Hi,
I don't post too much anymore but of course being that I was diagnosed with Lyme's disease and having an abnormal EMG this thread caught my eye. I wanted to shed a little light on this subject of Lyme and ALS. I've been seeing one of the leading neuro diagnostic neurologists in the country for the last 7months since my crazy story began. You can read back on my posts and updates for my story.
What I learned about ALS and Lyme's disease over the last few months is that in Lyme's disease it can cause a mononeuritis multiplex of which you can google on the internet for the information. It gives a very similar "dirty" EMG and can progress in the same aspect as ALS being that it can cause total paralysis and death.
There are two distinct differentials in deciding on a diagnosis of multiplex and ALS and even then the lines are very blurry when handing out the diagnosis of one or the other. Dr. G told me that the reason she would not be diagnosing me with ALS even though I had denervation, fibs, and giant mups..all that jazz..is bc for one I had a positive Lyme titer that was very high and also a high EBV titer. Secondly, she said I did not show any denervation in my paraspinal muscles at all.
I guess what I am trying to say in summary is that Lyme's does not cause a dirty emg but if it has caused a mononeuritis multiplex that will show dirty. If you are responding to Rocephin, you would not be seeing instant improvement in weakness or cramps etc that has to do with the muscle denervation. However, you would see a change in your speech possibly, in your reflexes, basically anything that would be an UMN symptom bc Lyme's invades the central nervous system and instant improvement due to treatment would be feasible. You wont see any instant symptom relief due to LMN damage only bc when the multiplex sets in, it is there and will take at least 6 months or more from the eradication of the Lyme's to begin to heal.
All in all, if you have Lyme's and a multiplex then you should start seeing improvements in your UMN stuff and then in 6 or more months you should have another EMG to check for active denervation in the affected areas. I must add that not all people recover from a multiplex but most do within a year or so. I would say a year from now if you still have active denervation and you see any progression in UMN symptoms ALS is probably the correct but if you dont then you had a multiplex of some sort.
Hope this helps..its taken me so many questions and research to get where I understand this Lyme/ALS question but at this point there is no research that links Lyme to causing ALS. Lastly, I want to make it clear that Rocephin is used to kill Lyme bacteria and is used in ALS trials because of its ability to stimulate natural glutamate blockers in your body which is theorized to cause oxidative stress which kills motor neurons. This is also why trials are being done with high doses of glutathione bc of its ability to detoxify as to alleviate oxidative stress.
If you have any questions..I have a wealth of knowledge on this subject. I'm an open book and a dirty fibber
It sucks but 6 months another EMG will shed light. And if you are like me...they will do a new clinical exam and if that has improved they will have to take back the diagnosis of ALS. I improved over 6 months so they took away the threat of ALS as my differential and even took away my multiplex diagnosis.