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EMG results
Hi,
I am very confused by my doctor and what seems to be her lack of caring of my sickness. In September I was very healthy and suddenly became very ill with what my primary care dr thought was a flu. So I stayed home to rest only to become what turned out to be deathly ill. I didn't have the flu, the results were negative. After almost 1 month of drinking Gatorade and eating chicken soup(for the flu) I was no longer able to walk to the restroom. I had no feeling in my legs by now, and it was starting to move up my arms. My breathing was more than difficult and heart-rate was 140. I called my hubby at work and said not to worry but it's only getting worse. It's time to go to the hospital. I thought I could just tough out this, "flu" ,but knew it was far worse than they thought. My legs were colorless. By the time I arrived at the hospital, I had to be placed in the wheelchair. The DR. commented that my feet looked mottled. Without color, like not alive. I had no reflexes and felt nothing at all while he was poking and scratching me with a needle. My primary care DR had been urging me to get a work-up for MS since Hurricane Ike. Finally, in February, I was to get in to see the Neuro. who did an MRI w/and w/o contrast of the head neck and thoracic spine. She said it was fine. No lesions. Hmmm, now it's anxiety? No way! I had a prior EMG that read 3.6. At that time the Neuro performing the test said that something is wrong, we just need to find out what. The reading was not a concern to my MS Neuro. She says she only becomes concerned at 3.2. Which one is right? I know whats going on in my legs. I not only have muscle spasms, but tiny muscle twitches all day long. My legs do not have total feeling back. I guess first I would like to know if anyone knows what the reading for the EMG should be? I would be so grateful for any help. Thank you in advance.
I am very confused by my doctor and what seems to be her lack of caring of my sickness. In September I was very healthy and suddenly became very ill with what my primary care dr thought was a flu. So I stayed home to rest only to become what turned out to be deathly ill. I didn't have the flu, the results were negative. After almost 1 month of drinking Gatorade and eating chicken soup(for the flu) I was no longer able to walk to the restroom. I had no feeling in my legs by now, and it was starting to move up my arms. My breathing was more than difficult and heart-rate was 140. I called my hubby at work and said not to worry but it's only getting worse. It's time to go to the hospital. I thought I could just tough out this, "flu" ,but knew it was far worse than they thought. My legs were colorless. By the time I arrived at the hospital, I had to be placed in the wheelchair. The DR. commented that my feet looked mottled. Without color, like not alive. I had no reflexes and felt nothing at all while he was poking and scratching me with a needle. My primary care DR had been urging me to get a work-up for MS since Hurricane Ike. Finally, in February, I was to get in to see the Neuro. who did an MRI w/and w/o contrast of the head neck and thoracic spine. She said it was fine. No lesions. Hmmm, now it's anxiety? No way! I had a prior EMG that read 3.6. At that time the Neuro performing the test said that something is wrong, we just need to find out what. The reading was not a concern to my MS Neuro. She says she only becomes concerned at 3.2. Which one is right? I know whats going on in my legs. I not only have muscle spasms, but tiny muscle twitches all day long. My legs do not have total feeling back. I guess first I would like to know if anyone knows what the reading for the EMG should be? I would be so grateful for any help. Thank you in advance.
I don't even remember when Hurricane Ike hit! Anyway, This diagnosis can take some time. If it really is MS you will eventually know.
My MRI's on my brain are not normal but they do not look MSish. But my clinical exam, Optic neuritis, and LP were enough for my MS doctor to make the diagnosis.
Stick with your MS doctor if you are comfortable with him or her. If not you need to find a new one.
LA
My MRI's on my brain are not normal but they do not look MSish. But my clinical exam, Optic neuritis, and LP were enough for my MS doctor to make the diagnosis.
Stick with your MS doctor if you are comfortable with him or her. If not you need to find a new one.
LA
I guess that I would start off asking your neuro what she thinks this could or could not be. Like LA said, if you are comfortable with your MS doctor and you feel she answers questions to your satisfaction, stick with her, otherwise find someone else.
If this all started with a fever, one thing that you should want her to rule out is Lyme Disease. This can produce neurological symptoms. Lyme is documented by the CDC in Texas and is not out of the realm of possibilities.
At this point, there should be a battery of blood tests and others to rule out mimics of MS. There are a lot of them (mimics), and your neuro should be able to discuss them with you and the tests that she is ordering to rule things in or out for your diagnosis.
