Status
Not open for further replies.

T4xx

New member
Joined
Mar 27, 2017
Messages
5
Reason
Other
Country
FR
State
Lyon
City
Lyon
Hello,
I am very worried because I have symptoms that can be caused by ALS.
It all began 3 month ago with sensory disturbances caused by entrapment of the ulnar nerve. I had sensory problems (elbow pain, numb fingers at night etc) and I felt an awkwardness in my right hand.

On that occasion, I began to look at my hands and realized that I had muscle wasting in the first dorsal interosseous space of the right hand (between thumb and forefinger). There is a clear difference between the left hand and the right hand. I do not know how long it's been like that, if it's been a long time.

I saw a neurologist on February 22, 2017 who did an EMG. It showed a right ulnar nerve entrapment : myelin and sensitive axonal impairment and a pure myelinous motor impairment. The neurologist planted a needle in my muscle and told me that there was no neurogenic amyotrophy.

It reassured me at the time, but after reading a lot of messages on the forum, I worry again ...
Moreover I had tested the Hoffman sign and it is positiv on both hands.

In conclusion I have:
- "amyotrophy" between the thumb and forefinger of the right hand seen since 2 month,
- an entrapment of the right ulnar nerve (but which does not explain a possible amyotrophy because only a myelinic motor impairment not axonal),
- few diffuse fasciculations for 3 weeks in a context of stress,
- right wrist pain for 6 months (in support),
- I wanted to test the sign of Hoffman and I find it positive for both hands (but not in the same way, it is not the same fingers that move: index on the left hand and the thumb on the right hand) .

I do not have :
- cramp,
- Loss of strength,

I already had an episode of fasciculations in 2011, which lasted 2 months and was very intense. I have sometimes had diffuse fasciculations.

I spend 2 month in Canada and I've seen a doctor today who said "yes, there is an amyotrophy", so he gave me the adress of a doctor to do an other EMG.

Do you think it can be the first symptoms of ALS?
The 2 things that scared me the most are the "amyotrophy" and the Hoffman sign. Some people say that it is not a specific sign and normal people can have that sign but on both hands.

Thank you
 
ALS is a disease of the motor neurons, which manifests as muscle weakness. You report no loss of strength, therefore no clinical sign of ALS. Bilateral Hoffman's reflex can occur in perfectly healthy people.

In short, no, your symptoms do not suggest early signs of ALS.
 
Thank you for you reply.
2 pictures to show you the difference :






Is an ulnar nerve entrapment can explain that? The doctor said that it is a sensitive entrapment and a LITTLE motor entrapment. I dont inderstand why the EMG said no amyotrophy.
 
I'm very afraid that the doctor made an error during EMG and missed something... I have now twitching betwen the thumb and the forefinger on both hand! My thumb is moving on my rigth hand and the forefinger on my left hand too. Since 3 days, but I spend my time testing the force of my hands since 3 days too. Is it possible that twitching are the consequence of all my tests on my hands?
 
I see no reason for you to be concerned about ALS.

I don't think you can second-guess your doctor.

Normal, healthy people twitch. Don't worry about it.
 
Hi, thank you for the answer.
But since 2 month now I'm thinking non-stop about ALS, I spend all my free-time at looking after my hands and I have discovered something that worry me a lot.
On my left hand this time. The wasting on the rigth hand is the same, nothing has changed.
But last week I watched at my hands and I have seen something weird on my Thenar eminence : there is a relief on it when I extend my thumb and I don't remember ever have seen that before. I wonder if it could be a muscle wasting. I do not see some loss in strength but I have twitching in all my body since 2 month (but I have already had that few years ago and I have twitching sometimes like that).

With thumb at rest


With thumb in extension


I am very worried, I have an other appointment for an EMG but it's in june and I would to know before that if it could be a wasting or not.
Thank you
 
There are many benign reasons for thumbs and hands to differ in terms of feel, stiffness, etc. If the EMG was normal, lower motor neuron dysfunction / neurogenic atrophy has been ruled out. Since you have demonstrated ulnar entrapment, that is clearly a plausible root of your symptoms. The next step is home exercises and perhaps PT. Neither can happen here, so this is not the place for you.

Best,
Laurie
 
Thank you Laurie,
The EMG was clean for the right hand, the doctor hadn't test the left hand. And the ulnar nerve entrapment causes interosseous wasting not thenar wasting, that's why I'm worried (and it' son the other hand)
 
Funny, how when you started fixating on your hand (self testing and the like) you noticed waste and twitching.
Listen to Laurie and Mike. Follow up with your doctor. Go live your life.
 
In ALS, you are going to see EMG abnormalities in "the good hand" as well. As for the precise location(s) of atrophy, that's not the red flag you seem to think.
 
Status
Not open for further replies.
Back
Top