4 years in - mildly dirty EMG
Hello all,
Skyfox here. It's been a long time since I've checked in. Reason being that, mostly, I wanted off the anxiety train and to just go live my life as fully as I possibly could in defiance of any prior health anxiety associated with worsening symptoms. It was, honestly, the best decision I've ever made for myself.
Despite progressing symptoms, additional pain, mobility loss and daily struggles, in time, I adjusted to my new normal. Dropping small objects or fumbling buttoning a shirt just became a minor annoyance, the invasive thoughts about life being nearly at its end were pushed to the back of my mind, and when they came up I'd focus on doing things that made life feel worth living. In the end, I came to feel that there's no way to know when my time is up, and I'll waste whatever time I do have if I spend each day focused on the final days instead of being present for my loved ones, my son, my friends, and even my continued healing of my mental health and happiness. Years ago I lost everything with worry when *** fears took over my life. And I never wanted to go back to that dark place.
So I don't come here today in fear for the future. Or spiraling about the end. But rather. Just to post an update, and perhaps gain some insight on these results if anyone else has also gotten something similar before.
Specifically, Neurology is suspecting this may point towards cramp fasciculation syndrome. And I am curious if others had an EMG similar to this one, a diagnosis of CFS, and how that played out for you long term in terms of symptoms and progression.
Background:
My symptoms began in June of 2022, with first EMG a couple months later. Normal. My last EMG was in 2023, also normal, and at the time I didn't feel quite satisfied with the dismissive attitude of the neurologist I was seeing. I was investigated for small fiber neuropathy, ***, and other conditions at the time. But results came back normal. At the time, also, most of my symptoms had been on the left side, but were beginning to migrate to the right side as well. I was diagnosed with fibromyalgia (and implied health anxiety) and sent on my way.
Things continued to decline but I stopped getting testing or investigating until recently when my handwriting became almost illegible, my right hand began to have tremendous stiffness that came and went, and my thumb wasn't wanting to follow instructions when it came to typing or other tasks. Also occasionally losing my voice for days at a time before it becomes back, developed a chronic cough, and much more difficulty navigating stairs. My legs feel smaller. I've lost a lot of weight, but it isn't fat weight. So. It felt time to check again.
MRI came out normal save for an enlarged perivascular space in my basal ganglia. Today I had my EMG. Surprisingly, despite all of this originally starting on my left side, only my right side is now showing abnomalities on the EMG.
Here's the interpretation and results:
Impression:
There were findings isolated to the right APB with increased spontaneous activity, fasciculations, and cramp discharges, with no other significant localizing findings elsewhere.
In the setting of scant/very rare fasciculations in non-localizing muscles elsewhere, this can be seen in benign cramp-fasciculation syndrome, metabolic/electrolyte disturbances, local muscles factors (non-neurological) or could be a normal variant. Clinical correlation is advised.
Otherwise, there was no evidence of large fiber polyneuropathy, myopathic discharges, right C5-T1 radiculopathy, bilateral L2-S2 radiculopathy, right median or ulnar neuropathy on today's study. Serial NCS examination over the last three years has continued to be unremarkable.
Nerve Conduction Studies:
The following nerves were tested and were normal/unremarkable:
Motor: right median, right ulnar-ADM, right fibular-EDB, right tibial-AHB, left fibular-EDB, and left tibial-AHB
Sensory: right median DII, right ulnar DV, right radial snuffbox, right median-to-ulnar palmar comparison, right sural, right superficial peroneal, left sural, and left superficial peroneal
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EMG Summary:
1. Findings of scant fasciculations in muscles listed in EMG table
2. There was disproportionate increased IA, frequent fasciculations, and cramp discharges in the right APB
3. Otherwise, muscles selected for testing in the bilateral lower limbs and right upper limb were normal.
Results images: