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iceygricey

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May 11, 2018
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Learn about ALS
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va
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chesapeake
Hello all,

I want to share back story. I was involved in a motor vehicle accident, I was hit by a drunk driver going 57mph while I was parked. I was wearing my seat belt and sustained damage to my shoulder. With the damage came a tingling sensation all the way down my arm to my fingertips. The symptoms eventually got worse where my whole arm felt it was asleep and at one point I couldn't move it. I was given a cortisone shot and that helped the pain in my shoulder as well as my regaining feeling in my arm for a few days. Now I have the tingling sensation down my arm and my hand feels as though it's week, but I still have full mobility and grip strength, it just has an abnormal feeling of being week.

The doctor wanted to order an EMG to find out if I had nerve damage. This is the part that has concerned me, I would have chalked it all up to being the car wreck, but the car wreck could unearth a deeper issue I might have been unaware of. The neuro doing the EMG stated the test was normal, then I get the report. The report didn't make sense to me at all so I will post his findings here.

"Strength is normal in the arms except for inversion and eversion of the humerus graded 4."

"normal nerve conduction's, borderline increase in long-duration motor units in left deltoid, bi-ceps, and first dorsal interosseous"

"Impression-borderline findings of chronic denervation/re-innervation affecting several myotomes of the left armwould not be related to the patients injury, as the time of the study is such that acute denervation, if present should be detected. Whereas it is too soon for chronic re-innervation to occur.

This report has confused the mess out of me. I am going to see my shoulder specialist in over a week, but I am concerned. I googled chronic denervation and and re-innervation and brought up ALS. I have always had random cramps sometimes in my foot, charlie horses in my calf. I sometimes get random twitches, but I have had that for many years as well. I was not concerned at all regarding this test until he added the word "chronic" what is the difference between chronic, acute, and active? He stated that my findings were borderline. They came back as +1 long in the "dur" category in C5-6, C7-8, and C8-T1. I am sorry if I am freaking out for no reason, and by no means am trying to take away from the seriousness of ALS. Getting this report back has sent my head spinning and if anyone has any insight I would be most appreciative.

The symptoms in my arm is like a tickling sensation and like a weakness feeling but I have full functionality of it. I started to kind of the same feeling in my right arm, but not nearly as bad, and I think that was related to PT because it started to feel like that after my PT session two days ago.

I was also told that they are considering the fact that I might have had a "mini-stroke" or stroke like event or I might have a compressed vein/artery and pinched nerve some place. I am a 30 year old male. Thank you for all the help and if I posted this in the wrong place I do apologize.
 
I’m assuming the injury was to the left arm? Injuries can really mess things up in terms of nerves, muscles, and soft tissues. I’d be concerned if you had abnormal EMG findings in areas other than the left arm or if you had weakness in that arm prior to the accident.

History and physical exam are more important than test results. Tests used for diagnostic purposes help confirm or rule out a suspected diagnosis, but they almost never would suggest a new problem that wasn’t already suggested by the history and physical exam.

Bottom line: I wouldn’t be concerned about ALS from your post and EMG results. Hopefully you are starting on a good rehab program.

If, by the longest of odds, you were developing a motor neuron disease coincidentally, it would manifest itself in other areas over time and those areas would show characteristic EMG abnormalities.
 
Hello and thanks for the quick reply!

I forgot to add this to the main post. I have had 0 issues before the accident. I have 0 family history of ALS or any other disease except for diabetes. And the injury was to the left arm. They currently believe that it's a brasitus injury. I also had an MRI of my head due to headache and that came back normal. It doesn't help that I'm also a bit of a hypochondriac :-( and I have a tendency to freak out. I am very unfamiliar with how ALS works, and I want to thank you for the feedback and helping me rest my fears.
 
Yup, we don't see ALS in this picture; the EMG may be seeing something that has long been a minor issue, and thus not necessarily related to your accident. Or as they say, the accident may have caused another type of damage that isn't as visible as your L arm. But as always with any kind of neuromuscular issue, we encourage a second opinion, esp. if you begin therapy and don't see improvement.

All the best.
 
Icey,

Seven years ago, I was stuck at a green light with the traffic backed up. The bone head coming up behind me at 80 kms failed to see the backed up green light and rear ended me. Because of where the seat belt sat across my left shoulder and chest, when he hit me, my shoulder muscle suffered a tear and, as a result, my left shoulder now has bursitis as well as nerve damage.

To date, my left arm still remains way weaker than my right, if I hold my left arm in front of me, I cannot hold it there for long and I get pins and needles running down my arm into the pinky and ring fingers. I cannot lift near what I can lift with my right side although I've done countless hours of PT and strength training to no avail. it still remains quite weak to this day. Do I think I have ALS because of this? No, I know I have permanent nerve damage to my shoulder because of the seat belt and the force of the hit from the car behind me.

Unfortunately, you may be stuck with this feeling for quite some time as a result of your car accident. You may be able to regain strength in your left arm with very light weight training and massage to stimulate circulation in your shoulder. You don't have ALS, though, just nerve damage from the car wreck.
 
Thanks all for the responses!
I’ve been in therapy for 8 weeks now. I’ve only gotten slightly better in the tingling department. I am going to have a second opinion on the EMG. I wanted to thank you all very much. I know this might seem silly with my story, but it was brought up to me as a possibility of something that was previously there. Thank you again for any/all advice and stories.
 
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