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Old 12-24-2008, 12:22 PM   #1 (permalink)
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Default How does foot weakness present?

Im wondering, everywhere I read ALS starts in hands or feet...but AFAIK the first "foot" symptom is drop foot, that is actually calf weakness, not the foot itself.
I may sound crazy, after second clean EMG, but I have twitching in my left instep for more than month, I can barely feel it, but I can see it..its the muscle abductor hallucis.
I would have second question (for wright probably - muscle denervation is proccess that involves not the whole muscle, but piece by piece (I have read it). So its possible that the needle in muscle is in the "healthy" area and EMG shows no signs, altough in different area of the same muscle is denervated?

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Old 12-24-2008, 12:58 PM   #2 (permalink)
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hi,i now have some atrophy in my left foot that used to twitch constantly.
about 18mths ago i started having problems with my ankle feeling weak and foot cramp, earlier this year my pt found that my arch has collapsed on my left foot.
i thought it was from the start of the atrophy but recently found out that the collapsed arch can be from the hypotonia in my left lower leg.
i think the foot issues are somewhat related to the lower leg.
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Old 12-24-2008, 01:12 PM   #3 (permalink)
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Hi Blizna,

I have leg onset ALS. First weakness I noticed was because of my "funny" walk. My wife commented and I had to stop and think about what it was. Since there was no pain I didn't really think of it as a limp, but of course it was. Anyway, I realized that I was not able to push off with the ball of my foot after walking about 100 yards, and that my ankle was weak. Of course the muscle that controls the ankle is in the calf.

My guess is I also had weakness in the foot. The muscles in the foot mostly control the toes. But there's nothing I do on a regular basis that makes toe weakness apparent like there is walking for the calves. No way to notice it, but I assume it was there.

Keep the faith,
Tom
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Old 12-24-2008, 01:17 PM   #4 (permalink)
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Olly, please,what muscles do you reffer as a foot? Im not sure what part of the foot we are speaking about?
Im really sorry for asking, but Im so confused. You said you twitch constantly on that place - that looks like "bag of worms" or simple twitch here and there? Thank you
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Old 12-24-2008, 03:40 PM   #5 (permalink)
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Blizna, foot drop is usually because the shin muscles at the front of the lower leg weaken and allow the front of the foot to drop or slap on the floor. I didn't notice I had it until the nurse at the ALS Clinic heard me walking down the hall one day and commented on it. Like most things with ALS, it creeps up on you slowly.

AL.
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Old 12-24-2008, 03:50 PM   #6 (permalink)
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hello again.
the twitching was constant like worms ,the atrophy is in my outer ankle were there is a crater.
in the foot my foot is thinner(shoes are too big on that foot now)the tendons stick out on top of the foot as were the muscle should be inbetween the tendons is were it is wasted.
i first noticed the atrophy after having the foot ankle problems as i did not think anything of the twitching back then.
i get stiffness in that foot ,even though i can still lift my toes up abit(not as much as my right)if i try to wiggle them or spread them apart my three middle toes wont move.
the left leg/foot gets very tired and takes effort to move when walking,as i am still walking(only round the house mostly,not very far outside and need stick/walker) my pt encourages me to keep going and not to have a powerchair yet.
but i do need somekind of a brace for my foot/leg now so i have an appointment in the new year.
what problems are you experiencing with your foot? legs?
hope the reply helped a bit more.
i will have to take a photo just to show and tell
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Old 12-24-2008, 04:28 PM   #7 (permalink)
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Olly, thank you for your answer. I have twitching/buzzing feeling in the left arch of my foot. It lasts for more than month..the neuro stick the needle in the middle of the muscle and the EMG was clean..Im affraid if denervation really could progress in one part of the muscle without being detected by EMG.
I have video of my twitching here: www.youtube.com/watch?v=rUiO4sqMi5E.
I still have something like that, its faster and on more places
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Old 12-24-2008, 07:46 PM   #8 (permalink)
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Jesus man, everyone that knows about ALS is going to tell you that you don't have it. Why are you bringing this up now? You have been told many times you don't have ALS. Try to have a happy Christmas for gosh sakes.

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Old 12-24-2008, 08:18 PM   #9 (permalink)
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Blizna, I watched your video. This is not fasciculations; I think you were just moving your big toe (intentionally or not - I don't know).

Al, may be we should close "Do I have ALS" forum. It does not seem to serve any good purpose. The ultimate advise to everybody is always the same: "go and see a doctor" (which may be a neuro, or a psychiatrist ).
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Old 12-24-2008, 08:37 PM   #10 (permalink)
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We started this particular forum so that people just asking general questions or looking for support wouldn't have to sort through a lot of stuff that didn't interest them. So the best advice is, if you think it might bother you or P you off, move to the next forum. Fortunately for you but not for us, Cindy and I read everything and I don't mind saying, I'd like to strangle a couple of people every month. As luck would have it, I can't even choke a chicken anymore. LOL.

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Old 12-24-2008, 10:14 PM   #11 (permalink)
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I noticed foot weakness because of leg weakness. It causes balance issues for me. Or at least I think its this that is causing balance problems. The AFOs do help me propel myself forward, and my heel to actually strike the ground rather than walking kind of flat footed, but they don't help with balance issues.

Pitch, I will have movement like what is shown in the video sometimes. It will actually pull my big toe sideways, a direction that I can't voluntarily move it. It was so extreme one night that the cat thought I was playing with him under the covers and kept pouncing on my foot LOL

Blizna, I continue to encourage you to stop thinking about ALS. Make it your New Years resolution. Why let this fear rule your world?
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Old 12-25-2008, 06:00 AM   #12 (permalink)
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hi blizna.
looked at your video,does look a bit like what i had in my foot but mine have calmed down now and not as bad as they were before.
i have had my big toe twitch in that foot,like how the thumb twitches.

rose.
my arch collapsing has caused it to be flat footed,i do still have some footdrop.
when i first got ill the footdrop was bad and i would drag my foot about,it got a bit better but now with the other problems i dont know.
if i try to walk my lower leg swings back then instead of going forward straight it swings out to the side and flops,i then drag it forward.
i can tell the footdrop is still there as my foot does drop forward from the front of the ankle,and i do slap that foot down.
i will be seeing about afo brace in the new year,my pt was supposed to sort it out months ago.
how comfortable are they? do they fit under your jeans? over or inside your shoes?
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Old 12-26-2008, 09:51 AM   #13 (permalink)
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I can still choke a chicken, AL. Maybe not strong enough to kill it but I can give a pretty good try, LOL.

On a happier note, I got the best Christmas gift of all from my new pulmonary doctor, who is my new BFF as well. He finagled another sleep study, which I had on Dec 23rd, and he set me up for "pi-pap express," so I left the lab the morning of the 24th with a bi-pap under my arm.

I cannot believe the difference. For the last 2 mornings, I woke with no headache, no nausea, no dizziness and no confusion. Life is good again.

Love to the world! (Just beware. I am not so filled with good will that I won't try to choke anyone who ruins the spirit of the season and breaks Al's plea for no whining! )
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Old 12-26-2008, 11:28 AM   #14 (permalink)
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Cindy, a vision of Al choking a chicken is not very pleasant to me. Don't be too naive.
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Old 12-26-2008, 01:37 PM   #15 (permalink)
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I am thinking AL had a different kind of chicken in mind. And , YES , the mental images are not pretty.

CindyM , amazing what a little boost (psi) can do for a good sleep eh ! I sleep with a turbo-charger (cpap) as well.

Enjoy your holidays everyone.

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