Could these be early signs of ALS?

Stevey_OD

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Hi

So for the last few months i have seen the development of a number of neurological symptoms and unfortunately i don't see a neurologist until May so am starting to get worried and seeking advice from those who know.

I have been having calf fasciculations almost daily, but have also observed in the FDI region of hand as well.
I've had muscle spasms throughout the body
I've also had a seizing of both thumbs while working on my computer and a visible tremor in the left thumb.

Attached below i also noticed recently an indentation when i extend my thumb. This is of the left hand but i have a slightly smaller one on the right hand as well.

As a side i have read that ALS is typically painless and i have been expereicing random darts of pain at times during this time which may suggest it is not ALS, however the indentation in particular recently has given me the biggest fright.

As for muscle weakness it's difficult to say. I feel like i can contract at full strength, however when i hold semething heavy i have observed my hand and arm tremble where it wouldn't have had in the past and i have found myself occassionally dropping smaller items that again i wouldn't have in the past.

When i compare left to right hand my right hand is also much more noticeably muscular in the FDI region although this may just be because my left hand is my non-dominant hand.

I don't mean to be insensitive to any users who do indeed have ALS, maybe i am overthiking my symptoms but if i am right i may be observing spasms and the beginning of muscular wasting and weakness which as i understand are the hallmark symptoms.
 
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lgelb

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I don't think so. As you await your May appointment, which I expect to be reassuring, I would focus on the things you can improve, perhaps sleep, stress, nutrition, hydration, exercise, and social interaction, even virtual, all of which help keep mind and body fit.

I don't think you can consider any of these "neurological symptoms" without some evidence to that effect. What did your GP say?

Best,
Laurie
 

Stevey_OD

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Hi Laurie

Thanks for responding and i have certainly been focusing on those variables i have control over since symptom onset. But my GP has advised she believes my symptoms are neurological.

Unfortunately my photo was removed but i had posted it to show the indentation i am seeing across what would be the abductor pollicis brevis muscle, it is on both hands now and worse on the left and i have tried to measure strength myself to monitor but unfortunately its a tricky muscle to measure without the right equipment.

I know from the main post to read first it talks about complete failure as the identifying symptom, however i've also read about how there are some 1700 motor neurons that control the hand and that failure is often only observed after about 70% or more have been killed so what i was most worried about was if i am seeing the early stages of that process in my left hand in particular.

Unfortunately the two muscle groups i am seeng the issue in have also been outlined as defining muscles in ALS which doesn't help my thought process either.

Thank you for responding though and i certainly do not wish to sensationalise a very serious condition, it was more the new and relatively sudden noticing of these issues combined with their specific connections to ALS that got me worried

Best
Stephen
 

Stevey_OD

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Hi, 33 year old male, currently referred and awaiting neuro consult in May.

Symptoms that may suggest ALS that worry me are as follows:

Weakness or much easier and quicker to fatigue in the left arm. Example was gardening and after using the strimmer my whole arm felt tired when it never would have before and when I bent at 90 degrees the whole arm was shaking almost like a tremor from the effort of doing so.
Also weakness in right thumb where it is seizing up quite a lot when typing or using the mouse in work and also my mobile phone which also never happened before.

Atrophy, I appear to have what looks like atrophy of the abductor pollicis brevis muscle in both hands. It's very noticeable when I extend either thumb and to my knowledge is new as of about 3 months.

I also have calf and tongue fasciculations and have observed hand fasciculations at times as well as a very recent onset of some tongue difficulty when talking. It's not very pronounced, only when combining certain words in a sentence where I seem to just struggle a little at the tip of the tongue. But it's new and has remained now almost a week.

Now there are 2 potential symptoms that would point to it not being ALS which are random bouts of nerve pain, in particular the cranial nerves and arms as well as occasional dizzy spells.

Onset of nerve pains and dizziness is 1 year ago, onset of neuromuscular issues is roughly 7 months ago which started with the calf fasciculations which have remained almost daily since.

My GP is of the opinion that the nerve pain and dizziness may be separate to the neuromuscular which if correct fits my understanding of stage 1 ALS and certainly frightens me.

I've still another month to wait for my consult and then will need to await testing after that and am driving myself insane worrying about this. Google is of course not my friend and I do apologies for those who are going through the process having received a confirmed diagnosis.

I'm anxious as hell, losing sleep with worry and generally mentally falling apart with the wait over this and have people around me trying to tell me to relax and wait to see what the neurologist says which I know is all I can do for now but the not knowing and worry is torture.

I hope the wisdom of this forum can help maybe shed some light that info sites would be less nuanced in and if there are any suggestions of questions to ask when I see my neuro that would also be much appreciated!
 

Nikki J

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I have merged your posts. We ask you stay on one thread for all your questions. Thank you
 

Stevey_OD

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HI Nikki

Thank you, I couldn't find the original that's why I started again apologies!

I hope you or Laurie can have a read of the updated post though and let me know what you think!
 

lgelb

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ALS onset is not typically about fatigue or effort-related weakness. You just can't do things.

Distal UE bilateral onset as your reported bilateral hand atrophy (confirmed clinically?) implies, would be rare.

If no one else says, "What's wrong with your speech?" it's not a problem. It can be something as simple as dry mouth or allergies.

And it would be quite a coincidence for pain and dizziness and a completely different neurological or systemic problem to arise in the same time frame as ALS. But again, there is nothing here to suggest ALS, and so I continue to expect your consult will be reassuring.
 

Stevey_OD

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Hi Laurie

Thank you once again.

Since your response i have been in with my GP in preperation for my Neuro consult and her analysis of the hands is that it does indeed look like atrophy, but she did also say the same as you that now that more time has passed and some of my symptoms have proven to be very non-typical and eratic at times that it would point away from a motor neuron issue and more towards something more autoimmune in nature.

Thank you for sharing your knowledge and having patience to do so!

All the best

Stephen
 

Stevey_OD

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Hi Guys

I'd just like to say thank you for the advise given on this thread, i had my neuro consult yesterday and my neurologist suspects vaccine induced peripheral neuropathy. She also advised this is something she is seeing on the rise after the covid vaccine and expects it could end up on the label as a potential side effect in the near future. I would suspect it could explain a rise in people like myself comeing to your forum as its frightening for sure and then Dr. Google is not really helpful here either!

EMG and CKD blood test for definitivie diagnosis to follow.
 
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