?
I'm curious because I wasn't aware that there are quantifiable ranges like there are in blood tests.
Bradford
Selfless giver of time
Selfless giver of time
 
Posts: 109
Joined: April 19th, 2004, 3:30 pm

Postby dwl on April 22nd, 2004, 12:26 am

Hey guys, THIS IS NOT NEW!!!

There are very few medical tests which are black and white normal or not normal. For instance almost all blood tests have a normal range and you're only abnormal if you fall outside that range. An emg gives a very complex set of different results and of course there has to be a range of what's normal. An ecg is the same. So is a chest xray. So if people are going to start freaking about "what does normal really mean?" and convince themselves that their test was not normal then they will (a) go mad very quickly and (b) be wasting their brainpower.

This is simply not an issue. It is a hypochondriac's paradise.

David
User avatar
dwl
Hero
Hero
 
Posts: 312
Joined: September 22nd, 2002, 4:50 am
Location: UK

Re: a post in addition to the negative emg als post

Postby Kerri29 on April 22nd, 2004, 6:23 am

Kerri29 wrote:Please do not do this, I have had probably 9 emgs at this point because of people saying crap like this. I will have you know meg had an emg in the begining of her symptoms, and NORMAL emg does not mean it was completely normal, it just means it was within normal limits, you may want to take a look at your emg report.

I have my doctors ready to choke me because I read stuff like this.

Kerri



Normal limits means for example, if a fasciculation shows up, it is a fasciculation which can be percieved as bad but if he does no see any indications such a fibrillations and so forth then it is considered NORMAL.

You should always get a copy of any medical test that you are unsure of. I have all my emg reports.

Kerri
Kerri29
New Member
New Member
 
Posts: 5
Joined: April 20th, 2004, 11:55 am

CORRECT

Postby Kerri29 on April 22nd, 2004, 6:27 am

dwl wrote:Hey guys, THIS IS NOT NEW!!!

There are very few medical tests which are black and white normal or not normal. For instance almost all blood tests have a normal range and you're only abnormal if you fall outside that range. An emg gives a very complex set of different results and of course there has to be a range of what's normal. An ecg is the same. So is a chest xray. So if people are going to start freaking about "what does normal really mean?" and convince themselves that their test was not normal then they will (a) go mad very quickly and (b) be wasting their brainpower.

This is simply not an issue. It is a hypochondriac's paradise.

David



Thanks David, this is what I was trying to say but did not come out as well. These people who go around saying they had a normal emg, may have had some findings show up on that emg but not enough to make a complete diagnosis at the time. I was so upset about hearing the garbage again that I asked my neuro friend about my emg, he said the minute he sticks a needle in someone he knows it is going to be ALS even if all the puzzle pieces are not there, apparently the muscle is irratable.

HE ALSO CANNOT BELIEVE THIS GARBAGE ABOUT PEOPLE WITH NO WEAKNESS AND TWITCHING GOING ON TO HAVE ALS AFTER 4 YEARS.

Kerri
Kerri29
New Member
New Member
 
Posts: 5
Joined: April 20th, 2004, 11:55 am

Postby Pole on April 22nd, 2004, 7:31 am

So why do you believe in that garbage, Kerri?
M.
User avatar
Pole
Hero
Hero
 
Posts: 472
Joined: June 12th, 2003, 12:56 am
Location: Warsaw, Poland

EMG is over 50 years old

Postby Bradford on April 22nd, 2004, 11:56 am

No, this is nothing new, and I believe we all are saying the same thing-
that if your neuro says your study is "clean" than there is no need for any further worry. That is as black and white as you can get! Granted there are abnormalities that are considered non-lifethreating and begign-fasics are a prime example.

I do disagree with those who think electrodiagnostic studies have a quantifable "number" that defines a normal range. (Exception given to the nerve conduction velocity) The EMG study isn't a numbers study its an electrical waveform study looking at the shape of the waveform at different states of the muscle and how the muscle reacts and recovers.
This includes the "phase" or timing issues as well.

Blood tests are different because there are definable numerical values, but even when the values go outside the normal range it may be a beging process and a normal reaction of the body to compensate. For example the RBC for a marathon runner can be high because of the high oxygen demand. Same thing for those who live in higher altitude cities.

