Dx. Fasciculations.. emg question

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Dx. Fasciculations.. emg question

Postby Snowblined on September 12th, 2002, 6:18 pm

Have been having a lot of twitching since the end of May. Think I probably twitched some before, but I decided on seeing a doc when my toe started tremoring because of calf/ instep fasciculation. Then it became body wide and the rest has been what you all have probably experienced. Neuro exam was basically unremarkable. Only thing mentioned was a "trivial" asymmetry of reflex. Two months later, had the emg.

Just got my emg report via mail. Dx. Fasciculations, R>L LE, intermittent. My NVS was normal, as was my emg (as said by neuro, who said that she can't find evidence of MND). There were three fascics noted (no mystery there!). The only thing I'm a little concerned about is the fact that my right gastroc, left Gmax, and right L5-S1 paraspinal muscles showed slightly large motor unit potentials.

She did mention this to me during the test, and said it was well within normal range. Do you think I should be overly concerned about this? :?:
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by the way,

Postby Snowblind on September 12th, 2002, 6:23 pm

the interpretation was that she feels this problem is the residua of a mild right S1 radiculopathy. Any feelings one way or other about this?
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you are ok

Postby concrete on September 12th, 2002, 9:46 pm

a normal emg means no als.
do not question your dr. they are pros.
they can tell signs of als a mile away.
you have bfs and nothing more...
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Postby Arron on September 12th, 2002, 11:50 pm

I'm no spinal expert but from what I read about youyr exam is that you probably have some kind of disc problem in your back that could be the result of a slightly bulging disk or compressed disk maybe from a bicycle accident, a roller skating accident or anything like that at a younger age and back injuries (or spinal injuries) can cause all kinds of strange problems and sensations. Not saying that is what you have, because it does sound like you have BFS but maybe you have a back thing going on as well? Like so may of us out there, all it takes is one single "oops!" and it is there for life. maybe Dr Jon (who is a chiropractor) here can elaborate a bit more for you. Like I said, I don't know much about L01's L'5's or L-10-11 Jets for that matter. Congrats on your clean EMG though, that pretty much rules out ALS or anything like that so you can relax now. :-)
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Abnormal motor unit potentials/Fasiculations/EMG/NCV/MRI

Postby Dr. Jon on September 13th, 2002, 5:06 am

Snowblind, Im the Chiro that arron spoke of. I have seen plenty of emgs with slightly abnormal motor unit potentials. While we would take note of any symtoms that would indicate any upper or lower motor neuron disease the negative nerve conduction velocity test would have shown this, especially in lower motor neuron lesions. Your symtoms and test results sounds like a case of benign fasiculations. You may also have an underlying L5-S1 mild radiculapathy. When a pin wheel or safty pin tesst was performed was there any difference in sensation? If you continue to have worry which you should not! but if you can not shed the concern then have a lumbar MRI performed checking for mild cord pressure (usually from disc herniation). It it is non avasive and there is no radiation. Really not necessary as your symptoms due not warrent it but do it if you need it to sleep better at night!
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EMG

Postby Jenn on September 13th, 2002, 11:20 pm

I am new to this website, and what a relief it is to find it. I can identify with nearly all of the symptoms that are described. I had my second and final appointment with a neurologist today. My blood work is normal, and an MRI of my brain is normal, as is the EMG that was done today. During the EMG, the muscles that were being probed (?) would spasm. It was as bad as being in labor. While they spasmed, I had twitching everywhere else. The neuro could not see the twitching, nor did the twitching show up on the EMG. On my first visit he said that I might have Benign Cramping Syndrome. Today, he said that maybe I have Chronic Fatigue Syndrome and he is sending me back to my GP. I looked up CFS, and I can't relate to those symptoms. He never mentioned BFS, and frankly I'm not sure if he even believes that I have any twitching at all after today. I wish that I had found this website before today so that I could ask him about it. Do some neuros not recognize BFS as a condition? Also, are EMG's normally very painful? Two of my in-laws had EMG's last year and said that they were only mildly uncomfortable. One in-law's EMG lasted for 90 minutes! I was nearly in tears after just 20 minutes of toruture today!
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Postby Dr. Jon on September 14th, 2002, 12:37 am

Jenn, basically what your neuro has concluded is that you do not have any neurological diease. It is not abnormal for the needle insertion to cause some cramping. Most people do not get twitching from it but then again since you probably do have benign fasiculations and it would make sence that the stress of the test activated the twitches. Most people complain that the test is painful to some degree. Some do complain of extreme pain. There is no association with the degree of pain one feels on an emg test to mean anythingthat i know of. From the posts that i have seen from arron there does seem to be some overlap with bfs and cfs and bcs, but most neuros will just call it as benign fasiculations and there is nothing to worry about them. trust your neuro in that he is sending you back to the gp becasue there is nothing neurologicaly wrong with you other that a case of benign twithes and cramps.
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Question for Dr. Jon

Postby wooglins on September 16th, 2002, 9:05 am

I have been having problems with BFS-Whatever it is, for about 3.5 months. When this started I went to my chiropractor, who discovers if he bent me to the right and back I had severe pain that ran all the way to my toes. This was on the leg I have problems with. I was excited because I thought we had found an answer to my problems. Well My Spinal MRI on my lower back was normal. What should I think?

PS-

Had a normal EMG in leg 1.5 months ago, and normal Neuro Exam 2 weeks ago.
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Moved my question

Postby wooglin on September 16th, 2002, 9:55 am

Moved my above question
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leg pain and fasiculations

Postby Dr. Jon on September 16th, 2002, 9:30 pm

Wooglin, the test you are referring to is called "kemps" orthopedic test . It checks for radiculapathy caused by facetal imbrication (jamming of the facets at in the loerback at L5-S1 level). Unfortunatly there is no association with that and your fasiculations. Since the mri was negative that rules out disc involment and confirms facet imbrication. Fortunatly this condition responds very favorably to chiropractic care. You should notice a difference within a few treatments (manual adjusting) and should take no more than 12 visits. Lower back flextuin excersisses are helpful and stay away from any hyperextension excersises. (leaning backwards).
Sounds like your twitches are benign and the only thing to do about thenm is to try and ignore them.
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Thanks for your response

Postby wooglin on September 16th, 2002, 10:57 pm

I have been to the Chiropractor about 10 times, and the weakness and pain in my right leg has not gotten better, and my right lower back is sore off and on. I do have bad cramps in the affected leg, as well as other parts of my body.
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leg numbness

Postby Dr. Jon on September 17th, 2002, 2:20 am

Wooglin, I would need to know more info on what tpe of adjustments that you are recieving and if the chiro is using any p.t. with you.
howerver since this will get off the bfs info i think it would be best to send me a personal message or email.
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Postby Jen on September 25th, 2002, 7:14 pm

Thanks for your reassuring words, Jon. Looking back on my post (I signed on as Jenn-guest), I realize that what I wrote could inadvertently discourage someone from getting an EMG. Yes, my EMG did hurt, however, my neuro said that it is NOT common for an EMG to cause the spasms that I experienced. Regardless of how the EMG felt, I would do it again in a heartbeat. I am much happier and calmer knowing that I have a clean EMG. It was worth every bit of discomfort.
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