Can ALS weakness disappear during day?

[Martin_Sk]

Dear members.
At first, please forgive me for my bad english. I will use AI to translate.

My problems started roughly two weeks ago. While working as a barber, my left hand started trembling, and since then, I've felt weakness in it. It's a strange sensation, like a muscle missing in my forearm. Or rather, as if a muscle is so overstrained that I can't feel it. I can still perform all activities, but my hand shakes during certain movements. Since ALS isn't widely discussed in our country, I began to fear it might be the onset of ALS. Tomorrow, I'm going for an examination with a neurologist, but the reason I'm writing this thread is to seek an answer to my question.

I experience this weakness in my hand more or less throughout the day, but occasionally, during the day and especially after waking up when my hand is 'rested,' I don't have these feelings of weakness, and my hand is fine. But as soon as I start to notice it, the feelings of paralysis return. Is it possible for someone in the early stages of this disease to have moments during the day when they don't feel symptoms and their nerves and muscles behave normally?

I apologize if I've violated forum rules and morals, but I'm very desperate and extremely scared.

Thank you.
Martin

 

[ShiftKicker]

Hello-

This part of the "Read Before Posting" post answers your question:

Clinical Weakness—ALS is about failing, not feeling.
ALS is about failure—falling down, being unable to stand on your toes or heels, being unable to button your shirt, being unable to lift your hand, being unable to open a ziplock bag, etc. It is not about these things becoming more difficult. It is about these things being impossible… no matter how hard you try. If you can do normal things, but it is more difficult, you do not have ALS. If you used to be able to do 100 curls and now one arm can only do 50; that is not ALS. If you used to run 2 miles and now you can only run 1; that is not ALS. If you used to run 2 miles and now you can’t lift up one of your feet, you may have clinical weakness.

It really does happen that something stops working all of a sudden. It is generally one muscle so it will not be a whole limb, but the movement done by that muscle is suddenly gone. An example is a calf raise. It won't happen. Think of it like your wifi signal. You are surfing the net, then signal is lost and you can't do anything online no matter how hard you try or how long you wait for a page to load. This is what happens to a muscle in beginning ALS it has lost the signal from the nervous system that tells it to work. First it is one muscle, then another ,then another so the things you can’t do increase. This is why you see progressive weakness mentioned

There are many things that cause a sensation of weakness or temporary weakness. To go directly to ALS is a huge leap. If you work with your hands daily, you may wish to work with a physiotherapist to find ways to prevent repetitive stress injury.

Please take care.

 

[Martin_Sk]

Hello,
Thank you very much for your opinion and time. In the meantime, I underwent a brain CT scan, which was fine. Today I underwent EEG and EMG with a result that I don't understand very well. Since the final medical report is written in Slovak, I allowed myself to translate it into English using Google Translate. The doctor told me that everything is fine and I don't have ALS. However, during the measurements of the affected hand with needles, lower numbers came up (circled in red). I'm not a doctor, but could it be that the nerves in the affected hand are dying, hence the doctor measured lower values?

I apologize in advance if I asked a silly question, but I'm still uncertain.

Thank you from the bottom of my heart for any opinion.

 

[Nikki J]

Hi. The table that you are showing is from the nerve conduction test ( shocks). First it is not a test related to ALS at all. The emg ( needles) is the ALS test. Secondly those numbers do vary and if your doctor said it was normal believe them. We just had this question yesterday. See here So confused and worried for ALS, 23 Male

 

[Martin_Sk]

Thank you very much for your words. I've read the thread you sent me and I agree, I'll trust the doctors. During the EMG examination with needles, the doctor told me everything is clean. The only deviation she noticed was during finger tension, when the curve on the monitor should have been dense, but I had some missing spots in a certain section. The doctor said it's likely due to compression of a nerve in the cervical spine. Then she looked into my eyes and said, "You don't have ALS, the examination went well." I'll believe her, I have nothing else left. I'm mainly trying to rid myself of all the anxiety. I hope I can do it.

Take care.
Martin

 

[Martin_Sk]

Hello,

I apologize in advance for bothering you again, but in the meantime, I have undergone a series of examinations and have also received the results of my EMG. After the EMG examination and a brain MRI under the MS protocol, my neurologist concluded that the tremor and feeling of weakness in my hand are caused by tetany, as all other tests were negative. I won't burden you with unnecessary information. I would just humbly like to ask if there is anyone who is knowledgeable about EMG curves who would be willing to look at my results and confirm my neurologist's opinion that these results are indeed normal and that it is not ALS.

Thank you in advance for your time
Martin

 

[lgelb]

Again, this is only a nerve conduction study and not the needle test that would relate to ALS. If the neurologist did not see any issues on the exam that would make the needle test necessary, she would not do it.

As for the problems in your hand, you could ask about physio to help it feel more like the other hand, and look closely at the way you are doing your work, to see if you are putting undue stress on that hand, as ShiftKicker suggested earlier.

 

[Martin_Sk]

Hello,

Thank you very much for your opinion. However, the doctor also performed a test with needles. I had two needles inserted into my left (affected) hand (on the sides of the palm) and one in the area of the shinbone on my right leg. I thought that the charts I just added were from that examination, but I was apparently mistaken, and they are charts from a previous nerve response test. I will try to locate the results from the needle examination and get back to you.

Take care and have a nice day.

Thank you,
Martin