Could this be ALS

Status
Not open for further replies.

Bubba23

New member
Joined
Jan 29, 2017
Messages
1
Reason
Learn about ALS
Diagnosis
00/0000
Country
US
State
VA
City
Ashburn
Appreciate all the folks who take the time to respond to scared folks who come to this forum.

I am looking for some helpful thoughts about some of my issues.
I have been twitching for about five years now. Also bad headaches. Mostly in my calves, but at times all over. Throughout this entire time I’ve been an active weight lifter. When this all started I went to a local neuro who checked me out, nothing of note on EMG or neurological exam other than brisk reflexes (all over though). The twitches seemed to come and go, definitely a positive sign.
However, around 2018 I started to experience some weakness with my left thumb. I would often get a very fine twitching/burning feeling in the FDI. This seem to progress until the summer of 2019 when I went to a hand doctor and some atrophy was noted mostly around the APB. At the end of the summer after a heavy bench day I noticed my tricep was completely numb. Got a new EMG Which indicated radiculopathy from the C6 C7. MRI agreed. I got a cervical fusion that September. Fixed the headaches but I continued to twitch. My tricep felt much better at the time, but not my thumb. Life went on. Still twitching.
Fast forward to August of this year, I started having Difficulty with a few lifts on the arm that was affected. I noticed that my triceps and biceps looked somewhat deflated. My hand also does not look any better. The FDI Looks OK, but the intrinsic muscles and ABP seem to have atrophied more. I went back for another EMG which thankfully did not show any active denervation. With all that said you might be asking why I’m posting, without active denervation I would most certainly think motor neuron disease is excluded. I did notice on the EMG report that remote radiculopathy was noted, I don’t really understand what that means. It also noted +1 poly on the PronatorTeres and a >12 duration in the tricep. The arm that feels somewhat atrophied and weak continues to be very sensitive, like an electric current continuing to run through it. Lifts have been much harder.

I guess I’m just asking, is it at all possible for radiculopathy to be confused with MND? What is the difference on EMG, and would it be obvious? Does it matter which part of a muscle the needle goes into for the NCS?
It just concerns me that I’ve atrophied a bit and experiencing these issues after my fusion, I was really hoping I’d get better and wish I could explain the continued issues. Had I not been a twitcher then I don’t think I would’ve thought much of it. The logical part of me just points that this was a lack of recovery after the ACDF or some continued nerve irritation.

Thanks for taking time.
 

lgelb

Moderator
Forum Supporter
Joined
Nov 5, 2009
Messages
11,065
Reason
Lost a loved one
Diagnosis
00/0000
Country
US
State
WA
City
Seattle
No, radiculopathy and MND do not show up on the EMG the same ways. And as you note, both active and chronic denervation are present if ALS is. Twitching means nothing in itself, and the electric current feeling is indeed consistent with radiculopathy.

A muscle is a muscle -- but an experienced examiner knows where the needle goes. An old injury can certainly flare up, for nerves as well as muscles. A cervical fusion is a big deal and if your sensitivity persists or worsen, I would think someone would want to image your C-spine to make sure nothing has gone awry.

Meanwhile, I would ask your PCP or surgeon for a PT referral, maybe to someone with a sports specialty since you lift and want to continue to do so safely. I see no reason for you to think one more minute about ALS.

Best,
Laurie
 
Status
Not open for further replies.
Top