question regarding EMG

[dont]

Hello.

I have had generalized anxiety disorder with twitching for exactly 8 months. I went to my neurologist 3 times. Had normal exams all three times with insistence that it was just benign fasciculations agravated probably by my anxiety. I could not stop worrying about it being ALS.
I saw him yesterday and I told him that I was still worried about this being ALS and couldn't get past it. He did an exam and said I should play sports I was so strong and said reflexes were great. He did a very quick nerve conduction study which he said was normal and he did 4 EMG pokes in my right leg which is the most affected by the twitching. I do twitch from my eye brows to my toes, however. the first 3 pokes showed nothing and the 4th poke he said showed some nerves firing but he said it was not a fasciculation. He called the study normal and told me to go play a sport or exercise to rid myself of anxiety.
Can you please tell me if 4 pokes in one leg after 8 mo's of twitching is enough with no other symptoms? No weakness or atrophy just twitching all over for 8 months. He said because of my all over symptoms that the 4 pokes in one limb was enough to rule out anything bad accompanied by my excellent exam. Also in addition to telling me if you would feel this was enough for me to move on what does "nerve firing" mean as opposed to a a fasciculation or fib that is seen on an EMG with disease?

Thank you for your time

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

I am not certain what your doctor meant by the term nerve firing. An EMG is a test which will vary from one physician to the next. In order for an EMG diagnosis of ALS to be made abnormalities need to be seen from the cranial muscles to the legs. Therefore, a normal EMG in the leg would not allow for a diagnosis of ALS. The normal examination over 8 months would also go against ALS. Without seeing you I can not state that your testing is complete. It appears that your local doctor feels confident that there is nothing to worry about, however, if you remain concerned, perhaps a second opinion would put your mind at ease. Good luck.

[dont]

I just want to add that I got the written report and the muscles that were tested are: R medial gastrocnemius, r lateral gatrocnemius, R anterior tibial, R vastus medialis and R rectus femoris so that's 5 sticks. For Fibs and Pos Waves there are all 0's next to each muscle and for fasciculations there are all 0's and for firing number, pattern rate, ampl, polyphasia and duration it says normal listed by all muscles. Is it safe to say I'm okay or should other areas be teste?????????????

[suzanne L.]

you are fine

[dont]

Thanks Suzanne. I got your PM on BFS but haven't had a chance to respond. I just cannot get past the one limb only thing as you know many of us cannot. He tested 5 muscles in my worst effected leg but I cannot bang it into my head when I start twitching and hurting.

Thanks for your response and your PM.

Karen