Hang in there, have patience (easier said than done) and hope that you feel better soon and learn the reasons behind your medical problems.
Audrey
If this all started with a fever, one thing that you should want her to rule out is Lyme Disease. This can produce neurological symptoms. Lyme is documented by the CDC in Texas and is not out of the realm of possibilities.
At this point, there should be a battery of blood tests and others to rule out mimics of MS. There are a lot of them (mimics), and your neuro should be able to discuss them with you and the tests that she is ordering to rule things in or out for your diagnosis.
Hang in there, have patience (easier said than done) and hope that you feel better soon and learn the reasons behind your medical problems.
Audrey
The way that you describe your symptoms and how they come on sound a lot more like Transverse Myelitis than MS. Especially how it moved up your body and onset was sudden.
TM does not always show up on MRI, spinal lesions are more difficult to image and your MRI would be better if it was a T3 machine, often the weaker strength machines miss lesions. Are you reflexes still abnormal, are you still having ongoing problems? Do you have any bladder problems, sensory issues, TM usually presents with sensory issues, there is usually a clear defined sensory line below the lesion, pain, and weakness. It often can occur after a virus. I am not an expert and I don't know your full story, but if you have neurologist that you like and who is monitoring you perhaps stick with them but a second opinion never hurts. Sometimes to diagnose TM you need to have the timing of the MRI just right to see the inflammation.
Welcome to our forum, we have some very good health pages on on MS and on MRI and MS if you click the yellow icon in the right hand corner.
If you google TM you should come up with some great info on that too, but be guided by your doctor and if in doubt seek a second opinion. I hope you get better and get some answers soon.
Udkas (dx TM)
TM does not always show up on MRI, spinal lesions are more difficult to image and your MRI would be better if it was a T3 machine, often the weaker strength machines miss lesions. Are you reflexes still abnormal, are you still having ongoing problems? Do you have any bladder problems, sensory issues, TM usually presents with sensory issues, there is usually a clear defined sensory line below the lesion, pain, and weakness. It often can occur after a virus. I am not an expert and I don't know your full story, but if you have neurologist that you like and who is monitoring you perhaps stick with them but a second opinion never hurts. Sometimes to diagnose TM you need to have the timing of the MRI just right to see the inflammation.
Welcome to our forum, we have some very good health pages on on MS and on MRI and MS if you click the yellow icon in the right hand corner.
If you google TM you should come up with some great info on that too, but be guided by your doctor and if in doubt seek a second opinion. I hope you get better and get some answers soon.
Udkas (dx TM)
Hi there brakalyn, just wanted to say hi and say this sounds like a really tough time, and I am sorry you're going through this. Especially with all the added anxiety of not knowing what's wrong! I hope this changes soon.
I am just a limbolander who spends a lot of time googling, so I don't know how much this observation is worth - but one thing you mentioned brought something up for me. Have they checked you out for vasculitis? I remember reading something about mottled extremities, and maybe about the high heart-rate too?
I'm sorry I don't know anything really about EMGs, I wish I could help answer that question! I'm wishing you luck with this difficult situation.
Best to you -
Louey
I am just a limbolander who spends a lot of time googling, so I don't know how much this observation is worth - but one thing you mentioned brought something up for me. Have they checked you out for vasculitis? I remember reading something about mottled extremities, and maybe about the high heart-rate too?
I'm sorry I don't know anything really about EMGs, I wish I could help answer that question! I'm wishing you luck with this difficult situation.
Best to you -
Louey
Hello, I do not believe we have chatted yet. Welcome to the Forum :)
When all of this happened, did you have any loss in either your bladder or bowels?
Meaning, were you able to control them....Are you having any lasting affects since this happened? On any medications? i am questioning the ER doctors definition of having true "mottled" skin......
Mottled Skin: Imagine a leopard's skin (but MUCH less severe!). It is where there are faint spots or patches on the skin. They can very in colour depending on what the cause is.
Mottled skin refers specifically to blood vessel changes in the skin ... Alternative Names. Dyschromia; Mottling or mottled skin refers specifically to blood vessel changes in the skin which cause a patchy appearance.
So the entire foot should not be colorless but rather have "spots" if you will.
Having your feet turn (white) sounds like it would be that the circulation is impaired.
