u/Rich-Cow-8056

Update, original post: https://www.reddit.com/r/BFS/s/sXtPwZUDRX

https://ibb.co/XZkQgGFL

https://ibb.co/TMkKZv2g

https://ibb.co/Ps06gj4M

https://ibb.co/TxnDPJ9f

https://ibb.co/TMkKZv2g

https://ibb.co/sdgXJHcH

So unfortunately although my MRI did not come back clean but apparently it's not suggestive of causing the twitching that I've been having nor the nerve damage apparent on my EMG.

My autoimmune panel also came back clean.

After a bit more research I am more concerned than I was before not only because my differential diagnosis has suddenly reduced to two things, one of which we've already tested for, but also that I have chronic damage in my thoracic paraspinal muscle which appears to be a warning sign of MND.

Edit:doctor also consulted with a 2nd neurologist and they both think it doesn't look like ALS so recommended I redo the EMG.

Am freaking out a little, have booked a flight back to the UK for a consultation with an MND specialist in London next week.

Anymore reassuring stories of people with dirty EMGS/widespread reinnervation that turned out ok are very welcome right now 🙏

35 M

Results here:

Edit: new links for results https://ibb.co/vChYjDV1 https://ibb.co/CRLcCnC https://ibb.co/wN2zMdPY https://ibb.co/chnXtFWp https://ibb.co/fVWtmG38

https://postimg.cc/gallery/jRrSkgf

Been having widespread twitches for 11-12 weeks now.

No muscle weakness or atrophy.

Have actually felt I'm getting stronger in the gym.

No reduced recruitment or fibs in emg but worryingly has reinnervation in the thoracic muscle by the spine which is apparently rare in benign issues.

Mild denervation (grade 1)in right quads and right calf. Reinnervation in four of the five muscles tested.

I skateboard and lift weights and have had a lot of nasty falls on concrete the last few years, I don't give my body an easy ride (also very into partying during my 20s) and I'm wondering if that might be related to the widespread reinnervation I've seen.

I also suffered from quite severe long covid for several years.

My neuro was a little concerned about early stage ALS, but said it's more likely to be something else and has ordered spine brain and neck MRI which I'm doing tomorrow.

Wondering if it's worth getting a second opinion with a neuromuscular specialist once I get the MRI results.

Anyone had any similar experiences with your emg results?

Hi all,

Currently very anxious and stressed. Please help me make sense of my abnormal EMG results.

Symptoms:

- muscle twitching for 2.5 months. Moves around the whole body. Started on rib cage and above knee. Will stay in one place for a couple of days then move somewhere else and generally just rotate around multiple muscles. Comes and goes throughout the day. More obvious at rest.

- No muscle weakness. Gym lifts have got heavier in this time period.

- I quit caffeine 8 days ago. The twitches improved drastically for a few days then came back milder but also more widespread. I thought it might be related but after seeing actual denervation this might be a red herring.

I saw two doctors, the one who performed the EMG and a neurologist. Both told me there is a chance this is ALS. The neurologist said it's possibly a 10% chance. The other doctor said he would estimate under 10%.

The issue is, that when discussing with both of them I couldn't get any real answers on what else it could be.

I have had long covid for years, with weird symptoms coming and going since 2022. But I have lived a normal day to day life since 2023/2024.

They're both saying since I have both denervation and reinervation present that it could be ALS. But due to the way it's presented they both believe it's unlikely. The first doctor also told me the degree of denervation is low (grade 1) and he usually sees grade 2-3 in ALS patients.

I am of course freaking out, the EMP was hopefully going to rule out ALS and although they both told me it's a low chance I honestly can't think what else could be causing it based on what they said.

Could anyone give me some more insight? This hospital is in Thailand and there is definitely some level of language barrier at these appointments.

Thank you in advance

Full results:

https://postimg.cc/gallery/jRrSkgf

"conduction test was unremarkable in al 1 of the tested nerves: L Median - APB e motor he sensory conduction test was performed on 2 nerve(s). The results were normal in 1 nerve(s): L Median - Digit l1 (Antidromic). Results outside the specified normal range were found in 1 nerve(s), as follows: • In the L UInar - Digit V (Antidromic) study the peak latency result was increased for Wrist stimulation ‣The nerve conduction study was stopped due to patient's intolerance.

The needle EMG examination was performed in 5 muscles, It was normal in 1 muscle(s): L. Quadriceps. The study was abnormal in 4 muscle(s), with the following distribution • Abnormal spontaneous/insertional activity was found in R. Gastrocnemius (Medial head), R. Quadriceps. he MUP waveform abnormality was found in L. Flexor carpi ulnaris, R. Gastrocnemius (Media head), R. Quadriceps, R. Thoracic paraspinals (mid) Conclusion: The electrodiagnostic study shows chronic neurogenic changes involving involving multiple muscles, witt active denervation identified in the right medial gastrocnemius. These findings are consistent with a multifocal neurogenic process. The study is limited because nerve conduction study could not be completed Jue to poor patient tolerance. Further imaging studies should be considered to evaluate for structural lesions that may account for the electrophysiological findings. Clinical correlation is recommended"