Hand worries

[worriedinca]

42yo male, no family hx of MND, years of muscle twitching in different places. I’ve read the sticky and not concerned about twitches.

3 weeks ago my right arm was a little shaky when pouring wine. Then it started feeling weak (like heavy to hold a cup, clumsy to hold a fork) etc. But no actual failure. But my anxiety became very high and I saw a board-certified neurologist here in CA who performed a clinical exam and an EMG/NCS on my right arm (5 muscles tested) which was all normal. Told to forget MND or any other neurological disorder.

2 days later, I felt the same type of weakness/clumsiness/heaviness in my left arm/hand and felt like my gait is a little altered. Also started questioning my speech-sometimes tripping over a word, etc.

The neurologist agreed to do another clinical exam and EMG on the other 3 limbs tomorrow, admittedly only after much persistence from me. I am well aware that I may be dealing with some health anxiety/OCD here, but am generally a logical person that believes objective tests, so I hope this will put it to bed.

To help me do that, I have the following questions:

1. If the clinical exam and EMG are normal tomorrow, can I definitely put ALS out of my head?

2. If (perceived) symptoms continue, can I confidently conclude that they are from something other than ALS?

3. Can anxiety cause these kinds of symptoms, ie can they be somatic or psychogenic?

Thank you very much for your time and responses.

 

[ShiftKicker]

1. Yes. Especially as the neurologist already stated it was not necessary.

2. Yes. See above.

3. Yes they can. There are many anxiety and FND (functional neurologic disorder) support groups out there with folk who struggle with absolutely debilitating physical symptoms caused by non-organic disease process.

All the best with your upcoming EMG- please do let us know how it goes.

Take care

 

[worriedinca]

Second neuro exam was completely normal. EMG of both arms and legs were clean. I don’t have ALS and I’m moving on. Thank you for your response yesterday.

 

[Nikki J]

Thanks for letting us know

 

[worriedinca]

A quick follow-up question about my EMG. It tested 4 muscles in each limb. In the limb that has symptoms (left arm) it tested the first dorsal interosseous, biceps, triceps, and deltoid muscles, all normal. Is that a sufficient number of muscles to rule out LMN issues in that limb? I sometimes see people getting more muscles tested in their EMG and it gave me some doubt.

A response from those with EMG knowledge (Nikki, LGelb or anyone else) would be appreciated. Thank you.

 

[Nikki J]

Four certainly seems sufficient. It has been a long time but I was in studies for asymptomatic carriers where they did emgs I don’t believe they did any more muscles in any of the limbs. When they found an abnormality they did test more to see how far it spread and to confirm it was widespread

 

[lgelb]

Those 4 muscles go from your hand to your shoulder so that makes perfect sense to me.