hawkid
New member
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- Oct 2, 2015
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- Buckingham
I have some very puzzling and scary symptoms and was hoping I would be able to get some advice as to my best course of action from here.
Background:
I am a 36 year old male. I am very active and in good shape. I played rugby for several years but now focus on triathlon. I also lift weights in the gym 3 times per week.
Symptoms:
For 2 months now, I have had progressive weakness in my left arm. Initially I noticed my hand shaking, then I noticed the muscles in my forearm were quivering when trying to hold my arm out and use my hand. The arm got progressively weaker and then the twitching started, just a few twitches at first but now constant 24/7 twitching of many muscles in my forearm and bicep. The arm feels very weak now and I have lost significant muscle in my forearm. If I tense my forearm now it generally locks out or cramps. I can still do most things - apart from lift heavy weights in the gym, but there is an overwhelming feeling of weakness and fatigue in the arm.
At the same time the twitching started in my left arm, I began twitching in other parts of my body. My calves twitch like mad (I have always had this after exercise but not constantly), my feet twitch underneath, I get twitches in my hands and randomly on my upper body and thighs. However, there is no feeling of weakness or fatigue in my legs, hands or feet.
For 2 months now I have also suffered from cramping. Particularly in my right foot where I have previously had plantar fasciitus - but it seems that any muscle in my body is prone to a cramp if put under tension.
Most worryingly, over the last week I have felt progressively weaker in my right arm. There is no significant muscle loss at this stage but there are a few twitches, especially at night. Driving, for example, is now becoming an issue as both arms feel very fatigued quite quickly. Also holding a mobile phone to my ear for more than 5 minutes is an issue.
Steps to Diagnosis so far:
I saw a neurologist last week (before my right arm started getting weak). He performed all of the standard tests and concluded that he was 99% certain my twitching was benign. I raised the issue of weakness and muscle loss in my left arm and he attributed it to soreness from cramping and said my left arm will naturally be smaller than my right. I was not convinced so he agreed to refer me for EMG and NCS.
I had the EMG and NCS yesterday and got a 'clean' result. The only issue with the NCS was an slight inconsistency around my right ankle but the neurophysiologist attributed this to the 2 operations I have had on that ankle. With the EMG, she tested my calves, which were fine (apart from fasciculations) and then went straight to my left forearm. She tested 4 different sites in my forearm where the twitching and weakness is at it's worst and found nothing sinister. No other areas were tested, which concerns me slightly. I should have at least asked her to test my right foot, where I get twitching and the most cramping. She recommended I get a scan on my neck to look for a compressed nerve. She also suggested that this would be a very uncommon way for ALS to present itself. She said that it would normally start in the smaller muscles in a hand for example, rather than the forearm itself.
Next Steps:
I have another appointment with my neurologist next week to discuss the results and the next steps. At this point I am truly in shock that the EMG was clean on my left forearm. I was totally convinced I had ALS and it would show up. A compressed nerve seems like a nice solution but surely this is unlikely considering the problem appears to be in both arms?
Questions:
1 - Given the information above, should I still be concerned that this could be ALS?
2 - If not ALS, then what else could this be?
3 - Should I look for a second opinion on the EMG - maybe to ensure that more muscles are tested?
Any thoughts or advice would be most welcome.
Thanks
Background:
I am a 36 year old male. I am very active and in good shape. I played rugby for several years but now focus on triathlon. I also lift weights in the gym 3 times per week.
Symptoms:
For 2 months now, I have had progressive weakness in my left arm. Initially I noticed my hand shaking, then I noticed the muscles in my forearm were quivering when trying to hold my arm out and use my hand. The arm got progressively weaker and then the twitching started, just a few twitches at first but now constant 24/7 twitching of many muscles in my forearm and bicep. The arm feels very weak now and I have lost significant muscle in my forearm. If I tense my forearm now it generally locks out or cramps. I can still do most things - apart from lift heavy weights in the gym, but there is an overwhelming feeling of weakness and fatigue in the arm.
At the same time the twitching started in my left arm, I began twitching in other parts of my body. My calves twitch like mad (I have always had this after exercise but not constantly), my feet twitch underneath, I get twitches in my hands and randomly on my upper body and thighs. However, there is no feeling of weakness or fatigue in my legs, hands or feet.
For 2 months now I have also suffered from cramping. Particularly in my right foot where I have previously had plantar fasciitus - but it seems that any muscle in my body is prone to a cramp if put under tension.
Most worryingly, over the last week I have felt progressively weaker in my right arm. There is no significant muscle loss at this stage but there are a few twitches, especially at night. Driving, for example, is now becoming an issue as both arms feel very fatigued quite quickly. Also holding a mobile phone to my ear for more than 5 minutes is an issue.
Steps to Diagnosis so far:
I saw a neurologist last week (before my right arm started getting weak). He performed all of the standard tests and concluded that he was 99% certain my twitching was benign. I raised the issue of weakness and muscle loss in my left arm and he attributed it to soreness from cramping and said my left arm will naturally be smaller than my right. I was not convinced so he agreed to refer me for EMG and NCS.
I had the EMG and NCS yesterday and got a 'clean' result. The only issue with the NCS was an slight inconsistency around my right ankle but the neurophysiologist attributed this to the 2 operations I have had on that ankle. With the EMG, she tested my calves, which were fine (apart from fasciculations) and then went straight to my left forearm. She tested 4 different sites in my forearm where the twitching and weakness is at it's worst and found nothing sinister. No other areas were tested, which concerns me slightly. I should have at least asked her to test my right foot, where I get twitching and the most cramping. She recommended I get a scan on my neck to look for a compressed nerve. She also suggested that this would be a very uncommon way for ALS to present itself. She said that it would normally start in the smaller muscles in a hand for example, rather than the forearm itself.
Next Steps:
I have another appointment with my neurologist next week to discuss the results and the next steps. At this point I am truly in shock that the EMG was clean on my left forearm. I was totally convinced I had ALS and it would show up. A compressed nerve seems like a nice solution but surely this is unlikely considering the problem appears to be in both arms?
Questions:
1 - Given the information above, should I still be concerned that this could be ALS?
2 - If not ALS, then what else could this be?
3 - Should I look for a second opinion on the EMG - maybe to ensure that more muscles are tested?
Any thoughts or advice would be most welcome.
Thanks