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Apricotmelon

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Hello everyone!

I am here to ask a question about possible ALS symptoms. My uncle recently noticed that his left arm has been acting strangely. He cant seem to balance things he carries (think like how one carries a pizza box. He makes pizzas and holds boxes with that hand but seems to be unable to balance it after 10 seconds or so.)He says its worse when he is distracted and he "forgets" he was holding the item causing him to be inable to balnce the item and thus he drops it. He has also noticed that whenever he is extending his arm as in he is holding a cup, he notices that after a few seconds, his arm feels fatigued and begins to lower. This has led to incidents of him dropping things or spilling things due to this. I have asked him to demonstrate and he is able to hold an item but after around ten seconds his arm starts lowering and says he feels tired and just lowers. We went to a doctor and they did strength tests. His grip is strong and he can move his fingers well. The only thing is that she found that his tricep area when pushing forward was a little weaker in his left arm than the right arm. He could still push back but they noticed it was a little weaker. He can still carry bags with the arm and can zip up and grasp things. But whenever it comes to extending his arm or holding things while extending his arm, it lasts a few seconds before his arm begins to lower/droop/feel tired.

Any idea if this seems related to ALS? Thank you for taking the time to read my post. I really appreciate it.
 

Apricotmelon

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I hope I posted this correctly. Can Anyone offer any insight? Thank you.
 

Nikki J

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I would explore an arm issue. That is infinitely more likely than ALS. If it is a triceps issue it could be as simple as an unrecognized injury. What did the doctor say about his functional issue?

It is not etched in stone but ALS usually starts at the end of an extremity in limb onset in a hand or a foot
 

Clearwater AL

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Nikki, don't mean to jump in here but what you wrote needs to be quoted more often
in future DIHALS posts...

"It is not etched in stone but ALS usually starts at the end of an extremity in limb onset in a hand or a foot."

As I think back I said it started with my left leg but... it was my left foot climbing stairs,
stumbling and noticed when climbing a ladder.

As you wrote it's not etched in stone but numerous PALS have written exactly that.

I think it's more than "usually."
 

lgelb

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Assuming we are talking about limb onset, a notable exception to the "hand or foot" premise is the flail arm/"man in a barrel" subtype, in which the upper arm is affected first. But that is pretty unmistakeable, with significant atrophy for a stick figure look.
 

Lkaibel

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Brian was left foot, foot drop.
 

IgorZilio

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Mine was proximal. Left biceps. Funny thing though, in EMG distal muscles show more signs of denervation. The thing is, like this paper says: (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4653353/)
"ALS patients experience localized muscle weakness that begins distally or proximally in their upper and lower limbs. Usually, the onset symptoms are asymmetric and develop in progressive generalized weakness and wasting of the muscles." ; "Muscle atrophy, including muscles of the hands, forearms or shoulders, and proximal thigh or distal foot muscle in lower limbs, is usually discovered early in the development of limb-onset ALS."

There is a clear predilection for distal muscle weakness, but the key thing is weakness progression, proximally or distally. It's usually a mix of muscles of various regions at the same time.
Localized proximal weakness without any other symptoms points more towards myopathies, nerve root compression, etc. than ALS.
 

Apricotmelon

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Is this ALS and Can it develop THIS fast?!

Hi everyone

So my uncle was experiencing some arm weakness a few days ago and a bit of clumsiness. We went to the ER and he was able to touch the tips of his fingers on the same hand rapidly and had decent grip strength. He seemed to have a bit of foot drop but he blamed it on his knee problem but you could hear his left sneaker scrape the pavement. Keep in mind that TWO weeks ago he was walking fine and had arm strength as he was unclogging toilets at his job. Today, is around two weeks after him being completely fine and now he can barely open his weak hand, cant do the finger exercises that he did at the ER four days ago. His grip is much weaker four days after that ER visit. He Has virtually no grip on his left hand and his leg is dragging much more. Keep in mind all of this is happening on his left side. His right side is completely fine and strong. My question is, is this als and does it progress THIS quickly? Two weeks ago he was completely fine and now his left hand has no grip and his left foot has foot drop? Any insight would be appreciated.
 

ShiftKicker

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Mod note- moved to original thread. Apricotmelon, please continue posting on this thread only. It keeps the all the posts together and enables the members here to see everything in one place.
 

Apricotmelon

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Thank you and I apologize. Its just that there have been so many new developments that I felt that it warranted a new topic since it no longer only concerns arm weakness and now includes other symptoms. Would it he possible for it to be its own post so that more people see its a more developed situation and no longer only about arm weakness? Regardless thank you for your time.
 

Nikki J

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It is extremely unlikely that ALS would act like that in 2 weeks if he was fine then. If you are describing this accurately he needs to be reevaluated on an emergency basis as this could be any number of things Many would be time sensitive
 

lgelb

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I agree with Nikki -- he should be seen in preferably the same ER or an affiliated neurology office that can pull the records off the server. What you are describing sounds more like a stroke, tumor, blood clot -- and as she says, treatment could be time-sensitive. Please seek care for him, today.

Best,
Laurie
 

Apricotmelon

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Thank you all. We are headed to the ER as we speak. Thank you again.
 
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