Mental status was normal, Cranial nerve examination : bilateral ptosis but no ophthalmoparesis, otherwise normal cranial nerve exam. Motor: bulk and tone normal, no fasciculations, Strength 5/5 in the upper extremities. In the lower extremities 4/5 in the proximal flexors, 5/5 in all other muscle groups in the lower extremities. Sensation: normal to light touch, pinprick, vibration, proprioception; reflexes: trace in biceps, triceps, knees and 2+ at ankles, toes down going; coordination: No ataxia on finger to nose or heel to shin; gait was slow, difficulty in lifting his legs, difficultly in getting from a sitting to standing position, could not heel or toe walk.
Nerve conduction studies showed low CMAP amplitudes of all nerves tested whereas distal latencies, conduction velocities and SNAP amplitudes were normal. Needle EMG showed mild to moderate positive waves and fibrillations and myopathic units and early recruitment in the proximal muscles. What else do you do in the EMG study? click here.
