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EMG test
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EMG test

Hi everyone,
I had my EMG test done on my legs today by my neuro.  OMG, that was awful!! I definately do not have nerve damage,
My test was good, however, My right leg was extremely sensitive and jumping and kicking all over. He even said with a laugh " Please don't kick me" and I said with a laugh, " I will try my best but I can't promise anything" LOL

Question:   What type of response does the doc. look for in one of these tests?  And, What is that needle ***** in my legs and lower back for?

My response was overexcited in the right leg and normal in the left leg.

Thank you , Pamela
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the EMG tracks the transmission of the electrical current in your nerves and the impulses in your muscles.  Just because you had the feelings from the current doesn't mean you don't have damage.    When do you get your results?

Lu
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Hi Lulu, My neuro did the test so he gave me the results right then and there. He said everything looked good and that my left leg had a weaker response but it was still good .He said that my right leg was very sensitive to the test ( very jumpy and extreme).

He asked me if I have had a lumbar MRI (this is the third time he has asked me). I told him I did and it was ok. He then proceeded to tell me that I have some arthritis.
Once again, he was stumped and came out with an answer.

He knows I have all of the neurological clinical signs but because the MRI's are not showing anything, he is not saying anything. Oh wait... he did say, "You have had every test under the sun done" . So my next step is to get to Rochester ms center to see the ms specialist. I was told by my endocrinologist a couple of weeks ago, that he thinks its time that I saw one.


One more thing... the right leg that was responding so wildly is the leg that has a more brisk response during the knee tap. I have hyperreflexia, and when he just  so slightly touched my leg, it went berzerk!!

Thanks, Pamela
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They are looking for two things:  Waveform and latency.  If they are fine, then the damage is in the CNS.  Most of the time, the EMG which test the muscle action potential (CMAP) is combined with the an NCS (Nerve Conduction Study) that measures the SNAP (Sensory Action Potential.)  

In MS, these should be normal, although myclonic muscles can mess with the CMAP waveform.

Bob
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These tests (EMG and NCS) help determine if symptoms arise from a muscle or nerve problem.  The needle is used to better isolate and test small muscle fiber groups and deliver controlled stimulation to nerves.  

The EMG (electromyography) part was when you would have been asked to hold a muscle contraction briefly after a fine needle was inserted.  The machine records the electrical activity in the motor units of the muscle.  This shows the doctor how well the muscle is working.

The NCS (nerve conduction study) part was when you felt the zaps.  The machine delivers a small (yeah, right) electrical stimulation and then records how long it takes the muscle to react and the amplitude of the response.  This response tests the peripheral nerves conduction but doesn't involve the CNS (spinal cord and brain) therefore it doesn't evaluate for MS.  An abnormal test would point to a diagnosis other than MS.  Your exagerated response is of interest but not diagnostic.  

Remember, MS is a diagnosis of exclusion.  When it's nothing else, it's MS.  In theory anyway.  I know not all the docs see it that way.

This is one of the tests I'd have to really think about before submitting to again.  Who thinks these things up???  Glad your's is behind you now.

Mary
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Thank you Bob and Mary. I was quite shocked when my Neuro's answer to me after this test was "maybe you have a little bit of arthritis".

I am glad also that the test is OVER. I am in alot of pain today and my legs feel very weak. I feel like I was struck by lightening and still have the voltage going through my legs. I pray to God that I Never have to do that test again.

I am hoping that someone may be able to share their experience and how their responses were during a test like this.   I am curious about my hyper reactions.

Thanks for everything, Pam
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drsdonthelp,

I had my EMG almost two weeks ago - my test results were fine but I had the opposite issue as you.  The doctor informed me that I seem to have a high tolerance for pain because I barely responded. I have to say that I am suspicious that instead of having pain that I've become desensitive to it. I have two bulging discs and a annular tear in my neck and it barely is bothering me right now. This test more or less tickled me. My muscles jumped but it more or less cracked me up. Strange huh?  

The test I felt I reacted more to was the EEG. I felt muscle twitches (this is one of my leading symptoms) more significantly during the test and the days that followed. It also came back fine.  

I have my brain MRI on Friday. I am very anxious to see the report.
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Pam,

I hope you get some answers from the Rochester clinic!!
p.s.- if they send you for an MRI, be sure it is a 3T one. My first MRI was done on a 1.5, and they accepted those results at the Rochester MS Clinic. My current neuro sent me for a 3T MRI about 2 months later, and that showed multiple subtle lesions in my brain.

I'm thinking of you! Get some rest!
~Jess
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An EEG only measure voltages.  It should not cause you any discomfort.  If there was any twitching and jumping, your body was causing it.

I disagree with Jess.  If you have seen my thread on MS and MRI, it should be up to your doctor to decide what kind of MRI to send you for.  3T MRI time is in short supplu in most parts of the country.  A 1.5T with good technique and being read by a neuroradiologist will be fine in most cases.  Your best bet for quality MRIs and a good read by a neuroradiologist is at a teaching hospital.  The fact that Jess' 3T sudy showed them could just mean the first study was read by a General Radiologist.

In a clinical study, 3T units only resolved 20% more lesions than a 1.5T.   All the stories are anecdotal.

Bob
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Sidesteps- Did you have the test done on your arms? I have had that done before because of my disc bulges in my neck as well. LOL It wasn't as bad on my arms as it was on my legs.
No tickling for me on the legs, just alot of pain, and electricution. Super hyper responses.
Good luck on your MRI

Jess- Thank you, I will try to get some rest, but I know, you know, its kinda impossible when you have kids, and they are sick with strept throat on top of it.

My kids know when i am sitting, that's when I hear "mom, mom, mommy, ma, mama" just like that little kid on family guy. I don't even watch that show, but I cracked up when I saw that commercial.... that's my kids when I am trying to rest. LOL LOL

I still haven't found anything out about my appt. at the Rochester clinic. I am hoping and praying that I can have some closure on this waiting game that I keep playing.


Bob-  Thank you always for your wisdom. I appreciate and look forward to reading your answers. I have read your post, and obviously could not respond because I don't have that knowledge.

Would it be too pushy for the patient to suggest that type of  MRI after the doc. says he wants to get a test done? I normally try to just listen to what my doc's say and pretty much go with the flow on whatever they decide.

Maybe I won't even need another one, I have had all  the other signs pointing in that direction, just the neuros are not giving me the right answers.

Thanks again everyone,
Pamela

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Hi Pamela. That sounds horrific! I had an NCV done and barely felt it. But I've heard the EMGs aren't as easy to get through.

On the MRI issue, when scheduling my c-spine with the MRI center, I asked them if the doc ordered a 3T. They said it didn't say and asked if he wanted it done on the 3T. I told them I wanted it done on the 3T and that's what they did. They said it would be a longer wait, but the wait was only a matter of one or two days longer.

It's your test, you and your insurance company are the ones paying for it. It doesn't hurt to ask.
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Hi JJ, yes it was horrific! I can't believe how much my right leg was so hyper!! I was nervous when he said he still had my left leg to do. He said ok I am done. I was like, yay, and then he said, now I have to do the left one. OMG, I havve to go through this again!! That's when he said, please don't kick me!! LOL
I hope when I go to the Rochester clinic they reccomend another MRI. If I have to have one done before I go to my appt. I will ask to be sent to the new MRI place that just opened up close by to me. They have the 3T machines.
Pamela
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