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Old 07-13-2009, 02:08 PM   #1 (permalink)
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Hello,
Hopefully I am not disrespecting anyone on here by listing symptoms without a diagnosis. I am not looking for any of you to diagnose me, just looking for some advice.

I had anterior cervical fusion surgery for a herniated disc a few months ago. I was experiencing weakness on my left side-especially grip and pinch tests. Noticeable and measured muscle atrophy in left forearm, none in bicep or tricep. Left side was at 10% of the strength of my right, all attributed to a pinched nerve. Prior to the surgery I was noticing some muscle twitching and weakness in other areas as well.

Post-surgery (3 months) and I am still experiencing many symptoms such as left hand/arm weakness and twitching, left calf, etc. My pinch strength has doubled in the last three months, but grip stength has remained steadily weak.

I recently read a journal article where a small number of people that have the type of surgery I had are later found to have ALS, as some of the symptoms can be similar to that of a pinched nerve(?).

I was just curious if anyone on here had experienced anything like this. I meet with nerologist in 2 weeks, GP wants me to have an EMG, will have consult first.

Would my grip/pinch strength be improving after 3 months if ALS was a possibility? I am concerned about the weakness and atrophy. What can I expect if the neuro orders an EMG?

Thanks for your time and God Bless.
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Old 07-13-2009, 02:18 PM   #2 (permalink)
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Have you been getting any physiotherapy for your hand strength? I don't think your strength would improve anywhere if ALS was a possibility but then I'm not a doc. I'd try to relax until you see the neuro.

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Old 07-13-2009, 02:35 PM   #3 (permalink)
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I have been going to PT. Started when the herniated disc happened, and have since followed up after the surgery. All of my pre and post surgery stats (grip, pinch, musculature, etc.) have been documented. Pinch strength is back within normal adult range (was less than 50% before surgery), grip is increased, but still only at half of what is considered normal.

Thanks for your response. I am trying to remain calm. At this point I don't know if this is a normal reaction to the surgery, or if it is something more. The longer it goes, the more concerned I am.

Don't know if it makes a difference, but "twitches" are not constant but periodic, and take place in multiple areas of my left arm, including forearm, bicep, and shoulders, as well as other areas in my body.
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Old 07-13-2009, 03:51 PM   #4 (permalink)
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Twitches don't usually mean much unless you have BFS which could be a possibility.

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Old 07-13-2009, 10:11 PM   #5 (permalink)
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My completely uninformed and baseless opinion is that if your grip strength improved, even though it has not improved as much as your pinch, then that is a good sign. Maybe your grip was worse off then your pinch and has further to go to improve? I can see why that journal article worried you; I read a few that scared me silly. Just tell yourself that you are a part of the majority that have that surgery and who genuinely needed it and just have to ride out your recovery. For what it's worth, I really believe you should take comfort from your improvements. Doesn't nerve recovery move along at a snail's pace? Something like, I don't know, an inch a month? (I can't speak intelligently on this) Maybe that is all that is happening. Someone out there, help me out-

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Old 07-13-2009, 10:46 PM   #6 (permalink)
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My husband had carpal tunnel surgery for supposedly impinged nerves. He had a weak grip as his first symptom. He got worse after surgery and his right hand and forearm atrophied to the point of almost being unusable. He waited for almost two years post surgery for another EMG and Nerve Conduction testing as the surgeon said the nerves would repair at about a millimeter a month. He finally took action when he could no longer hold eating utensils, put a key in a lock, use the gear shift on his car etc. He saw a different specialist who said he had a progressive muscle atrophy, and he had a repeat EMG and nerve testing (his third go around with those tests). That neuro. was unsure what was wrong and he was referred to a neuromuscular disease unit where he had all four limbs tests via EMG and nerve conduction (first neuro. only tested one limb on his first three sessions). He had MRI's, lumbar puncture, and sensory motor blood profile done by Athena Labs. He had slightly elevated protein in the LP and the sensory motor blood work was negative. He had a query of ALS, but responded well to IVIG loading dose of 2G. per kilo of body weight. He is diagnosed with CIDP --MADSAM. So there are lots of other things out there other than ALS that cause weakness and atrophy and fasciculations. With the EMG, expect minor discomfort according to my husband. I think the fact that your grip strength is improving is a very positive sign. Let us know how things go, and good luck.
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Old 07-14-2009, 09:32 AM   #7 (permalink)
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Thanks for your responses. Mainly, my biggest concern is the muscle atrophy accompanied by the fasciculations. The atrophy is definitely noticeable in my left wrist and forearm. Just noticed this morning that there is an indentation on my inside wrist (thumb side) upon flexion that isn't there on my right. Am also having increased fascics in my left shoulder and lats now. I don't know if it is reality or due to stress, but I am beginning to have weakness in right arm and left calf, too. A know ALS can present itself in many ways, but can anybody tell me more about the muscle atrophy and weakness aspect?
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