dr. Kalra, here is my situation

[needhonesthelp]

Here is my story...is there any hope for me that I may be fine or could have a bright prognosis.

I have been dealing with odd sensations, aches and more for some time.  Brief overview:  2.5-3 years ago started getting tingling hands, fasiculations all over body, buzzing feelings, and more.  After 3 mos of worrying I saw a Neurologist.  EMG was normal, Physical normal, blood work normal, etc.

After dealing with these symptoms for awhile I followed up 1.5 years later.  Feeling similar symptoms with achiness at time, more buzzy feelings and more noticeable mild shakiness in my muscles when I lift or stress my muscle.  MRI's of brain and spine were normal, lumbar puncture normal, and blood work normal...hopefully ruled out MS and others.

Over the last few months I developed a dry mouth which may have started after a healthcare (Med Rep) work exposure because I was so worried and didn't handle the situation properly.  All I thought about for weeks and weeks was did I pick up a Infectious Disease.  After viral load and antibody tests out to 6 mos fro HIV, HEP C and even HTLV all are negative.  In addition to the dry mouth I developed dry eyes around the time of a cold...not sure if it is related.  This has been persistent for over 3 months and the dry mouth still bothers me a lot especially when talking for about 6 mos.  All bloodwork for Sjogren's, Lupus, Rheutoid, etc are neg.  Sed rate is 2, CRP is .3, all blood work was normal except CPK...around 215.  Was repeated but I have lifted a day or two before and it was 313, sed rate still 2.  I took a week off lifting and CPK was 361, but I was pushing hard on my calf for a couple days about 1-2 days before the test because they were really aching me and I felt a muscle all knotted up.  Anyway, I lifted for 3-4 days then took another week off and CPK was 137.  My Rheumatologist was concerned and did order an EMG.  Main muscle symptoms are stiffness in lower back, legs, achiness in knees and ankles, weird pains that developed in hand and calves, etc  

Nerve Conduction normal...However, EMG with needle shows some normal MUAP's, some brief duration, some low amplitude, and some polyphasic in 4 muscles...tricep, suprospinatus, peroneal longus, and gluteus medius.  Told this may be suggestive of myopathic process.  My strength seems to be fairly normal with normal clincal exam and normal reflexes.  

1) Is it possible to have these findings on an EMG and can it be benign.  Most of these muscles that are abnormal were not tested on my EMG from 2+ yrs ago except for the peroneal longus.
2) I do feel a little shakier at times when lifting weights but I can't say that my strength is awful...not sure if this is a sign?  I'm not in college anymore and do feel old, but still bench press 225 lbs 10 times and squat a similar amount.  No real major weakness, just weird buzzy tremoring afterwards sometimes, achiness that seems a little odd at times.
3)Can be a weight lifter effect an EMG?
4)My Rheumatologist is ordering a muscle biopsy but is suprisingly optimistic that it will be negative???  Then why is my EMG abnormal...which apparatently it is mildly abnormal.
5) I still don't have answers for my dry symptoms, can these things be related?

By the way, I am 30 yr old male that has been athlectic my whole life and is worried sick that everything is going to change.  With 2 youngs kids I am so scared what my future holds.  Please let me know your honest professional thoughts.
THX

[needhonesthelp]

Last comment, I feel like my muscle are buzzing or shaky a little after a hard workout or yard work.  It seems odd, maybe related to EMG changes, maybe benign...I don't know.

Sorry for all my responses...clearly I am worried.

Your final thoughts would mean a great deal to me.  Thank you sir!

[needhonesthelp]

Also, when I asked the MD that ran the test if lifting can cause these findings, he said wieghtlifter do not have different EMGs??  He is a Physical Medicine and Rehab Doc...

[needhonesthelp]

By the way, I did not lift for a week before the EMG test.  Not sure if this means anything but I didn't want to have sore muscle before getting tested to throw it off...  I certainly hope you are right...

[needhonesthelp]

Thanks for your reply.  When you say weightlifting can cause some EMG abnormalities, are there specific changes commonly seen.

My report says I have some Normal, some brief duration, and increased percentage of polyphasic motor unit action potentials.  The muscle involved were triceps, supraspinatus, gluteus medius, and peroneus longus.  What concerns me is that my EMG from 2+ yrs ago was normal and the peroneus longus was tested.  I'm not sure if you can see some changes based on who is doing the test or the specific area of the muscle tested, etc.  And the NCS was normal.

I do feel some shakiness in some of the muscles that seem to be abnormal when I lift sometimes...during the contraction or when I hold the muscle in a contracted position for a few seconds.  Maybe this is normal and I just never noticed it before.  Of course, I am getting a little older too and maybe this is part of aging??

Your final thoughts based on the specific of my EMG report is greatly appreciated!  I'm not sure why I ache so much unless stress can causes these types of problems?

Thx again!

[Jagdish Vishnoi, MD]

Hi,
Here are two seprate issues.One muscle aching,buzzy feeling and other dryness of mouth.Mild abnormality in EMG is related to weight lifting exercises because its in same group of muscles which are active during your exercises.CPK levels again variable with exercise and its normal in that respect.Just check on calcium,phosphorous,potassium and sodium levels.Muscle biopsy is not required as per your clinical scenario.
Dryness of mouth is because of increased sympathetic tone as you are thinking a lot on your symptoms.Consult a psychologist for counselling that may benefit you.
Enjoy your life and best wishes.
Regards,