Old 11-05-2017, 07:43 PM #1 (permalink)
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Default Localized Hand Twitching

HI all,

First and foremost my heart goes out to everyone battling this dreaded disease. You are all stronger and braver than most people could ever hope to be. I'll try to keep this relatively short:

I am a 26 year old male with no weakness so I am expecting many of you to be somewhat dismissive and I understand if you are. Roughly two months ago my left hand ring finger began twitching non-stop. For the first two weeks it was pretty slight, then during the second two weeks it was strong enough to move the whole finger side-to-side. The small hand muscle between my ring and middle finger was contracting, presumably causing the finger to move. The twitch would cease with movement and then start again at rest. Only naturally, it was mostly gone by the time I got in to see a neurologist. I showed him some videos and also realized at that point that I was able to induce the twitch by slightly extending my hand. He labeled it a postural tremor. I told him I thought it was only occurring at rest for a month and he basically said it may have seemed like a resting twitch/tremor disguised as postural. He's the expert so I didn't really argue. He was kind enough to order me an EMG which is still a few weeks out.

I work on computers all day, play a lot of video games, and played drums for 15 years before recently quitting. I just assumed it was probably carpal tunnel as that would make a lot of sense, but the docs don't think that's the case based on two physical exams; not to mention twitching usually isn't a sign of that. The neuro theorized it may be peripheral or ulnar nerve damage, but I'm skeptical of that only because I have little to no pain, tingling, burning, etc. Sometimes my fingers feel a little stiff, but that's about it.

Here's what has me scared: I am noticing various other small fasciculations throughout the same hand. The hand muscle between my pinky and ring finger is now twitching ever so slightly. I can't feel it and can barely see it. I never would have noticed it if I weren't constantly inspecting my hands so closely. I can seem to induce a good bit of very small movements throughout the hand upon lightly contracting it. It is my understanding that localized twitching and these tiny, fine fasciculations are potentially ominous signs.

I know no one here can diagnose me, but has anyone experienced anything like this? Are these bad signs? Is it at all possible the constant ring finger twitch transitioned to being postural because of ongoing denervation/reinnervation and that process is now taking place in the hand muscle next to it? But in that instance, wouldn't I be feeling some weakness by now? After all, it's been two months and the hand muscles are very small. Any feedback at all is much appreciated. Thank you all very much for taking the time to read this.
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Old 11-05-2017, 07:58 PM #2 (permalink)
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Default Re: Localized Hand Twitching

Had you read the Pinned Post titled Read Before Posting , you'd have had your answer already.

Twitching is far too common to be diagnostic of anything!!!

Go check it out, now, plz.
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Old 11-05-2017, 08:15 PM #3 (permalink)
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Default Re: Localized Hand Twitching

Greg,

Thank you for the response. I did read that section before posting and I realize twitching alone is not indicative of anything, but my concern is that it appears to be spreading locally. If I were just having random twitches throughout my body, I would't be as concerned. As I'm sure you can understand, I am simply very worried.
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Old 11-05-2017, 08:59 PM #4 (permalink)
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Default Re: Localized Hand Twitching

Best wait till you get that emg before worrying about ALS. There are a whole host of reasons for twitching. It is the equivalent of having a cough. How many things cause a cough? Or a headache?

We get many people through here with twitching who insist it's ALS. Or who state there can be no other reason that they have a singular symptom like twitching. The vast majority of them move on when their doctor clears them. We do get some who wish to stick around and insist they have ALS despite what their doctors and the people here tell them. This type of person becomes a burden to this forum, as the people here, some of whom are very seriously affected by ALS, are confronted with a person who is arguing with them about a thing they know very well.

ALS is a pattern of symptoms. Twitching in and of itself means absolutely nothing. ONLY in combination with a pattern of other symptoms does it add up to ALS. Many of the symptoms that indicate ALS are only detectable to a doctor via clinical exam. Wait for your emg. In the meantime, I'd seriously consider a physio to help you with your posture and neck/arm strength. Sitting at a computer or looking down at your phone creates a huge strain on your neck- which can pinch nerves and cause all sorts of painless and painful symptoms.
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Old 11-05-2017, 09:37 PM #5 (permalink)
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Default Re: Localized Hand Twitching

