A few questions

[German2]

What a pitty, that they just did mainly one limb in the EMG with me (left hand), which was NOT ok...except my neck and one muscle in the right foot - both ok. But all of the neuros were telling me, that after 2 years of symptoms and 15 month of twitchig there is nothing more to be afraid of. Hope they are right...

[TwitchyDoc]

German, after 2 years, the damage would be quite widespread across the myotomes. Depends on the findings in your hand, when you say it was not OK. Apparently it was not consistent with MND, which is great!

[Xina535]

Ok I think I am getting more informed here, thank you both.

Questions, hopefully simple ones:

What test/s can be done to determine UMN damage?

If the EMG can't detect UMN damage, but UMN damage is happening (only UMN damage), then will the EMG be clean/normal?

If someone has UMN damage, will it be obvious clinically (by the person's symptoms), or will they already have had at least some lower neuron damage picked up by the EMG?

[TwitchyDoc]

Xina, as I mentioned:

UMN damage is assessed by the clinical examination. Basically hyperreflexia (typically with spreading, i.e. the reflex can be elicited from a location nearby), spasticity, weakness, impared fine movements, loss of abdominal reflexes, positive Babinsky, clonus, increased jaw jerk (masseter reflex)..probably some more.

Trust me, UMN signs would not be missed during the exam. EMG would be clear.

If your clinical examination was clear, then you certainly do not have your descending motor pathways (UMN) involved.

UMN damage is not linked to LMN damage, both can exist independently as they are different structures. If only UMN is involved and there is no progression, the condition is called primary lateral sclerosis (because only the lateral columns - UMN - are involved). There are no LMN signs and hence no fasciculations.

Hope it helps with understanding and you can be reassured completely

[Xina535]

I see, ok ok!! Thank you! It does reassure me, thank you again!