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What Are The Symptoms Of Myopathy?
Question: Does EMG Impression of axonal loss on right at a length dependent fashion with diffuse evidence of myopathic discharges appear to be a diagnosis of ALS?
Brief Answer:
Not at all.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Straightforward,the answer to your question is a big-''NO''
Though,nerve conduction studies(NCS) may show findings suggestive of axonal loss but its almost of no significance unless and until EMG shows-
1)NEUROGENIC PATTERN OF MUAPS
2)HIGHLY INCREASED AMPLITUDE OF MUAPS.
3)DECREASED RECRUITMENT OF MUAPS.
4)Last and most importantly,FASCICULATION POTENTIALS.
The findings you have described take nowhere,as if now because-
length dependent axonal loss is suggestive of neuropathy, and
myopathic discharges are suggestive of myopathy.
So,its just illogical to say that patient has neuropathy and myopathy at the same time.May be,I can make a better impression if you can upload your EMG reports.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review as your rating will be of help to me.
Dr.Ajay Panwar,
MD,DM(Neurology)
Not at all.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
Straightforward,the answer to your question is a big-''NO''
Though,nerve conduction studies(NCS) may show findings suggestive of axonal loss but its almost of no significance unless and until EMG shows-
1)NEUROGENIC PATTERN OF MUAPS
2)HIGHLY INCREASED AMPLITUDE OF MUAPS.
3)DECREASED RECRUITMENT OF MUAPS.
4)Last and most importantly,FASCICULATION POTENTIALS.
The findings you have described take nowhere,as if now because-
length dependent axonal loss is suggestive of neuropathy, and
myopathic discharges are suggestive of myopathy.
So,its just illogical to say that patient has neuropathy and myopathy at the same time.May be,I can make a better impression if you can upload your EMG reports.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review as your rating will be of help to me.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Shanthi.E
Reports are attached with transcription information.
Brief Answer:
Please provide clinical details.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and uploading documents.
Surely,left tibialis anterior and right rectus femoris show findings suggestive of neurogenic pathology.
But,EMG has any significance only if it is in clinical correlation.So,please provide the clinical details so that I can make an impression about the pathology.
Please be in follow-up.
Dr.Ajay Panwar,
MD,DM(Neurology)
Please provide clinical details.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and uploading documents.
Surely,left tibialis anterior and right rectus femoris show findings suggestive of neurogenic pathology.
But,EMG has any significance only if it is in clinical correlation.So,please provide the clinical details so that I can make an impression about the pathology.
Please be in follow-up.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Shanthi.E
Dr. Panwar, unfortunately that is the only results provided to me.
I went to the ER this evening because my muscle weakness has increased since the EMG and I have abdominal discomfort and low back pain. I also have muscle twitching throughout my arms and legs.
I am a single Mom with a 20 year old daughter and I am so worried. We have no family.
Do you think any additional tests will be done or is this study enough to confirm ALS?
Thank you!
I went to the ER this evening because my muscle weakness has increased since the EMG and I have abdominal discomfort and low back pain. I also have muscle twitching throughout my arms and legs.
I am a single Mom with a 20 year old daughter and I am so worried. We have no family.
Do you think any additional tests will be done or is this study enough to confirm ALS?
Thank you!
Brief Answer:
I feel concerned.Repeat EMG after 2 months.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up again.
I feel deeply concerned about your situation.I offer my prayers to God for your health.
EMG is the only diagnostic test available to diagnose ALS.So,please get it repeated after 2 months to see whether similar changes evolve in further muscle groups.Actually,to diagnose ALS we need similar changes in muscles corresponding to atleast 3 or more spinal regions(bulbar,cervical,thoracic or lumbosacral distribution-out of these atleast 3).Please follow-up with repeat EMG.
Further,I would like to ask-
1)What is the total duration of your illness?Since how many years?
2)Which of your muscles are weak?Name them or just tell region wise like distal hand,or distal leg or proximal arm or thigh----like that.
3)Are the muscles just weak or are they thinned out also?
4)About low back pain-since when it started.Does it radiate from back to thighs or gluteal region?Do you have tingling in legs?I am asking these details because your EMG is abnormal in leg muscles only and quite commonly lumbosacral radiculopathy can present with such changes in muscles,which can confuse with ALS.Is your MRI spine done?
