A question

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Gorbos

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Hello everyone.
I'm back in this forum after some months.
I had a negative neurological examination in October 2018 and a clean EMG in January 2019, but still I feel weakness at my left upper limb.
This weakness is true, because when I pinch a finger of the right hand using my thumb and first finger of the left hand and I compare with the right ones, I feel there is a difference in strength. I am also left-handed, so I think it's not normal that left hand is the weak one.
Now, it's been a year (and maybe more) since my first symptoms started.
I still have dexterity preserved, I can do everything with my left hand but I feel it's weak compared with the right one.

Now i'd like to ask: is it possible that this could be an upper motor neuron dominant als? Maybe that's why the EMG Didn't pick up changes. And I also read that UMN -dominant has much slower progression than the "classic" one, so I tell myself that maybe that's why I still have dexterity preserved.
 

Nikki J

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There are many many reasons for hand weakness and most are far more benign and likely than ALS. I suggest you return to your doctor who can examine you,confirm if weakness is indeed present, check for any associated findings including upper motor neuron signs and make a plan to find out what is wrong.
 

ShiftKicker

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Past threads here:

UMN issues are a pattern of symptoms a neurologist can detect based on a physical exam. There are also some signs that can be detected on EMGs, that along with a clinical exam, indicate there is an Upper Motor issue. You can not examine yourself or test your own reflexes- but it can be very clear to a doctor. Please, if you have any further questions, speak with your doctors about your symptoms.

Gorbos, you've been given many many answers over the past months and you have been unable to believe or gain reassurance from the people here, nor from your doctors. This indicates you may also need to work on getting help for health anxiety while you work with your doctors to track down any cause for your physical symptoms. Not believing EMGs or your doctors and returning to a forum for ALS over and over again to ask questions when you have been cleared are all hallmarks of health anxiety.
 

Vincent

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Allow me to explain. In ALS the motor neurons die one motor unit at a time. A motor unit is the nerve and the portion of the muscle that that nerve controls. Before you would notice weakness you have to have lost about 70% of the nerves to that muscle. This means that at the same time other motor units in other muscles are dying at various rates. This is why they don't have to test all muscles, because other muscles would show changes as well in other parts of the body. So congratulations, you are officially in the clear!
 

Gorbos

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Thank you all for your kind replies.
Unfortunately, the fact that I'm still feeling this sensation of weakness does not reassure me, because I read two things (on a serious article):
1. UMN-dominant is the most common presentation among people in their 20-40 age (and I'm 30)
2. UMN-dominant is "slow progression".

So I am just asking: if it was a "slow progression" UMN-dominant ALS, would I still be able doing all of the normal things of my life after one year from symptoms onset?
I have some weakness sensation when I brush myself in the shower, and the left arm moves a little slow in comparison with the right one, but this happens when I try to move it very fast.
But all of the other activities (like using keys and so on) are OK, just a feeling of weakness when I try to open a jar.
 

KarenNWendyn

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We don’t believe you have a motor neuron disease. Apparently neither do your doctors. There’s no “feeling of weakness” as we’ve tried to explain. We’ve answered many questions for you. Apparently you don’t believe us and you are trying to argue with us. You’re trying to convince a group of people actually dying of ALS that your motor neurons are dying. Enough already. Sorry, but this isn’t the forum for you. Please work with your doctors.

Please reread the answers we’ve given you as well as the “read before posting” sticky. I’m closing this thread. Please do not start another.
 
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