I have been having serious fasciculations (mainly calves and thighs, although occasionally in biceps, hand, and upper body). My wife said it looks like an alien trying to get out of my leg.

My neurologist (already under care for chronic microvascular ischemia and lacunar strokes) has done testing to establish the cause and has been able to rule out everything but BFS and ALS. He said that the definitive test that is recommended is a 3 limb needle EMG. I have had needle EMG twice before (ulnar nerve) and prefer not to go through this painful procedure since a positive diagnosis for ALS will have no impact on the prognosis or treatment (there is none).

Also, my local neurological practice (in DE) does not seem very familiar with or dealt with many (probably very few) cases of these rare disorders. My PCP has recommended that I go to Jefferson (Phil) or Johns Hopkins (Balt).

Does anyone have experience with this type of situation? Has anyone used surface EMG vs needle. I have read that good results can be obtained with this without the pain of a needle EMG, and I think that Penn offers it.

My next neuro appt is 12/11. I am contemplating getting a second opinion from Penn.

TIA,
Keith