Fasciculations all over, mostly in triceps, calves, thighs. More on R side. Can create at will w/ contractions. Started 8 wks ago. No weakness, no tripping, slurring, or coordination problems.
37 yr male, overall good health. No focal muscle mass loss, 5/5 strength in all areas Normal gait, slight assym of reflex w/ upper extremeties less than lower, normal response to pinprick and vibration. R lower numbness and tingling from Sciatica.
Motor NCS R peroneal nerve over EDB normal.
RNS of R ulnar normal. Sensory NCS of right ulnar and sural sensory normal. Needle demonstrates fib potentials in R tibialis ant, R pronator teres, biceps, & triceps. Scattered fasc potentials seen. Neurogenic MUPs seen in the R L5-S1 myotomes & scattered throughout the R upper extremity, max in the R C6-7 myotome. Some scattered signs of chronic active denervation in the R C6-7 and L5 myotomes. May reflect an early MND; but given the relative focality of the abnormalities & some radicular complaints, need to exclude focal radiculopathies in these areas.
Columns across the top: Spontaneous: IA, Fib, Fasc, H.F., MUAP: Amp, Dur, PPP, Recruitment: Pattern. Everything a "N" except:
R. Tib Anterior = Increased IA, 2+ Fib, 1+ Fasc
R. Gastrocn (Med) = +1 Fasc, 1+ Amp, 1+ Dur
R. T Fascia Lata = 1+ Amp, 1+ Dur
R. First D Inteross = 1+ Red Recruitment Pattern
R. Pron Teres = Increased IA, 2+ Fib, 1+ PPP, 1+ Red Recruitment
R. Biceps = Increased IA, 1+ Fib, 1+ Red Recruitment
R. Triceps = Increased IA, 1+ Fib, 1+ Facs, 1+ Amp, 1+ PPP, 2+ Red Recruitment
R. Deltoid = 1+ PPP
More information - I'm SO sorry for posting twicw when I could have responded to my own first post to get more info to you. Any information, whether good or bad, will be most helpful.
Everything is within normal ranges except:
Glucose = 114 (high - diabetic neuropathy?)
ALT = 46 (high - viral infection?)
MPV = 6 (low)
Lymph = 17 (low - )
Seg = 75 (high - )
Ca Channel Bind Ab, P/Q = 0
Ca Channel Bind Ab, N = TNP
ACh Resep Muscle Bind Ab = 0
Lyme Antibody Screen = Negative
ANA Screen = Negative
Paraneoplast CRMP5 IgG = Negative
TSH Hormone = 1.7 (normal)
PTH Hormone = 45.4 (normal)
I don't have the facts, but he says that the following have been ruled out: Huntington's Disease, Kennedy's Disease, Lyme Disease, HIV
He has pain in lower back and in neck. When he sits with his legs crossed, they go numb.
When he pulls his chin to his chest and arches his back, the fasciculations in his arms go away.
1. Could he have MMN or D-LMN instead? He doesn't appear to have any muscle weakness and his physical exam showed no upper motor neuron loss at this time.
2. How come he was told there is a strong possibility of ALS when everything I've read says it's not possible without upper motor neuron loss?
3. He was told by his doctor that there's a very small chance it could be a viral infection. How would we know?
4. His mild stenosis, bulging, and sciatica were promptly dismissed as being part of the problem.
Why - especially when EMG shows concern in the same areas where stenosis or bulging occurs?
5. Could this be a combination of other things and not necessarily ALS?
Thank you SO much for taking the time to share information!
I will look at those sites and share this with my brother.
At this point in time, all we want are answers so that we can move in the correct direction towards recovery, if possible.
I know that you must feel frightened; we all would. Just a thought; have you recently been prescribed any new medications, such as antidepressants or antianxiety drugs? Also, is the twitching always involuntary, and have you ever experienced motor type tics in the past, such as eye-blinking, involuntary tensing of facial muscles, etc.? I wish you the best, and thanks to the doc. who informed you on the facts about ruling out/ruling in Lyme's disease. Informed patients who can advocate for themselves have the greatest power to heal.
This is to all who are questioning Carol and her discussion of lyme. I believe she save my sons life, he struggled with headaches and it ended up lyme. Many people have it and do not know it. Read about it get all the knowledge you can and get the right tests. Carol is a wonderful person and has helped many people/
I've been looking over this topic with a lot of interest. I applaud people like Carol. This issue of Lyme Disease is one of the most bizarre medical mysteries at work today, any of us that have researched this one understand that.
Furthermore, Carol isn't expressing negativity toward our doctors, she is merely pointing out her belief that a particular test method might not be as reliable as others.
If another lady comes on here and says that Carol might have played a role in saving the life of her little child, that sounds pretty wonderful to me.
Worse case scenario- you get a negative Lyme test.
Carol, if I might ask your opinion, what is the most reliable test method for Lyme's, based on your research, experience, etc? Is it the PCR, a different one?
Thanks for the help, if you find the time to respond. We will be moving soon, so I had to request that my account be closed down for now-but if you do respond, I'll try to sneak online at some point in the coming days to see if you reply. Thanks a bunch.
I have had these symptons for around 3 years now. A dull aching pain down my right arm and up the right side of my neck. Sometimes my arm goes numb and it feels very weak. I have been to my doctor may times and they dont know what it is. I have been for a general radiology scan on my shoulder and arm and it came back fine. I need some help as I dont know which way to turn. I am 21 and dont want this pain anymore!!
Please help I would apprecaite any comments you may have
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