5)Name muscles or atleast tell region wise that in which muscles you have twitches?
MRI Spine has to be done before we can label a disease as ALS.It is -THE PROTOCOL.
Please follow up with details.
Dr.Ajay Panwar,
MD,DM(Neurology)
I feel concerned.Repeat EMG after 2 months.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up again.
I feel deeply concerned about your situation.I offer my prayers to God for your health.
EMG is the only diagnostic test available to diagnose ALS.So,please get it repeated after 2 months to see whether similar changes evolve in further muscle groups.Actually,to diagnose ALS we need similar changes in muscles corresponding to atleast 3 or more spinal regions(bulbar,cervical,thoracic or lumbosacral distribution-out of these atleast 3).Please follow-up with repeat EMG.
Further,I would like to ask-
1)What is the total duration of your illness?Since how many years?
2)Which of your muscles are weak?Name them or just tell region wise like distal hand,or distal leg or proximal arm or thigh----like that.
3)Are the muscles just weak or are they thinned out also?
4)About low back pain-since when it started.Does it radiate from back to thighs or gluteal region?Do you have tingling in legs?I am asking these details because your EMG is abnormal in leg muscles only and quite commonly lumbosacral radiculopathy can present with such changes in muscles,which can confuse with ALS.Is your MRI spine done?
5)Name muscles or atleast tell region wise that in which muscles you have twitches?
MRI Spine has to be done before we can label a disease as ALS.It is -THE PROTOCOL.
Please follow up with details.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Shanthi.E
Dr. Panwar,
I have felt weak for several years. I was always at the doctor telling him, I must have thyroid problems, lupus or something. I would wake up at night and could not swallow and had a swallow test done (which still happens - thought it eas from thyroid nodule) have had problems with foot pain for 2-3 years and numbness in toes along with weakness in hands and abdominal discomfort. When the pins and needles started up my feet and legs I also experienced pain in my calves. I ignored for many weeks and by then the feeling had started in my fingers. I went to doctor and he ordered EMG. The pain is currently in feet, calves, thighs, back, abdomen, hands and head. The twitches are in my thighs/calves and arms/hands. My fingers are numb holding my cell phone now.
I wish you could help me, but I know that is not possible. Thank you for you prayers. I cannot even get my doctors here to return my phone calls.
Thank you!
I have felt weak for several years. I was always at the doctor telling him, I must have thyroid problems, lupus or something. I would wake up at night and could not swallow and had a swallow test done (which still happens - thought it eas from thyroid nodule) have had problems with foot pain for 2-3 years and numbness in toes along with weakness in hands and abdominal discomfort. When the pins and needles started up my feet and legs I also experienced pain in my calves. I ignored for many weeks and by then the feeling had started in my fingers. I went to doctor and he ordered EMG. The pain is currently in feet, calves, thighs, back, abdomen, hands and head. The twitches are in my thighs/calves and arms/hands. My fingers are numb holding my cell phone now.
I wish you could help me, but I know that is not possible. Thank you for you prayers. I cannot even get my doctors here to return my phone calls.
Thank you!
Brief Answer:
Please get MRI spine done.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up again.
See,I am concerned and I advise you sincerely to get a MRI spine done and follow-up here.This is because there are a few points which are almost against ALS and these are-
pins and needles sensations
numbness(may be seen rarely)
So,there may be a possibility of this being degenerative spine with radiculopathies rather than ALS.
Also,please upload your latest 'Thyroid function tests' report.This is important too because hyperthyroidism very commonly cause diffuse muscle twitches.
So,at this point itself,I just am not able to accept it as ALS.
I shall be glad to have you in follow-up if you have further questions.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Please get MRI spine done.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up again.
See,I am concerned and I advise you sincerely to get a MRI spine done and follow-up here.This is because there are a few points which are almost against ALS and these are-
pins and needles sensations
numbness(may be seen rarely)
So,there may be a possibility of this being degenerative spine with radiculopathies rather than ALS.
Also,please upload your latest 'Thyroid function tests' report.This is important too because hyperthyroidism very commonly cause diffuse muscle twitches.
So,at this point itself,I just am not able to accept it as ALS.
I shall be glad to have you in follow-up if you have further questions.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Shanthi.E
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