3 months of symptoms. First EMG/NCS done. No help from Neuro

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Miamicanes

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Hello, I am a 29 yr male and in late Jan starting having troubling symptoms. Here is a timeline.

Late Jan - action tremor in hand, left pinky felt odd to move and stiff. Middle finger and ring finger felt somewhat numb but no weakness to report.

Feb - stiffness in left hand continued and some discomfort on ring finger as well. Mostly noticeable when typing or doing sports. Noticed that I could not engage with that finger like before. It’s a pinky so usually not as engaged as other fingers anyways but still hard to tell.

Mar - starting to feel weakness or slowness in both legs. My left leg would feel very sore and heavy when engaged. It would cause occasional pain in the cold or when humidity would strike. Feet also feel numb at times. Ran a 5k with a family member the day I really noticed my left leg weakness and knee pain and have yet to workout since. Haven’t fallen or tripped even though I’m certainly more conscious of my gait and stride. Leg easily tires. Full body twitching started night before the run and has since never left, more prominent in legs now but still can happen or does happen everywhere else.

April - now my right pinky joined the party and is having similar issues to my left. Issues with fine motor movements and stiffness as well. Went to a neurologist and was sent for EMg/ncs and I have attached results.

Full symptoms at this moment:
Both pinkies have issues with fine motor skills, stiffness
Left leg stiffness and soreness
Weakness even though it hasn’t been clinically observed with my 2 neuro visits
Body muscle twitches and occasional cramps as well

I’d also like to add. I had a back injury 5 years ago and bulging lumbar discs that caused damage. No surgery done although I’ve been unable to lift weights or do heavy exercise without feeling soreness and stiffness. Recommended to never lift weights again. After my EMG I was sent to get a cervical MRI and I’ve also included those results.

All the neurologist has essentially said is to get my anxiety in order and relax. The EMG and NCS both have findings, although they assured no ALS so no problem. It hasn’t been a long time in symptoms and since my symptoms started with my fingers he only conducted the EMG on my hands, arms and neck.

Much love and respect to all fighting this disease. My ex girlfriends mother passed from it and I witnessed it upfront and I have so much compassion for the ones enduring the battle, patients and family members alike.

Thanks for any guidance or relatable stories I can find for my current situation.
 

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The EMG wasn't done on the "wrong" muscles [ALS shows typical changes even in muscles that seem OK], and it doesn't show damage consistent with ALS. Nor does your report of your issues (e.g. tremor, widespread twitching) resemble it. So I'm not sure why we're even talking about ALS.

Since you have a spine problem that seems to be causing symptoms that bother you, I would ask about PT. An orthopedic surgeon specializing in back issues might be the person to order/oversee this.

You should know not only things not to do, like lifting, but exercises/stretches you can do at home toward reducing the impact of the spine damage.

Best,
Laurie
 
Hi Laurie,

Thanks so much for your reply. The report does read tremor and wide spread twitching but that wasn’t my laundry list of symptoms, I’ve stated those above. Not sure why that’s all that’s written on my report. I wasn’t thinking ALS prior to being sent in for the EMG, and while being relatively clear, the EMG does show problems in numerous muscles (half the ones tested) My cervical MRI did come back with some issues as shown in the images of the documents so that was enough for the neuro to state that could be the reason for the finger problem and why my pinkies are stiff and uncoordinated, but I hadn’t “hurt” myself per say in that neck area. I always associated nerve damage or injury with pain. Nor does it really explain the stiff and weak knee, all coming one before the other.

However, my hands did show on the NCS part of the test since almost all muscles tested showed declined peak amplitude for both motor and sensory muscles. Is that something worrisome should I continue to progress more so into the hand? Im in an office setting and type nonstop.

Reflexes tested were okay and am able to walk on toes and heels so my clinical was passed. I guess the hand/nerve issues did not put me at rest since I haven’t associated any pain with them and normally carpel tunnel/ulnar nerve problems and such include some pain (from my understanding)?


Thanks again for your comments and I apologize for any ignorance on the matter and my descriptions.
 
Actually, your own account mentions tremor and "full body twitching" that has "never left." I didn't take it from your attachments.

It is incorrect to infer that nerve damage in any body part requires pain. It does not. It is also incorrect that abnormalities on EMG somehow mean ALS. There are hundreds of disorders that an EMG illuminates, and the spine damage you have is very common. It can also be exacerbated by bending your neck to talk on your phone, keyboard, etc.

Hand problems from work are also extremely frequent. If you type nonstop, it might be time to consider dictation, taking breaks every hour, re-evaluating your work setup (chair, keyboard, monitor height/angles). Look at an "active sitting"chair.

I agree that hand therapy might be beneficial but would start with the spine issue since often that might be folded into a full PT plan and there is documentation for both hand/forearm damage and cervical radiculopathy.

Damage to the motor and sensory nerves in/around the hand might or might not include pain/tingling, but that is not the point. You need evaluation for these issues, beyond just understanding that they ≠ ALS.

I hope what you are taking from this is that you have nerve problems, that can be generally improved with work setting adjustments/therapy, and there is no reason to worry about ALS.
 
Hello again,

It’s been 3 weeks since my NCS/EMg and I have zero doubt in my mind that I am going through beginning of ALS. Both pinkies are losing grip strength and motor function and now my left middle finger is also stiff and going down same path. I have noticed on multiple posts that having paraspinal fibs and PSW is a bad sign and likely leads to ALS and that’s where I had them on my tests , see above. I had multiple findings in my NCS but they were both motor and sensory abnormalities. The neurologist will not want to see me yet but I have felt no pain, just discomfort and an inability to move my fingers in the same way. The left leg stiffness is the same, not worse not better. Has anyone reading this gone through a similar process?

Also both arms are atrophied or beginning to and that correlates with the findings on my EMG for both forearm and tricep muscles. This is terrifying and truly sad but there’s no other explanation for this progression.
 
Nothing, absolutely nothing you describe remotely resembles ALS, and your EMG supports this. If you think you know more than the folks here and know more than the doctors that have examined you, why are you here arguing? Just diagnose yourself with ALS and call it a day.

Truly, your symptoms do not say ALS. There are many other causes to explain what you're going through. One of those is not ALS, though.

Good luck to you
 
Your ex-girlfriends mother passed from it and you witnessed it.

Now you've convinced yourself you have it. You are suffering
with considerable Health Anxiety. There is a link... but you
probably won't accept that either. It's the cycle of Health Anxiety.

At least give it some honest thought and ask for some help for
that.
 
Yes, I think we're done here. You don't seem able to objectively examine the evidence that's laid out for you, demonstrating the lack of reason to worry about ALS.

Like the others, I strongly urge you to seek counseling to put this happy news in perspective, and to seek appropriate care to manage the symptoms arising from your common hand and spine problems. Print out this thread and read it periodically if that helps.

Closing this thread -- please do not start another -- to help you focus on what you can do to feel better, none of which is online. All the best.
 
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