Ask a doctor on the topic of Neurology

Fasciculations

August 10, 2017 | 25,00 EUR | answered by Dr. med. Frauke Gehring

Hello,

Last week I had already asked you about fasciculations in both calves, and since then I have also been to a neurologist. I also mentioned ALS to him. He conducted a complete neurological examination, which showed no pathological findings.

The electroneurography revealed the following values...
PN program on the right side.

Peroneus: dl 3.2 ms, MOT 30 m/s, 3.1 mV
Tibialis: dl 4.6 ms, MOT 41 m/s, 11.6 mV
Suralis: SENS 43 m/s, 3.1 uV

Findings: delayed nerve conduction velocity

Electromyography:
Right gastrocnemius muscle: no PSW at rest, no fibrillations, occasional fasciculations. Slightly increased polyphasic rate with slight voluntary activity, interference patterns with maximal innervation.

Assessment: There are indications of polyneuropathy, but no signs of ALS as there are no upper neuron signs present.

Assessment/Diagnosis: There are indications of polyneuropathy, but no signs of ALS as there are no upper neuron signs present.

What does "slightly increased polyphasic rate" mean in EMG ??? What does electromyography indicate ??? Can I trust the diagnosis as it is ???

I would like to ask the doctor about this, but unfortunately, he is currently on holiday :-(

Dr. med. Frauke Gehring

Good day,

A delayed nerve conduction velocity is essentially the opposite of ALS: in ALS, the nerves are hyperexcitable. An increased polyphasic rate, as well as the delayed conduction velocity, indicate a polyneuropathy, which means there are issues with the peripheral nerves. There were no signs of ALS found.

Of course, you can leave it at that. I would just recommend checking the levels of Vitamin B12 and folic acid, as a deficiency can harm the nerves.

Warm regards, Dr. Gehring