My husband has had increasing fasciculations for a couple of years with no pronounced muscle weakness (which is a big relief as I understand that muscle weakness absolutely accompanies fasciculations associated with ALS).
However, his emg tests were considered "abnormal" and he has recent loss of strength when using his fingers. (It is subtle ... for example, he can't use finger nail clippers).
Needle EMG examinatioin shows fasciculatioins and chronic reinnervation in multiple muscles in the right arm and leg. Active denervation is observed in one distal arm muscle. As a result, the ALS neuologist is having him come for repeat testing every four months or so. We haven't yet had the opportunity to ask the neurlogist what he thinks this means. Can you offer any thoughts to this?
One other thing ... he has other rare but definite symtoms more related to the brain ... brief memory issues (once at night before sleeping he lost all recall of the day we had just lived, but was fiine in the morning ... the only thing he couldn't remember was that he forgot), a strange smell followed by a lightheaded "high" feeling in which his words are briefly garbled ... perhaps an overall change in judgement that only his spouse would notice. Could any of this be connected in any way? He also has loss of smell and big night sweats. He just had a sleep deprived eeg yesterday to see if there is any seizure activity.
Thank you for having this forum and thank you in advance for taking the time to answer. This is my first time on the site and the first time to ask a question. I misttakenly asked these questions in the wrong forum ... i'm looking for a neurologist's opinion! Thank you ...
Electromyography or EMG mainly tests the strength of contraction of the muscle fibers. The weakening of the muscle fibers can be due to a primary muscle problem itself (such as myopathies) or with problems with the nerve supplying the muscles (such as with the ALS). However, ALS will not be sufficient to explain the other symptoms pertaining to judgement and lightheadedness and I believe that there might be an element of some mild depression or anxiety. I suggest that you discuss this angle with his doctors and probably get some treatment.
Thank you so much for your response. It is a relief to be able to reach out on a website like this and ask questions at a time when there are so many unknowns. This morning I heard back from the neurologist ... and she said the sleep-deprived eeg showed abnormalities consistent with her concern about seizures. Before analyzing more, she wants to get the results of an upcoming MRI (hopefully to determine what is causing the seizue activity). I am wondering if their is a link between the two distrinct things going on in his body. Do you think that is likely?? I have read various things about BFS and a small percentage that have frontal lobe dementia ... and also about a group of ALS patients who also have frontal lobe issues ... I think I know him well enough to detect if the judgement/absent minded issues were depression related. I wish they were ...
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