Shiftkicker,

Thank you for the response. I can tell you I definitely have bad posture and feel pain in my neck from time to time. If these issues are all correlated, it would make sense. One thing I will promise you is that if my EMG is clean, I will NOT return here to pester you guys and others. As I stated earlier, I am just very worried about this. Thank you again for replying.
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Old 11-09-2017, 09:29 AM #6 (permalink)
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Default Re: Localized Hand Twitching

Just an update:

I have realized if I flex my neck muscles, they immediately begin to shake and pull and tremor. Could this be an abormal stretch response due to spasticity? Everything I've read about spasticity points to this being very bad. Very scary. Any input?
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Old 11-09-2017, 12:44 PM #7 (permalink)
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Default Re: Localized Hand Twitching

Artie, have you been for your emg yet?

Have you seen a physiotherapist?

Shaking and tremoring is not spasticity, nor is what you describe an abnormal stretch response. A physiotherapist can help you with postural issues and help provide a baseline for muscle strength, with which you can track any changes over time to see if you are gaining strength or losing strength.

Your diligent research on symptoms of ALS is an excellent way to feed health anxiety. While I sympathize with your concerns over symptoms, there is not much we here can do to allay your fears it seems.
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Old 11-09-2017, 01:13 PM #8 (permalink)
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Default Re: Localized Hand Twitching

Shiftkicker,

Thank you for responding again. EMG is next week. Seems like it's taking forever. Depending on those results I will obviously go from there. I just happened to flex my neck for whatever reason and it resulted in some pretty scary-looking movements. I know any muscle will shake if tensed for long enough, but this is instantaneous. Perhaps this feeds into the theory that my neck and/or back are the root cause of all this. I guess I will just have to wait and see, but that is (clearly) proving to be difficult hence my presence here.

As far as the research goes, I'm afraid it's far too late for that. I fell into the Dr. Google rabbit hole weeks ago. My fiancÚ actually pushed me to book an appointment with a therapist. I will likely keep it even if the EMG is clean. I have just never endured a health scare like this and it has really taken its toll. I apologize if I am coming off as annoying to you guys. I am just very scared. I did, at least, follow the rules in the sense that I only posted again due to a new "symptom"...

Thank you again for your time.
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Old 11-09-2017, 02:12 PM #9 (permalink)
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Default Re: Localized Hand Twitching

I would respectfully request you only post once you have your emg results. In no way am I dismissing your feelings, only that you do yourself no good continuing to engage with people who have a terminal disease- you are actually making it worse for yourself and also burdening the people here. There are many things to reduce anxiety- be proactive with your health and go see a physio and actually do something about relieving your symptoms. Being here is detrimental to your health and does nothing for you- be it physical or mental.

Please be mindful that you are asking folks who have ALS and its attendant struggles to engage when there is absolutely nothing they can do for you.
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Old 11-16-2017, 03:58 PM #10 (permalink)
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Default Re: Localized Hand Twitching

Another update:

Had my EMG and it was clean. I was firm in voicing my fears and the doctors took me very seriously. They even did my leg upon request when only my hand and arm were scheduled for testing. They couldn't find anything abnormal at all. I couldn't believe it considering my hand still feels stiff and off and the twitching is spreading to the other fingers. I asked them what they thought it could be and they didn't have many answers. Welcome to neurology, I suppose. I also showed them my neck muscles and they didn't seem too concerned. They reassured me multiple times that nothing bad is going on.

Just several hours later, my referring neurologist called me to confirm the clean results. I told him I was definitely relieved, but still ultimately want to get to the bottom of what's causing this if possible. I mentioned the spreading of the twitching and neck muscle issues. He seemed perplexed by that information, but reassured that the test was clean. All we can really do is trust the docs, right? He wants to see me again next month. In the meantime, I actually downloaded an iPhone app to monitor my posture while at work and am looking into another specialist such as a chiropractor.

I thank everyone who read this and replied and I apologize to anyone who I may have offended for posting here. Health anxiety is a dark place and self-diagnosis is a slippery slope. I advise anyone else posting in this section to step back and take a deep breath unless you have multiple, severe symptoms. You can be sure I will not be back unless it is with good reason. Thank you all again and I wish you the best on your journey.
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Old 11-16-2017, 04:52 PM #11 (permalink)
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Default Re: Localized Hand Twitching

Artie,
Thank you so much for posting your EMG results. I'm very happy ALS is off the table. Have a great holiday season.
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