Old 05-31-2009, 12:55 PM #1 (permalink)
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Default twitching - wrist issue - ALS?

Hi all,

I'm a 30 year old male and am having twitches since Oct 07 (19 months)
I'm having them 24/7 in my calves + random every 10 minutes , mostly back, right arm and right hand. I've been diagnosed BFS by 2 neurologists ( 2 professors in MND - 1 of them is an als reseacher for a cure) Had 2 clean emg's in first 2 months of twitching (only twitches were seen)

Now since last week my wrist, thumb and index finger are hurting. Also shoulder and arm pain on and off. My hand 'feels' to cramp but not acctualy cramp.
I notice lately that I drop a lot of things: keys, cell phone, pencils.. However I can pull or carry heavy object without problems. I'm wondering how hand/finger weakness presents in ALS. I can use all fingers & hand. Is it really obvious or is it like I describe?

Thank you for your time
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Old 05-31-2009, 01:06 PM #2 (permalink)
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Hi Bart, welcome to the forum. Twitching is not a sign of anything, could be nothing at all. As far as hand and finger problems, they are very obvious. You would notice a progressing weakness. From what you have said it seems that there is no weakness so it does not sound like ALS.
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Old 05-31-2009, 02:00 PM #3 (permalink)
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Bart, hand/finger weakness is pretty apparent. When you cannot do something that you have routinely done all your life, it's immediately obvious. And usually very surprising ... like, "Why can't I turn this key?" "Why can't I open a pop-top can?" "Why can't I button this shirt?"

With ALS in your hands, you usually lose the fine motor skills first, i.e., keys, buttons, paperclips, things that require very little actual muscular strength but a lot of finger dexterity. You can't detect ALS-type weakness by testing yourself with bicep curls, lifting weights, etc., as many worried people seem to do. It's the little muscles that go first.

(My guess about hurting muscles, by the way, is that when you twitch a lot, you are actually working those muscles, although only slightly. But if the benign twitches are frequent and strong enough to be noticeable, I bet you can get a delayed muscle ache from their constant activity, just as you get the next day from aerobics or a gym workout. That's just a hunch with nothing scientific to back it up...)

Take care.
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Old 05-31-2009, 05:10 PM #4 (permalink)
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Bart,

Carpal tunnel can cause those sort of problems with your wrist and hands. I think one of the tools the doctor uses to check for this is an EMG on the wrist/hand.

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Old 06-01-2009, 12:09 AM #5 (permalink)
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Bart,
I will add to what Kim/Zaphoon says--other things cause hand weakness and atrophy such as carpal tunnel and CIDP which is an autoimmune disease. My husband has profound atrophy of the hand and forearm and lost the ability to even hold a coffee cup, shift gears in a car, or use eating utensils and he has CIDP. He has had much improvement with treatment with IVIG, but still has minimal strength when the IVIg wears off at the end of each month until he gets another dose.
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Old 06-01-2009, 08:59 AM #6 (permalink)
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Hi everybody,

Thank you for your answers.
I can still do keys, buttons... Only my wrist hurts , the pain sometimes goes to my fingers. I don't know how ALS presents in case of arm onset mainly in the wrist, is it a drop wrist or pain?

Thank you
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Old 06-01-2009, 12:25 PM #7 (permalink)
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bart1, it is weakness.

You would start to notice dexterity issues and weakness. You would not be able to do the buttons up on your shirt or have the strength to pull your pants up, etc.
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Old 06-01-2009, 02:25 PM #8 (permalink)
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Your pain sounds like my wife's C/P. She had operation a month ago and is pain free. Her thumb was even starting to atrophy.

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Old 06-01-2009, 03:06 PM #9 (permalink)
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Thank you mr Joel and mr Al but what is C/P ? (sorry I'm not English)
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Old 06-01-2009, 04:42 PM #10 (permalink)
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Carpal Tunnel Syndrome. Sorry, I did notice that you were in Belgium but thought your English was ok.

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