Waiting for a MRI and EMG next week ... I have questions!

[Valentine14]

Hello,
My Mom is in her early seventies and for the past year she has thought she had arthritus in her left hand. Fast forward to this past October. She was wearing heels and stepped off of a curb and lost her balance. She fell and also broke her foot. Foot healed fine in a boot and was taken off early December. Later in December she noticed that her fingers were more stiff and would claw up. She could not use her left hand to open a jar, wrap gifts, etc. She has some mobility but not a lot. Just the left hand. She also noticed muscle loss in her hand. Her left leg has been giving her some trouble when she exercises. Mainly in her hip but her foot will flatten as well. ( she broke her right foot when she fell) She went to her internist who mention that he thought she had Spinal Stenosis and to see a neurologists. The neurologists ordered MRI and EMG next week. He said he was looking at three things 1. Brachial Plexus in the shoulder/ neck area. 2. Spinal Stenosis in the neck area and , 3. ALS. We are scared and just wanted feedback or insight from the forum. No other sympons than mentioned above.
Thank you!

 

[Nikki J]

I am sorry. I know it is very hard to wait for the tests when you have heard those 3 letters. But until she has the tests it is hard to say much except I hope it is not ALS. What did they clinical exam show? Were there comments about reflexes, babinski, hoffman deep tendon? Did they comment on weakness or atrophy? All of those are non specific but the absence of abnormal findings would be encouraging
Good luck. Your mom is lucky to have your support

 

[Valentine14]

Nikki thank you! Mom has perfect health, bloodwork all normal and reflexes are good. No atrophy in her left leg. She struggles with IBS and that is it. She goes to the gym everyday or walks. She is not overweight and very active.

 

[Nikki J]

Please let us know how things turn out. Pray for an abnormal MRI!

 

[Dusty7]

As we have discussed on the Forum, there are some neuros who will mention ALS as a possibility at the drop of a hat and others who will not say those letters until every other possibility has been eliminated. Of course, it's not ALS until everything else has been eliminated, but doctors in the first group like to give the patient a little advance warning of the possibility of ALS. Your mother's neuro is clearly in the first group, but as he pointed out there are other possibilities that, at this point, are probably more likely.

The fall may not even be nerve related for, as you point out she was wearing heels and "lost her balance". Balance is not really an ALS issue. On the other hand, if she fell because her ankle or knee simply gave out (as if the muscle wasn't there) that is a possible ALS issue.

ALS is a disease of widespread, acute and chronic denervation. I think you may get and abnormal EMG, but from what you describe, I don't think it will show widespread denervation. Hopefully it will just be in the left arm and will point to something treatable, like CTS or a radiculopathy or a pinched nerve in the brachial plexus.

Best of luck and let us know how it goes.

 

[Pedrots]

The EMG can be a bit uncomfortable and might hurt a little. Just make sure you can go with her and help her stay relaxed.