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Re: Hyperexcitability phase

PostPosted: March 12th, 2015, 6:28 am
by TwitchyDoc
The bulbar might not show up on the EMG if it is performed on the limbs only, of course. Bulbar muscles are innervated through cranial nerves and hence you would need to sample a muscle from this group (typically the tongue) to check if there is a damage in this area. But usually by the time a patient has bulbar symptoms, there is at least electrophysiological evidence of the disease in muscles innervated by nerves coming from the cervical spine. Patients with bulbar onset often has findings in deltoid and trapezius muscles.

So yes, with clean EMG, you can certainly rest. But you can rest by now already, all the issues you presented so far were just in your head (remember sending me the pictures of your soft palate, which was perfectly normal despite your perception?).

Re: Hyperexcitability phase

PostPosted: March 12th, 2015, 7:08 am
by misterjuanperalta
Further, that paper you point out also states that twitching by those younger than 45 years of age is typically benign. You seem to incline to pointing to evidence that does little to help your anxiety.

Re: Hyperexcitability phase

PostPosted: March 12th, 2015, 7:47 am
by crotwich
Hear, hear! Joycecaroll, you really need to stop this obsession, it's paralyzing you. I know it's hard, but just try to focus on real facts. Please read and reread what an MND specialist said to Bart about his concerns for bulbar (viewtopic.php?f=5&t=11487). Also, all neuromuscular specialists I visited said the same thing, so there is nothing you should be afraid of.

Re: Hyperexcitability phase

PostPosted: March 20th, 2015, 9:48 am
by joycecaroll
Had EMG and nerve conduction test today. He did my leg, arm, hand, trapzius and tounge. Nothing weird showed up. This is 6-7 months after fasciculation onset. Am I in the clear now? I wan't to let this go.

I still have minor swallowing problems. The feeling of liquid coming up my nose. Nothing shows if I blow my nose after swallowing, but if I sniss my nose it comes down my mouth. For example, if I've been drinking orange juice and sniff my nose and spit a while after, it will be orange.

Anyway. Clean EMG, no jaw jerk, can blow up my cheeks etc. Am I in the clear?

And PS: I'm really a wreck at this point, so please dn't say anything that will cause more doubt. It would just help to hear from someone that I'm out of the woods now, that's all I wan't to hear.

Re: Hyperexcitability phase

PostPosted: March 20th, 2015, 3:04 pm
by Yuliasir
you seemed to be checked in all critical areas, including tongue. Considering 7 months period, I personally think you could consider yourself cleared.

Re: Hyperexcitability phase

PostPosted: March 21st, 2015, 3:55 am
by TwitchyDoc
Joyce, there is nothing we can do for you. Only professional counselling/medication maybe - you were just cleared by the EMG, which would detect signs of the disease before they manifest clinically.
As for your PM - UMN would be clearly seen during the clinical exam.
Let this go, you are wasting your life. Now there is nothing that could reassure you more.

Re: Hyperexcitability phase

PostPosted: March 21st, 2015, 4:00 am
by joycecaroll
TwitchyDoc wrote:Joyce, there is nothing we can do for you. Only professional counselling/medication maybe - you were just cleared by the EMG, which would detect signs of the disease before they manifest clinically.
As for your PM - UMN would be clearly seen during the clinical exam.
Let this go, you are wasting your life. Now there is nothing that could reassure you more.


If UMN - would my tongue be moving slow?

Yes I know. I'm leaving this forum now and I'll work on my anxiety.

Re: Hyperexcitability phase

PostPosted: March 21st, 2015, 7:15 am
by misterjuanperalta
From my understanding, left, right tongue movement would appear as if the tongue was doing its own thing and not what you are intending for it to do, even if subtly. Slowness, upward tip curling, even pain when pertruding can manifest.

Re: Hyperexcitability phase

PostPosted: March 21st, 2015, 9:59 am
by joycecaroll
I read somewhere that Dr. Eisen think's that after 8 months, if there's no clinical signs, than it's not ALS. For me it's been about 6-7 months, so I'm thinking what if UMN signs show up in the next month etc etc etc. So that's why I'm wondering. Really, I can't believe I'm not feeling better after this EMG. I know I have OCD, but I'm really good at fooling my self. I really thought I would have let this go by now.

Re: Hyperexcitability phase

PostPosted: March 21st, 2015, 10:39 am
by joycecaroll
TwitchyDoc: I read your posts in this thread: viewtopic.php?f=4&t=21295&hilit=eisen&start=15

Serously, what does it mean? 14% presenting with only fasciculations?

Re: Hyperexcitability phase

PostPosted: March 21st, 2015, 11:15 am
by crotwich
I'm not sure if this will reduce your anxiety, but anyway:
1. You just had a clean clinical and a clean EMG after 6-7 months of (possible) fasciculations. When I say possible, I am not sure if they were confirmed by your neurologist?
2. To develop LMN signs after a clean EMG it would take (at least) several months.
3. Eisen said that, from his experience, if after 8 months there are no other clinical signs, then it is not ALS.

Conclusion: The probability that you have ALS is negligible. Or, to put it simply: You don't have ALS!!!

Re: Hyperexcitability phase

PostPosted: March 21st, 2015, 11:46 am
by Yuliasir
EMG is not a treatment procedure, and OCD could not be treated with any reasonable evidences.
OCD needs change of pathways in the brain, and this needs medication and counseling, not EMG etc.

Re: Hyperexcitability phase

PostPosted: March 22nd, 2015, 8:22 am
by joycecaroll
Oh I know Yulia. I would just love it if someone wanted to explain the thread I posted earlier. About 14% of patients having clean emg and clinical and still having als. Is this something I should worry about? Someone please just explain and then I'lI leave the forum and stop obsessing.

Re: Hyperexcitability phase

PostPosted: March 22nd, 2015, 9:17 am
by Yuliasir
Joyce,
I think it was explained many times before.
Anyway I did not read this study but only discussions. But I know - based on the stories of dozen of people here and two possible ALS cases (one later confirmed) - that in ALS or in MND, in general, neural deficites develop quite quiclky even if initial presentation is only twitching or twitching and cramps. So in 6-7 months there would be far enough evidences for at least keeping strict follow-up, if not for diagnosis.
You are not this case, none of your suspected and most often areas of deficite in MND - tongye, neck, limbs- has no signs of deneneration. No odds for you.

Re: Hyperexcitability phase

PostPosted: March 22nd, 2015, 2:36 pm
by misterjuanperalta
Normal persons twitch and there are studies that show this. Not feeling them is no different than feeling them. Therefore, you are in the same boat as everyone else. Regards.