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Hello,

I am writing with all my respect to people who are dealing with this terrible disease.

Two months ago I suffered a big motorcycle accident. Broken transverse process Th1, first rib, and etc.

I am writing as I have read on this forum about people who think their ALS was cause by a specific accident, medication or etc.

So getting to the point:
By week 2 I was getting strange sensations in my body but only I could feel (not feeling my muscles when training, cold feet up to the knee level, excessive sweating etc) them essentially all my senses are in normal values. The bigger issue is the major fatigue that I experienced from week 2 to around week 8. I could barely get out of bed.

I started seeing neurologists and other doctors, done a MRI of Head, Cervical, Thoracic, and Lumbar with no findings except small prolapse at C5-C6.

Other than “rather brisk” bilateral knee reflexes, which were not pathologic, nothing important was noted.

I have random fasciculations in many different muscles daily. Mostly calfs, but also quads, biceps, hands.

I also get some slight tremor in my fingers when completing tasks requiring fine motor skills, whch I could blame to the medication I am taking. My body gets unusually shaky when doing planks and similar exercises, even when I flex my biceps, my forearm starts to shake visibly.

I did lose some muscle volume due to two months being mostly inactive, but I can’t see any strength diminishing.

Anyway, since I kept feeling fatigued I continued looking for more detailed examinations and did a surface EMG. And this is what really got me worried.

Velocity is fine, however there are numerous places where my amplitude responses are a lot lower than what should be.

I have lowered motor response bilaterally in Abd. Dig. Min., Ext. Dig. Brev., and Abd, hallucis.

The differences from the norm are from -25% upto -95%.
This to me seems especially important as I read that initial EMG findings in ALS usually look a lot worse than the patient.
My neurologists conclusion was unsatisfactory to me as he said “not clinically important, drink some vitamins”, but of course my hypochondria got activated and I read that lowered amplitudes usually mean lowered axons in the nerves.

I also get some minor tongue tremors when I stick my tongue out, but thanks to the FAQ, I read that despite the common perception tongue tremor when sticking tongue out is actually normal.

Thanks to anybody who is willing to help and hope not to be intrusive to the forum
 

KarenNWendyn

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Your symptoms aren’t consistent with ALS. And while there’s some evidence that repeated head trauma may be a risk factor for ALS, I’m unaware of anyone developing it as a result of a single injury/ accident, especially after only 2 months.

Abnormal sensations and tremor point away from ALS. Random fasciculations are not a concern. And you say you haven’t lost strength— that’s impressive and also reassuring.

As far as lowered motor response on EMG — that’s not really what we see with ALS. In ALS, EMG shows a pattern of acute and chronic denervation with reinnervation.

So ALS doesn’t appear likely for you. Yeah!
 

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Thank you for the answer,

I will consult another neurologist and perhaps do a needle EMG to check for any dennervation and reinnervation signs, what I had is just NCS I believe.

The fatigue is worrisome, as I was unable to keep to my schedule, but I might be still recovering from the trauma. I believe that my huge depression and anxiety after the accident do not help me at all and I am excessively focused on every subtle change in my body.
 

KarenNWendyn

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That all sounds like a pretty normal response to major trauma. Allow yourself time to heal. Counseling may also help if you continue to experience depression, anxiety, and obsessive thoughts.

Best wishes.
 
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