EMG Results

[pfalletta]

I have had left leg weakness/heaviness for about 9 months with no foot drop. These symptoms occured 6 weeks after an overdose of cymbalta/strattera. I went to see a neuro who gave me an NCV test and neuro exam both came back normal with no evidence of atrophy (Although I think my left thigh seems smaller to me). He then did an EMG of the left leg testing the following muscles: AntTibiialis, MedGastroc, VastusMed, Semimembra, BicepsFemS and the Paraspinal L3, L4, L5 and S1. Everything was normal except the BicepsFemS which read:

Ins act: Nml
Fibs: Nml
Psw: Nml
Fasc: Nml
Amp: Increased
Dur: 12ms
Poly: 1+
Recrt: Nml
Int Pat: Normal

Impression: A normal electrodiagnostic study of the left limb. No evidence of active denervations on all muscles tested.

My question is how can he say this is a normal study with the obvious abnormal finding in the BicepsFemS. I have read that those specific finding are common in ALS. When asked he said that there is no way I have MND and those findings indicate an old injury that is healing. How can he say I do not have MND with just those three test (neuro exam, NCV, EMG). He recommended weight lifting but I have alot of pain the next day after I hit the weights in that leg. Can you please clarify and let me know what I might have going on.

[Tarnea]

My mother has been suffering severe pain in her right buttock which seems to extend in to the groin area and to various places in her right leg.  After 9 days in hospital, 2 MRI's, X Rays etc she still is in extreme pain (despite the use of strong pain killers).  Are there any other tests which she could have to determine whether or not it is in fact a nerve related problem.  Sciatica was mentioned but has also been somewhat dismissed.  The amount of pain is severe and does not seem to have reduced.  It is very worrying as she has also been violently sick (presumably from all the pain killers/medication etc.  We would very much like to know the next course of action or indeed if we could pay privately for more specialist diagnosis.  
Thank you
Tania

[Abhijeet Ghosh]

Dear Friend,
It mostly looks due to the weakness of the muscle in that region.Please note that weakness and atrophy are 2 different things and please don't co-relate those 2 things.
Weight training will help you to strengthened these muscles.Hence don't worry about this.I hope you have a fitness trainer in your Gym.
Regards.

[pfalletta]

My worry is the pain is just confined to that limb after weight training. All other limbs are not painfull but are being worked the same. What do you think about his answer about it may be an old injury that is healing. How would he base that conclusion?

[Abhijeet Ghosh]

Dear Friend,
I agree that in your EMG, there was some variation, but those are within normal limits.Hence the final report came as "Normal Findings".
So please don't correlate it with some gross abnormality.Also your treating doctor is convinced that there is n abnormal findings, so please don't think too much.
If still you suspect that there is some sort of Atrophy, then the easiest and best way is to measure the concerned muscle region with a measuring tape , at same levels, hence it can be easily differentiated.
The weight lifting, initially will be causing pain the next day.So again, don;t think and co-relate with abnormal findings.
If still you have some sort of doubt with your treating doctor, then i would recommend you to take a second opinion, as that will be the best way out, rather than stay is some sort of darkness.
Feel free to discuss more.
Regards