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keane

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Learn about ALS
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US
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IL
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Washington
Since my last physical therapy appointment, I've been curious about a finding and would appreciate some input.

Background: A few months ago, I began noticing clumsiness, cramps primarily in my left hand, which has progressed to severe weakness in the hand/wrist. I also have cramps and annoying twitching elsewhere. I went to a neuromusclular specialist. Nerve compression, MS and others have been ruled out. Since my overall muscle size is pretty large, my doctor wanted me to go to physical therapy once or twice a week to document muscle size and perform range of motion exercise. His assessment of the muscle size was relatively brief, but he noted that with the lack of atropy, he would wait a couple of months for a follow up EMG. The first EMG was not completely normal, but he stated that it was too early to be concerned since he saw no evidence of atrophy.

When pressed, he said he suspected PLS, but with time and a 2nd opinion at the Mayo, we should get an answer eventually.

On my last physical therapy visit, the therapist pointed out that the area between a few of the bones in my hand appears hollow, and significantly shrunken. I have absolutely no control of side-to-side motion on these fingers. The normal hand is very beefy between bones. I had not really noticed this previosly because the hand had been slightly swollen from a fall a few days prior.

Recently, I've begun to feel weak in very specific areas of my other arm and both legs.

Question: Have you ever heard of localized areas of atrophy? My wife, a nurse, and the physical therapist said they've never seen this. I wonder if this is an oddity, or if it is significant. I've come to a peace about this new medical issue and understand that it will take time.
 
Somebody correct me if I've misinterpreted the question, but in my experience and reading, there is no such thing as "global" atrophy with ALS. I don't know if there is or not with other conditions. I have localized atrophy in my tongue, which started 3 years ago, some facial muscles, and both hands and forearms, which started within the last year.
 
Thanks, I was beginning to suspect as much. My wife is a hospice nurse, so she only sees end-stage results.
 
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