Hand shaking and weakness - desperate guy here because ALS

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Kafi76

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Dears, thank you so much for your valuable time in helping all of us out here that are completely in panic to have ALS, like my case.

I’m 45 y male

I would like to ask your opinion on my history:

- In Nov.2021 started with my right thumb getting stucked and sometimes twitching after making force with it

- by that time started having difficulties in keeping right wrist up in the position to type in the computer or to use mouse. Some days were better then others. It has being slowly worsening and now after 4 months I can have my wrist up in computer for like 5-10mins I have to be making a lot of force, like raising 100kg. And need to stop using the computer because of this weakness

- beginning Jan.2022 I started twitching all over my body. Sometime it’s one twitch only, sometime it stays for 30sec. But this happens all over my body (fingers, face, back, chest, arms,…)

- I also notice now when I get to sleep I have much more and bigger “sleep starts jumps” (one leg bumps, then arm, then can be head)

- since 3 weeks ago my hands, specially in fingers started shaking. Shakes are much more evident in the fingers of my right hand. When I place my hand straight against gravity the hand starts increasing the amplitude of the shaking like uncontrollably

- I notice that my right hand is more atrophied then left, I can see a difference specially between fingers it’s (please see picture)

- I still can hold things and grip, but always shaking, like when holding mobile

- this sense of weakness is now going up to the arm. It’s like I need to make more effort to hold things and that makes me shake more

I got MRIs (clean) and EMG (clean with good NCVs which I would prefer to have been bad, then I would have an explanation…)

In clinical exam by neuro, he noticed that I use less the right arm then my left when walking.

But ge said it’s not ALS because of the clean EMG.

But because I have so many matching symptoms, this is taking my life away. I’m 24/7 thinking I have ALS, I just cry closed in a dark room 24/7. I’m now on antidepressants.

Could you please help me?

-can it be that EMG was made too soon, because I still can hold things and function with my hand (despite with difficulties), so maybe I don’t have yet enough de-enervation that EMG could detect? I was tested in right leg and both arms and hands

- can this shaking when holding things means that I am loosing muscle fibers slowly? Did anyone experienced it this way, I read testimonials like “my foot stopped working” or “the hand” , but can it be gradual like I have and going through this shaking phase I have?

1000 times thank you for helping a desperate guy completely lost!
 

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lgelb

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No, no, and no.

I would ask for a referral to a hand therapist for your R hand, and counseling for your health anxiety, which is probably a major factor in the twitching and shaking.

Best,
Laurie
 

johnny5

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Psychosomatic behavior may be the cause of some of this. Anxiety can trigger physical responses and seem to validate whatever your stressor is, which in this case is ALS. Not to say it is or is not, but it is something to be aware of.

Clean EMG does tend to "rule out" neuromuscular causes. There are many different conditions though that can cause symptoms that mimic ALS. My advice would be to ask for another EMG if you are not sure. Give it 6 months, just in case it is a slow progression issue, and if that comes back negative your next question should be what else would cause it. Take that extra breath though, because I do not think you have ALS, so rest easy and enjoy life. This is not worth that anxiety either way.
 
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Kafi76

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Thank you guys.

What is really scary is that I cannot hold my right wrist up to hold the mouse or to write in keyboard for more than 5 min. It starts shaking like if hand/arm is trying to recruit all muscles but they are not sufficient to hold wrist up. The forearm and and hand gets like really really tired because of the effort I'm doing. That, plus right hand thinner, plus the fasciculations, it's too many matches.

I have a new appointment with neuro tomorrow and I'll ask to repeat EMG, although I know it might be too soon, as I can see cases where EMG does not detect in early stages. I'm so scared to be that my case...
 

Clearwater AL

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Get Real
Kafi, You've made the spade hand signal... doing so from someone who know
about Split Hand Syndrome your Abductor Pollicis Brevis muscle and your
Opponens Pollicis muscles are normal/fine. My opinion for what it's worth.

Asking your Neurologist for another EMG may not go over too well as you
may expect.

" it's too many matches." Yes, too many matches for things besides ALS.

Let us know what the Neuro says tomorrow. I'd bet you'll get good news
if you believe what you are told and don't come back searching old
threads like many do.
 

Kafi76

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Dears, had the appt with neuro and he was really convincing that this is not ALS. He explained me “technically” how our brain works to mimic things that we really think we have but in fact we don’t. As an example, he says that in medical university when he was doing the practice lesson of EMG, most of the medical students start immediately feeling fascis just before they get themselves to be tested. And just because brain identifies a threat by doing the EMG exam.
The fact is that one day after being with this doctor, my wrist weakness magically disappeared. Still shaking from hands, but now I believe that 90% was my brain tricking me!
This is a message to many of you that are really suffering thinking it’s ALS, pls be aware that I’ve had the same thoughts. Many people saying to me that it shouldn’t be ALS, but I didn’t believe because I really “had” those symptoms! I think my brain was tricking me.
I still have fascics and the shaking hands, but am now much more calm and in control.
Thank you all once again that helped me.
 

Kafi76

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Sorry to come here again, but my emotions are still a rollercoaster with this fear.
My right hand shakes everyday more for example when I’m holding mobile. I have a fine tremor on all right fingers and imprecision typing for example or doing fine motor things.
When I wake up it’s like it rested and hand is ok for about 30min after which comes the shaking of fingers. And weakness then comes as more time I’m using R hand.
Today I had a weakness test failure in my right ring finger. Thumb and indicator seem to be ok.
Still fascics all over body and right hand looks clearly thinner than left.
Did anyone experienced going through theses stages of fine hand/finger tremors mixed with very slowly increasing weakness from day of day, before reaching the “failure”?
Thank you so much!

Edit - also a permanent interior trembling/shake I feel along my arm down to the hand. Does this occur in ALS?
 
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lgelb

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Again, ask for a PT referral if you're concerned. There is no reason to think of ALS.
 

Kafi76

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I keep shaking a lot from R hand… I’m so confused and worried…
When I put both wrists in vertical on top of a table, my Right wrist starts shaking while left is still. And then my hand and arm gets really exhausted.
It’s confusing to me because it’s like the R hand has no strength to maintain wrist against gravity, despite that the so many times mentioned “clinical weakness” is not seen by the doctors, because I still have that force to raise fingers etc. This tremor comes after I’m typing like 10min in the computer with wrist up. And I have always my right hand cold. Like always…
And my fingers have no fine control anymore. And fascicles still all over body, from the moment that I wake up I immediately feel them coming. They are more persistent in both calves.
I’m completely nervous because all I read points to this behavior of everyday very slowly feeling a bit worse than the day before. It all points to ALS
Any advise or message that could help me?
Thank you
 

Bestfriends14

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"Again, ask for a PT referral if you're concerned. There is no reason to think of ALS."
 
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