Atypical Presentation

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Spiderman

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Learn about ALS
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Hi all,

I have some atypical questions/concerns that I wanted to get some input on. Before I start, I have read the “please read” thread on the forum.

Age: 36 year old male
Symptoms:
• 1/1/23, I started to feel a shock behind the top of my right hand (middle-finger knuckle) when I would twist my wrist (opening doors, turn keys in car). The shock when I twisted my wrist got better but I noticed when I touched or applied pressure to the right wrist on the radius side, it would send that exact shock to the top of my middle finger knuckle
• 2/7/23 received X-rays of ortho for wrist/hand and everything was normal. They gave me a steroid shot in the nerve on the wrist which didn’t help
• 2/14/23 I felt like my right forearm (brachioradialis) was so tight and huge (consistent spasm) after working out. It just didn’t feel right even after I stopped working out
• 2/24/23 PCP said no myopathy or strength issues. Labs were all good minus slightly elevated CK. I was referred to neurology
• 3/23/23 got fasciculations for 24 hours in the exact forearm spot and soon after started getting whole body fasciculations. Also, both thumb muscles in the palm started feeling a little crampy
• 4/3/23 neurology appointment with neurologist (who’s interest are neuromuscular disorders) with no issues on physical exam. EMG was normal.

This all made me feel great but the symptom spread to another body part

• 4/15/23 started to get a consistent spasm in my right soleus (calf muscle) that felt like my forearm. It does not feel like a charley horse. Then a couple days later, fasciculations in both calves but dominantly in the right one. Also vibrations/buzzing in right soleus muscle

Okay, so I know this all doesn’t exactly sound like MND but could this be a atypical presentation? I know pain doesn’t normally happen early but sometimes when I use my forearm for daily activities it feels like a slight, localized pain from irritating the tightness?

Current symptoms: whole body fasciculations, hard to describe “pain” in forearm, both thumb muscles on palm feel crampy, neck feels crampy like I need to pop it on left side and has caused tension headache

Thank you all for your time!
 
It doesn't sound like ALS to me, nor evidently to the neurologist you saw. It is pretty common for localized pain to appear in "another body part," without anything dire going on. This is particularly likely when you are stressed and anxious about the first part. Your mind is good at playing tricks.

You could discuss with your PCP whether PT and/or massage therapy might prove worthwhile. Sometimes it takes very little time to "break the cycle." At the very least, de-stressing and letting some time pass may shed light on where there is a physical issue that you can address, perhaps with postural changes at work, sports, leisure and/or sleep. A critical look at your mattress, pillow, chair, sofa, etc. couldn't hurt.
 
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