The point is that abnormalties do exist, but they often do not define a disease process. Same goes for an electrodiagnostic studies, but to say that the doctors have numerical value associated to the waveform is crazy! Again they are looking at the waveform's shape and characteristic

For those who have had multiple studies. Were those additional tests ordered by your doctor because he wanted to monitor your progress or did you pay for these extra studies out of your own pocket when you first study was clean.

During my first and only EMG I actually discussed this with my neurologist who performed the electrodiagnostic study. EMG is only a portion of the total study which includes nerve conduction velocity as well. However, insurance companies like to itemize these tests and give a payment value to them thus, it is difficult for doctors to get authorization on multiple tests especially when the first series came back 'NORMAL"

Finally, I would like to conclude my response and remind everyone that the electrodiagnostic study isn't specific for motor neuron diseases. It will dectect abnormalities for "treatable" conditions as well. Therefore, if your doctor found abnormalities, but nothing to indicate a motor nueron disease, I would be very relieved but would want to know about it so that quality of life can be maintained espeically if it was something that could be treated that would benefit me in my older years.

EMG is a picture study and not a numbers study. If your electrodiagnostic study was negative for motor neuron disease and your physical exam showed no changes in reflexes and resistance strenght tests-you're picture is quite different from somebody who does have this type of disease.

This is a great forum to voice opionions even when we disagree on the technical aspects.

Get Well Everyone!
Bradford
Selfless giver of time
Selfless giver of time
 
Posts: 109
Joined: April 19th, 2004, 3:30 pm

Hey there

Postby Kerri29 on April 22nd, 2004, 12:22 pm

Pole wrote:So why do you believe in that garbage, Kerri?
M.


I am so proud of you Pole, you started twitching well after me and you have a much better attitude.

WHY DO I BELIEVE THIS GARBAGE, IT IS LIKE THE CAROLMARIE STORY, REMEMBER THAT POLE MAN THAT DROVE ME OVER THE EDGE, AND THEN I FIND OUT SHE WAS NOT BEING TRUTHFULL. I AM A BOOB WHAT ELSE CAN I SAY.

KERRI
Kerri29
New Member
New Member
 
Posts: 5
Joined: April 20th, 2004, 11:55 am

Clean Means Clean

Postby puggriffey on June 6th, 2004, 8:23 pm

Ibrlieve the normal ranges everyone is referring to are the results of the Nerve Conduction portion of a complete EMG exam, and not the "needle=based" EMG itself.

For the NCS, there are a number of ranges generated that the results fall into - each range projects as normal or abnormal, and corresponds to the time it takes an electric charge to flow down the tested nerve pathway. In almost every case, an ALS patient will already be experiencing "blockages" of one or more degenerated pathways, and the time readings associated with this particular nerve grouping will come back "abnormal" - this is patially why it goes far beyond the fascics as to why the EMG is such a truly valuable exam for the neuro to diagnose ALS or something else.
puggriffey
Hero
Hero
 
Posts: 494
Joined: May 29th, 2004, 11:29 am

Postby dsiple on June 6th, 2004, 8:38 pm

So all of that being said, should I begin to worry more with having a few +1 fibs/pos. waves and fasics? I have been twitching since sometime in February of this year and still have no weakness/atrophy. My voice is much better than 3 months ago, but with a slightly abnormal EMG study, and a normal NCV test, I don't know what to think. I was hanging 4 X 8 sheets of drywall myself last night, so I know that weakness is not an issue, if it is, it is so slight that it is not noticeable. Suggestions or advice??

Regards
Duane
dsiple
Member
Member
 
Posts: 37
Joined: May 10th, 2004, 10:00 am

Postby puggriffey on June 6th, 2004, 9:02 pm

With all of that said, I think you have nothing to worry about, especially if the doc administering the exam is not concerned and gave you a "clean" report.
puggriffey
Hero
Hero
 
Posts: 494
Joined: May 29th, 2004, 11:29 am

Postby dsiple on June 7th, 2004, 7:50 am

Said at that time that they could not rule anything out and did state in their write up of EMG findings that it was an abnormal study. With improvements that I have had, I go back this Friday for re-evaluation.

Duane
dsiple
Member
Member
 
Posts: 37
Joined: May 10th, 2004, 10:00 am

Sponsor

Sponsor
 


Return to General Topics

Who is online

Users browsing this forum: Google [Bot] and 4 guests