Fasciculations on legs/ hand and arm weakness

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Paco78

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First of all thank you for your valuable time to answer my concerns. I am 42 years old and in May I started with cramps and fasciculations in my legs and feet. I went to the internet and looked up my symptoms and Als is what first appeared. This sent me to the ER for which I though for sure I was going to get diagnosed with. The doctor at the er said that she didn’t think it was als and recommended me to a neurologist.

I did get a appointment with on neurologist at the beginning of June and she checked my reflexes and strengths and did a emg on my legs where all she seen was fasciculations and said that my twitching and cramps were benign. So I was ok with that for a while but the twitching in my legs and feet continued and started feeling weak in my hands and arms so I decided to try another Neuro.

So at the end of August I seen the other neurologist and he did a thorough exam on me and didn’t notice any weakness and all
My reflexes were normal but he did schedule for a emg in October on just my legs and all that was found was fasciculations so this doctor also diagnosed me with benign fasciculations syndrome. He is a board certified neurologist with 39 years of experience but he said he only seen about 10 or 15 patients in his career with Als.

My problem is now I am having weakness in my arms and hands. My shoulders pop when I lift my arms up and they also have a burning ache to them. I can still take bottle caps off with my hands but my fore finger and thumb hurts when I do. My arms tremor when I am trying to lift up stuff and I have seen where tremors can be a sign of muscle failure I can still do push-ups but it is hard and my arms shake and it hurts wrist to put pressure on them.

Could this be als with a emg of my legs only showing fasciculations but my upper body showing weakness I’m just worried because they didn’t do emg on any upper parts. I forgot to mention I do drop things out my hands from time to time and I have been biting my tongue and cheeks a lot lately I also get choked on liquids sometimes is it possible that this could be bulbar als?
 
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KarenNWendyn

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Please read this if you have not already done so

Your EMG was done on a symptomatic area, legs, and was negative except for fasciculations. So that clears you of ALS. Burning and aching point away from ALS as do tremors. The first sign of bulbar dysfunction from ALS is usually slurred speech that others notice, not biting your tongue and lips. Choking is pretty nonspecific.

Since you believe you are weak, I suggest returning to your doctor for an exam to find it what is wrong with you. It may be anxiety, something mechanical, or perhaps a metabolic or hydration issue. But ALS is not in the picture here.
 

Paco78

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Thank you for time and response but when my emg was done on my legs there wasn’t any weakness on my legs and there’s still no weakness there could the emg have been done too early the second one was done 5 months after twitching started I guess what I’m asking is could I have als signs in upper body but not show up on emg of legs or would als show up no matter where they do it at and my pain hands only happen when I use my hands
 

KarenNWendyn

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EMG changes due to ALS show up early, often in advance of symptoms. So if you actually have ALS and your first symptoms happen to be twitching and/ or cramps, then the EMG would show denervation changes in that area.

But the first symptom of ALS is most often failure— that is, inability to do something that you could do previously. Examples include inability to stand on toes or heels, fasten a button, or open a ziplock bag. Feeling weak is not ALS.

Again, I’m hoping to reassure you, but if you disagree with me then it’s on you to go see your doctor and get it checked out.
 

Paco78

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No I'm no trying to disagree with you and I am reassured by your response. Thank you for your valuable time!
 

Paco78

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I’m sorry to bother you again but I have another question to ask if you don’t mind. It is about the weakness that I am feeling it is in both arms and hands and they feel normal until I go to use them like trying to take top of jar or lifting something I can tell that they are weaker my question is does als failure come on gradually like this. The pain I experience also only comes on when I am using my arms and hands. Another thing is I don’t if it is related to als but my nose has been congested and my voice sounds nasal ever since this all started

Sorry I forgot to mention I also have muscle twitching in arms and shoulders my left hand twitches on my pinky side and forearm and my right between my thumb and pointer finger
 

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Please go back to the read before posting thread as it does answer your questions really.
I can see that all these sensations are really causing you a lot of concern. It seems it is time to return to your doctor for answers as we only deal with ALS here. All the best.
 

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locked thread, multi id
 
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