Abnormal Muscle Response During EMG

Hi All,
I just had an EMG and the test showed abnormal muscle response. Has anyone else had this? If so, what did it mean for you? This one has me kind of concerned.
Neuro thinks it's scleroderma related but isn't sure.

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I had EMG last year because I was having severe pain in my legs and arms. My legs felt so heavy and I had to concentrated lifting my foot to walk. I acturally have tripped and had several falls. After the test I was diagnosed with severe sensory motor neuropathy in all four extremities. Some days are worse than others. Was on Prednisone for about a year and it helped the pain until I got down to 10mg and no relief from smaller dose. I gained 47 lbs. on it and since being off it since Dec. I have lost that weight. I now take Lyrica and it helps some. I take it only at night though because it gives me blurred vision and some dizziness although that seems to be getting better. Guess my body is getting use to it now. I am suppose to take one day and night. Eventually I may try to take it daytime as well. It flares up and I have some really bad days often. Neurologist feels it is related to Scleroderma. I had glucose test to rule out diabetes. All that was negative. The neurologist found and article from Mayo Clinic about experiment they did on over 500 scleroderma patients with neuropathy and found they had no other physical reason to have the neuropathy except the scleroderma. My ruemotologist does not agree but another second opion neurologist agrees with the other ones findings. All I know is I am in pain most all the time. I am on several meds a day and just have to suck it up I guess. This disease really knocks the hell out of people. I was diagnosed in 2009 although had Raynauds symptoms and other syptoms for a few years before that. Now I recently had a cardiac catherization due to shortness of breath and thankfully they found no blockages but did say I am in early stages of pulmonary hypertension. So I don't know where I go from here. Have appt. with cardiolist on Monday and when I go to Charleston in Aug. they are doing 6 min. walk and pulmonary tests. Well God Bless and hope you get some answers.

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Hi Dorisanne,
Thanks for your response. It sounds like the disease really is awful for you.
I don't have neuropathy (at least not in the technical sense of the word since my nerves are working according to the EMG) but legs are numb from the calves down. I do have major pain. Did your EMG indicate abnormal muscle response?\
I hope your appointment goes well on Monday.

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Unfortunately it isn't uncommon to have crossover diseases with auto immune conditions. If you have scleroderma, you are more likely to have over auto immune conditions. I had an abnormal muscle response on an EMG and an elevated CPK blood marker. A muscle biopsy confirmed that I had/have Polymyositis as well as diffuse scleroderma. At the time of my diagnosis five years ago, I was pretty upset and discouraged to learn this. The good news is that the treatment I did for Polymyositis helped stop the progression and reversed my scleroderma symptoms. So your neurologist is right, it is probably scleroderma related. It could be an indicator of the type of scleroderma you have or another overlapping disease. Do as much as you can to get a better understanding of what it might be. The more information you have about your disease/s, the more likely you will be able to find the right therapy.

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Thank you LaurenM. I'm glad your doctors were able to pin down a diagnosis for you. It's great news that the treatment for your Polymyositis helped with the Scleroderma as well.
I am hopeful that by August I'll have a grip on what it is. I'm trying to get an appointment at the Scleroderma Clinic at UofM. I'm hoping between them and the neurologist they can give me a clue of what it really is. At least the neurologist gives the impression that he cares (more than I can say about some of the doctors I've come into contact with).
Sometimes I feel like a mid-game pingpong ball bouncing from one spot to another without a win.

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You can have a "normal" response from your nerves on the NCV/EMG and still have small fiber neuropathy which is the sort of neuropathy more common to people with autoimmune diseases anyway. Basically when a neurologist orders the NCV/EMG they are trying to determine whether you have an identifiable neurological disease causing your neurological symptoms. Usually the NCV/EMG is trying to rule out these diseases as causes for things like tingling/weakness/numbness/pain. However, if your numb calves are being caused by a small fiber neuropathy, then this will not be evident on the test. I'm not sure whether it matters to you or not, but there are other tests that can try to diagnose SFN like a skin/nerve biopsy. Anyway, that's just to say that you shouldn't rule out neuropathy as the cause for your numbness.

I'm sorry to hear about the abnormal muscle response. If that occurs in an autoimmune disease context I would think it might be caused by polymyositis. Has the neurologist suggested a muscle biopsy to check on that? I guess the good news is what LaurenM mentioned above: polymyositis is treated in a way that is quite similar to the treatment of scleroderma so treating one tends to improve the other. Steroids, IVIG, and drugs like Cellcept or Methotrexate might be used.

There are other possible causes for an abnormal EMG though. I imagine your neurologist will now spend some time ruling out other options. Have you had an MRI of your brain and spine?

I have a NCV/EMG test next week. I had one a year ago which was normal. I have small fiber neuropathy. I doubt that there will be any changes this year, but my neuro wanted to rule out some other issues/diseases. I have very diminished reflexes in one of my legs and this puzzles him, which I think is why he ordered the new testing.

Hope you get some answers soon!


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Oh, by the way, my neurologist said that they try to rule out neurological diseases first by assessing the whole system of brain and nerves looking for abnormalities. If you have a connective tissue disease with neurological symptoms but no abnormalities on your MRI and NCV (I'm not sure about the EMG) then they assume your nerves are being affected by a musculoskeletal problem, i.e. scleroderma affecting the tissues that surround the nerves.

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Dear Topazst,
To answer your question, yes it did show poor muscle response. I have been to two differant neurologist and both concluded I have severe motor sensory neuropathy all four extremities. Muscles hurt, all around pain in legs and arms.
I wish you well and hope they figure out what is going on with you and are able to treat you. God Bless

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They did conduct an MRI of my head and all was normal there (now there’s a surprise for you). They did the MRI because of the dizziness and eye flickering issue that I've been having. I suspect they are trying to rule out MS.
The neurologist seems fairly confident that the muscle issue is related to the Scleroderma. He wants to do a muscle biopsy in August, after I’ve had some time for the vitamin D to work and been to my rheumatologist. He suggested that I start Cellcept but wanted me to confer with my rheumatologist first.
I’m just so tired of going back and forth from doctor to doctor with no positive treatment. The neurologist did start me on Neurontin, which has at least made the darned tingling sensation stop. I know it’s just masking it but it hate that feeling so much I’m okay with that for now.
I not usually a whiner but I’m so darned tired of being in constant pain that I just want it to end.

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