Is this EMG report considered "clean"?

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Is this EMG report considered "clean"?

Postby stevenvp on June 16th, 2008, 12:42 pm

First, some background...

1) fasciculations started occuring about 2.5 months ago. they first appeared in my right foot (arch/instep) and have since spread to both feet and calves (pretty constant) as well as episodic fasiculations in the buttocks, tricep, shoulder, hands.

2) onset of fasciculations followed a very stressful situation for me where i suffered a severe disc herniation that kept me immobilized for several months. then, started on physical therapy and cardio exercise, at which point the fasciculations commenced.

3) at the same time the fasciculations started, i got my orthopedic (back) doc to refer me to a neuroligst as i was experiencing nerve-related stuff in my back but also some numbness in my left hand. the neuro did a clinical exam and ran tests to check for MS (MRI scans of brain and neck, which were negative) and an EMG to see if there was something going on with the ulnar nerve. when i went in for the EMG, i told him that i just started experiencing the fasciculations. The EMG report results are below. The neurologist said "you are not showing evidence of ALS, but i cannot rule it out...come back in a few months"

Two questions:

1) is this considered a clean EMG report (see below)? the reason i ask is that the report mentions fasciculations and i thought i read somewhere that benign fascics do not show up on an EMG report. And, the report mentions that denervation is seen (but, the report also says that no "active" denervation is seen). i am hoping this latter statement is the more relevant.

EMG Report (May 7, 2008)

EMG of the upper left extremity shows a few fasciculations in the left abductor digiti minimi muscle.

EMG of both lower extremities shows a few fasciculations in the gastrocnemius muscles bilaterally and in the left abductor hallucis muscle. There was also chronic denervation i the iliopsoas, quadriceps, tibialis anterior, peroneus longus and gastrocnemius muscles bilaterally, left worse than right. No active denervation is seen.

Nerve conduction study shows borderline left ulnar motor conduction across the cubital tunnel. This could be within normal or might suggest a very mild irritation to the left ulnar nerve.

There was mild chronic denervation in the L4, L5 and S1 nerve root distribution bilaterally, left slightly worse than right and especially at the L5 nerve root.

There were sporadic fasciculations seen in the lower extremities and in the left upper extremity, mainly in the distal muscles. These were not associated with active denervation. These could be part of the lumbar radiculopathy or they could be benign fasciculations. Follow up study in 3 months is recommended.



2) i also made the mistake of googling whether fasciculations can precede the onset of weakness and atrophy and be and early sign ALS. Everything i have seen (particularly from posts from Aaron) lead me to believe that there must be weakness identified first (or at least at the same time). one of my concerns is that i have not been experiencing fascis for a very long time (2.5 months). see this excerpt from a Neurology journal article below, which concerns me....


Neurology. 2004 Aug 24; 63(4): 721-3de Carvalho M, Swash M
Fasciculation and cramps without weakness or muscle atrophy are recognized as a benign syndrome. The authors report a patient with cramp and fasciculation, which persisted for 1 year without abnormal motor unit morphology on EMG before progressive weakness, muscle atrophy, and EMG abnormalities developed. This observation raises the possibility that lower motor neuron hyperexcitability may precede motor neuron death in motor neuron disease.


i don't want to create any anxiety in anyone, i just want help in reducing the anxiety i am feeling.

thank you
stevenvp
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Is this EMG report considered "clean"?

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