I would suggest (for your own records and for other doctors you see) that you get copies of all these tests that you have had done. If you look up at the top right hand corner of this page...you will see a section called "Health Pages" You will find a lot of information there. Including dx criterea of MS as well as MRI results and what they mean.
Hope you get answers soon!
~Tonya
Welcome. I would like to comment in full on your story and hope to in the near future, but do not feel well enough right now.
From your story, I suspect you DID have the flu (the test can be falsely negative) and that what you had afterward is something called Guillain-Barre Syndrome. This is a demyelination of the peripheral nervous system (MS is of the central nervous system) and often follows an infection like the flu or other respiratory infections or an infection of the intestines (most notably one called Camphylobactor jejeunii). It is experienced as an ascending weakness or even paralysis - so that the lower legs, then the upper legs, then hips and then arms can become weak. It may go up only so far or involve the whole body, including the respiratory muscles.
With the history of ascending weakness, I'm sure they did a spinal tap. That can help diagnose Guillain-Barre. Also, the reflexes of the weak limbs are always decreased or absent in GBS, but usually increased in MS.
Ukas is right. This could be an episode of Transverse Myelitis. With the earlier suspicion that you might have MS this is also a good possibility. The results on the spinal tap can help tell the difference. In TM the EMG should be negative/normal. In GBS then EMG is often positive/abnormal. However, in Transverse Myelitis the weakness does not usually progress as you have described.
The MRI is usually normal in GBS.
The things that favor GBS as the diagnosis are 1) ascending weakness and sensory abnormalities, 2) absent reflexes, 3) normal MRI.
It is important to make an early diagnosis, because there are treatments that can help in Guillain-Barre Syndrome, such as IV Gammaglobulin or a procedure called Plasmapheresis.
You can Google
Guillain-Barre Syndrome
but many of the sites are pretty technical. The Mayo Clinic has a nice description
http://www.mayoclinic.com/health/guillain-barre-syndrome/ds00413
Your doctor sounds over her head and she has lost your confidence. Both of these are reasons to see someone else for a second opinion. Also, do you have the results of the spinal tap?
As for the EMG I wouldn't know how to interpret it without knowing the sites being reported plus the normal range.
Welcome to our forum. I hope we can help you as you search for answers. Please, see another opinion.
Quix
From your story, I suspect you DID have the flu (the test can be falsely negative) and that what you had afterward is something called Guillain-Barre Syndrome. This is a demyelination of the peripheral nervous system (MS is of the central nervous system) and often follows an infection like the flu or other respiratory infections or an infection of the intestines (most notably one called Camphylobactor jejeunii). It is experienced as an ascending weakness or even paralysis - so that the lower legs, then the upper legs, then hips and then arms can become weak. It may go up only so far or involve the whole body, including the respiratory muscles.
With the history of ascending weakness, I'm sure they did a spinal tap. That can help diagnose Guillain-Barre. Also, the reflexes of the weak limbs are always decreased or absent in GBS, but usually increased in MS.
Ukas is right. This could be an episode of Transverse Myelitis. With the earlier suspicion that you might have MS this is also a good possibility. The results on the spinal tap can help tell the difference. In TM the EMG should be negative/normal. In GBS then EMG is often positive/abnormal. However, in Transverse Myelitis the weakness does not usually progress as you have described.
The MRI is usually normal in GBS.
The things that favor GBS as the diagnosis are 1) ascending weakness and sensory abnormalities, 2) absent reflexes, 3) normal MRI.
It is important to make an early diagnosis, because there are treatments that can help in Guillain-Barre Syndrome, such as IV Gammaglobulin or a procedure called Plasmapheresis.
You can Google
Guillain-Barre Syndrome
but many of the sites are pretty technical. The Mayo Clinic has a nice description
http://www.mayoclinic.com/health/guillain-barre-syndrome/ds00413
Your doctor sounds over her head and she has lost your confidence. Both of these are reasons to see someone else for a second opinion. Also, do you have the results of the spinal tap?
As for the EMG I wouldn't know how to interpret it without knowing the sites being reported plus the normal range.
Welcome to our forum. I hope we can help you as you search for answers. Please, see another opinion.
Quix
1. Which EMG Systems do you use?
2. What problems did you face with the EMG systems?
3. How much EMG needles do you usually use every year?
4. What problems did you face with any needles?
5. How many pins does your adaptor cable have?
6. How are the pins connected?
7. Where do you buy your EMG Needle and Cable
We provide service for EMG System and EMG Needle
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