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Neurology (Expert Forum)
Clean EMG and development of MND?
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Clean EMG and development of MND?
by moz, Mar 12, 2003 12:00AM
This is a question for CC Neuro JT:
Did you find out any information on these reports? Thank you for your valuable time!
>Now there are a handful of reports in the medical literature of >patients who had twitching for a few months before the >development of weakness that went on to develop ALS. But I >don't have the data as to whether or not they had an EMG before >the development of weakness, meaning it's possible that there >may have been changes on the EMG (if one was done before ALS >was suspected) even before they had clinical weakness. I will >certainly get back to you on that in the next few days as a >followup post.
Did you find out any information on these reports? Thank you for your valuable time!
>Now there are a handful of reports in the medical literature of >patients who had twitching for a few months before the >development of weakness that went on to develop ALS. But I >don't have the data as to whether or not they had an EMG before >the development of weakness, meaning it's possible that there >may have been changes on the EMG (if one was done before ALS >was suspected) even before they had clinical weakness. I will >certainly get back to you on that in the next few days as a >followup post.
Doctor's Answer
by CCF-Neuro-M.D.-JT, Mar 17, 2003 12:00AM
Yes, I looked through 5 reports dating back to 1982. Unfortunately, none of them had any clearcut data as to when or if they they had the EMG prior to the development of weakness. Now keep in mind this was before the age of the internet and before people had widespread knowledge about ALS, fasciculations, and BFS. So I suspect that these patients who started out with twitching did not seek attention until after the development of other neurological problems such as weakness and wasting. Thus, their workup (including the EMG) was likely not done until after other more characteristic symptoms of ALS developed. So to make a long story short, as I stated before, I would tell my patients who had twitching in the setting of a clean EMG and exam that they did not have ALS. And although it's not clear as to exactly when the EMG was done in those brief reports of patients who presented with fasciculations first, it's very likely that they had the workup done after the other signs of ALS had set in(based on the fact that most people at that time didn't know the significance of muscle twitching and probably didn't seek help until later).
Hope that answers your question.
Hope that answers your question.
Mike