FOLLOW UP QUESTION ABOUT EMGS

I asked a question the other day about how long it took for ALS changes to show up on a EMG. tHE response I was given was 3-4 weeks-- however does this mean FROM THE TIME the person has first experienced twiches and spasms or from when the changes first start in the body but have not presented as VISIBLE OR FEELABLE symptoms.

I am a bit confused as an answer given by neuro MM ON 9/16/99 question EMG AND THROAT WAS:

SUBCLINICAL MANIFESTATIONS OF ALS THAT IS CHANGES ON EMG WOULD BE PRESENT THREE WEEKS BEFORE THE ONSET OF CLINICAL SYMPTOMS  ALSO ANOTHER RESPONSE GIVEN BY A NEURO ON THE FORUM WAS:

BY THE TIME THE PERSON TWITCHES WITH ALS DENERVATION WOULD HAVE BEEN HAPPENING FOR 5-10 MONTHS SO WOULD BE READILY SEEN OM AN EMG AS SOON AS THE PERSON TWITHES OR HAS CRAMPS OR SPASMS. pLEASE COULD YOU CLARIFY THIS FOR ME
tHANKS
ara

[CCF-Neuro-M.D.-JT]

For diseases that affect the neuromuscular system in general such as carpal tunnel syndrome or weakness/numbness related to trauma like a car accident or surgery, the rule is that nerve changes will not show up on the EMG until 3 weeks after the symptoms start.

This is NOT true for ALS.  Research is showing that there are very subtle changes on the EMG weeks to months before the typical symptoms of twitching (called fasciculations) occurs. What does this mean?  Well, when a person cames in with weakness of specific muscles known to be affected early on in ALS like the hand muscles or the neuro exam shows things like brisk reflexes at the same time as weakness and wasting, then doctors tend to think, "This may be ALS, but I'm not sure because he doesn't have fasciculations." Then this person goes to get an EMG and they can see little changes that point to the diagnosis of ALS.  However, if you already have true fasciculations whether it's ALS or benign fasciculation syndrome, then that fasciculation will show up on the EMG in the pattern of a fasciculation.  If it's just twitching it will NOT show up as a fasciculation, which is a specific, well-described EMG finding that most neurologists should be able to recognize when they see it. So if you're having twitches and they're not showing up as fasciculations on the EMG, then it's probably not a fasciculation. Also, cramps and spasms can be seen on EMG. If you are still really concerned, I would recommend a high quality EMG at the Cleveland Clinic. Hope that clarifies things. Can;t comment on the response of the other neurologist as I would need to read the entire response and perhaps discuss this with him/her.

[lizbeth219]

please could you answer my question-thanks in anticipation ara

[Craig]

Check out www.aboutbfs.com. Follow the links to the MGH site/neuromuscular forum.

[lizbeth219]

pLEASE CAN YOU ANSWER MY QUESTION--THANKYOU

[lizbeth219]

pLEASE CAN YOU ANSWER MY QUESTION--THANKYOU