Could this be thenar atrophy from ALS?

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coleshepter

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Hi,
I developed tremor in my thumb on my left hand. Then I started twitching all over my body, but lately is more localized in my whole left arm, mostly shoulder, biceps, thenar, upper back. Sometimes twitches happen while muscles are relaxed, but sometimes stretching and movement of muscles trigger these fascicullations. I also experience numbing pain from shoulder blade to my whole left arm and it feels like it's coming from the neck. I feel weak in my left arm but I can lift it above my head and my pincer grasp is also good so far. But from time to time I experience difficulties with some activities where I have to lift and rotate this arm. What concerns me the most is that I think my thenar muscle started to atrophy. It's very obvious when I compare it to the other hand. I am scared of ALS because my grandfather died of it. But it's true that I also have serious health anxiety. Thank you for any answers.

Can somebody answer me please? I don't want by any means to waste your time, but I am so scared and I am crying every day. I really appreciate this forum exists and that you all are being very helpful even with what's going on in your lives. Due to pandemic my appointment with neurologist is still far and my thoughts are more and more irrational. Thank you very much.
 

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Nikki J

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Pictures are really hard to evaluate but what I can see looks ok. people aren’t symmetrical My non dominant hand is still smaller than my now weak dominant one

I am sorry about your grandfather but one second degree affected relative is not FALS. Even if your family were FALS ( it isn’t) there are few forms that affect your age group. I also suspect that your grandfather was not 25 when he had ALS?

twitches are completely non specific It sounds like you probably tweaked your shoulder. Can you speak to your family doctor even if you can’t see them?
 

coleshepter

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Thank you very much for your answer. My grandfather was in his sixties when he was diagnosed and I remember it started with weakness in his hand and he was squeezing a ball because he thought it would help. It took a long time for him to get diagnosed because it wasn't very known disease in my country.

Yesterday I was in so much pain and today I went to emergency room and doctor thought it's because of vertebrogenic algic syndrom, because that's the main reason I'm having appointments with my neurologist, so maybe a pinched nerve somewhere. But I had MR of cervical spine last year and it didn't show any radiculopathy. MR of my brain is also clear. Anyway I showed him my hands and he didn't seem concerned, he also took the measuring tape and said it looks the same and prescribed me some pain killers. He also tried range of motion of my arms and head and it was good.

Momentarily I'm trying to cook lunch and the pain in my shoulder is so debilitating that it makes it very difficult to even pick things with my hand. It's twitching as well.

My family doctor isn't very helpful. I am having other issues like higher body temperature every day and she just doesn't know what to do about it. I called my neurologist a few days back and he prescribed me some muscle relaxants but I'm not feeling better. He also said that twitching can have various reasons and he needs me to come personally. It will take another 2 weeks of lockdown till I could go home and make an appointment. So meanwhile I am just scared everyday.
 

lgelb

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Agree, this doesn't sound like ALS at all. There's no reason to be scared. You might try to get a video consult with a shoulder specialist (orthopedic surgeon) since it does sound like a localized condition or injury, if anything, that physical therapy might improve, if so. At the same time, it doesn't sound like your serious health anxiety has been adequately addressed, so I would look into counseling (more or better) via video, voice, text, etc.

Best,
Laurie
 

coleshepter

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Thank you, Laurie, kindly for your response. You calmed me down a lot. My health anxiety makes my days miserable as I'm always having symptoms of something sinister which is almost never the case.

If I may, I'd like to ask you one more thing. I've noticed that many people afraid of ALS on this forum tend to have similar symptoms like twitching, percieved weakness, pain, tingling sensations, tightness of muscles or their limbs just feel off. That's what I would say about my symptoms too. I would say that my thumb and index finger feel off when I try to grasp something with my hand. For few days I am also feeling this vibrations and buzzing in my feet, especially the left one. It progressed to my calf and thigh on my left leg and now I also feel weakness and tightness around my joints and on my left tight when I walk for a while. So my whole left side feels like it just wants to give up and not move. I'm wondering if that's something usually caused by anxiety and if so, how can it affect just one limb or one side of the body? I know that mind can make us feel lots of things which aren't real but it is somewhat concerning that f.ex. twiching that began widespread is now localized more or less in the affected limbs. I am literally waiting for my right arm to twich somewhere but it almost never does anymore.

Once again sorry for the long post. Thank you for your time as you answer people like me and take care. I wish you the best!
 

lgelb

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The mind is more powerful than people realize. If you start to focus on your right thumb, it will feel off at some point. You can easily make this extend to your entire side just by wondering if it is in fact extending that far. Anyone who has heard that ALS usually presents somewhere on one side instead of both is subject to this, whether consciously or not.

Niggles with one side can also relate to how you sit or sleep, so those surfaces should be checked to make sure they are property supportive. We are also keyboarding, texting, using consoles, etc. more in these times and that can have a bearing as well since hand injuries can extend up the arm, you start thinking about the shoulder and then perhaps favoring that arm and feeling like that side "gives up." In a stroke scenario, one side is suddenly weak. But that would be readily evident as well.
 

coleshepter

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You are probably right. I am currently unemployed for about a year and I am spending my days usually laying around with my phone or console in really bad positions for my neck. My posture while standing is also poor. I sometimes experience dysphagia and dyspnea but it's believed to be caused by my cervical spine. These days I have a lot of time to be alone with my terrifying thoughts and I am paying attention to every little detail about my health. But as you can see, it's hard to stop overanalyzing. Thank you for helping with that.
 

coleshepter

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Hi, sorry to bother you but I have an update. Today I had an appointment with my neurologist. He himself noticed that my left thenar has shrunken. He thinks it is due to nerve compression in my cervical spine, that that muscle doesn't have enough nourishment. But he also was concerned about my twitching, he knew my gradfather and he was the one who diagnosed him. He said it would be highly unlikely for me to have ALS but he's not sure and because of Covid it's hard to find somebody to do EMG. Reflexes in my arms were normal, a little weaker in my left. Thank you for your time, every opinion will help me.
 
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