Initial weakness

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Hi All,

Sorry to pick your minds again.

With the Muscular Weakness in ALS does the always start at the furthest point in a limb and work up or can it start anywhere in the Limb?

IE if someone had weakness in their calf or Bicep but still had full strength in their toes/feet or fingers/hands could you discount ALS.

I'm just wondering whether you would always notice weakness of the toes/foot before you noticed calf weakness and similarly if you would notice weakness in the hands/fingers before you noticed forearm/bicep weakness.

Or is it possible that weakness would begin in the calf while the foot remained unaffected? Or in the bicep/forearm when the hand is unaffected?
 
mine started in left hand and worked up. va now rates permenent loss of left hand but still a little strength in arm
 
I've never heard of it starting out like that.
 
there are types of diseases that do start proximal...but ALS normally starts distally.
 
Agree with notme.
myopathies (deseases of the muscle itself) start in proximal muscles,where as neurological muscle weakness starts distally.
In als (other than bulbar issues) its starts in a hand or with footdrop.

Footdrop is caused by weakness in the lower leg muscles,from my own experience and is usually the case by the time i realised i was dragging my foot there was already weakness in my leg.....its very insiduous (sp)
Can not comment on the hand to arm weakness but i would think its the same in that by the time you realise the weakness on examination its shown there is far more involvement.

Please correct me anyone.
 
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You asked Olly :)
AlS can definitely start proximaly. It's less common, but the shoulders and hips are area where ALS can initially present as for an area inbetween, like the calf, I really do not know.
 
Both myopathies and motor neuron diseases can present either distally or proximally. I'm not an expert but I've read up on this stuff thoroughly for almost a year now. I feel compelled to cover myself now in the credibility dept, based on another recent thread. LOL
 
Awe shucks:oops:........i have always read it starts in hand or foot and both my neuro and pt said i could not have myopathy as my weakness was distal which indicated neuromuscular.
Personally i have only researched pls and a few others,will have to brush up on my als research.
See,this is why i stopped popping in here.............all these questions stress me out;):lol:
 
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