Autoimmune Disorders Expert Forum
Can you decipher this
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Welcome to the Autoimmune Disorders forum. Questions in this forum are being answered by Dr. Garth Nicolson. This forum is for questions and discussions relating to Autoimmune Disorders. Topics include, but are not limited to: Alzheimer’s, Amyotrophic Lateral Sclerosis (ALS), Chronic Fatigue Syndrome, Fibromyalgia, Gulf War Syndrome, Lupus, Lyme Disease, MS, Rheumatoid Arthritis

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Can you decipher this

Had recent EMG on left arm and would like to know how can a dr. diagnose with just one EMG?  Here are the results
Findings:  Sensory nerve action potentials and compound muscle action potentials were all normal in the left upper extremity.  Concentric needle EMG evaluation (all left sided) noted no spontaneous abnormalities at rest in any muscle tested.  In the flexor carpi radialis, flexor digitorum sublimis, and to a lesser degree, the biceps, were seen myopathic-appearing motor units (low amplitude, polyphasic) and in some areas, continuous dense firing of MEPs.  However, the degree of firing did seem to abate when I had the patient attempt to activate antagonist muscles.  Continuous MUPs were seen in the sternocledomastoid.  Needle study of the triceps an extensor carpi ulnaris were normal.
Conclusions:  Abnormal study.  The findings in this needle study were suggestive of a myopathy.  In addition, there is evidence for continuous firing and generation of motor unit potentials that may be upper motor neuron or cerebrally initiated.
Approx. 1 year ago I started with muscle spasms and overall weakness.  A month later, I was unable to move my left arm, shoulder and neck/head.  Muscle spasms continued and was put on baclofen and flexeril.  Noticed a change in the voice.  Now one year later, voice has become very "hoarsey" and at times like a whisper.  Muscle spasms have increased and I can no longer bend at the waist (muscle spasms in calves and backs of thighs) nor walk across the floor without wearing shoes.  Dr. wants to do Botox injections in neck to see if it will stop the spasms.  Had 2 MRIs of neck and cervical areas all neg. and the only abnormal bloodwork levels were CPK which was elevated.  What other tests should I ask to have done and is there any other medicines that would aleviate the spasms.?
Tags: ALS, Neurology, PLS
642304_tn?1242610324
Although I cannot intrepret your EMG findings for you (I am not a neurologist), muscle and nerve problems such as myopathy can be the result of chronic infections that invade the peripheral and central nerves.  We have seen this in atypical ALS and MS, where infections were common and could be successfully treated and symptoms slowly subsided.  In extreme cases, nerve cell death can occur, resulting in permanent loss of function.  You are fortunate to be looking for possible solutions before the clinical course worsens to the point where not much can be done to reverse your condition.

Prof. Garth Nicolson
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I would like to thank you for your quick response.  Finding the right doctor is very important in getting to the right answer.  Whatever the outcome, I at least know that I did everything that I could do to get there.
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