Please read and advise on hand issues/emg

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Jessicamitche11

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Good evening and thank you for this forum,

I am recently concerned I could have als. As a mother of two young kids, I’m terrified.
In August of this year, I began having numbness/tingling down my left arm into my hand as well as down my left leg and on my left cheek. I had been lifting weights so chalked it up to a pinched nerve or other injury from that. I stopped all weightlifting. I have yet to start back but have done cardio since. Last week, I started back with all of the same symptoms on the left side. What has me concerned and panicked is the fact that I now feel my hands are weak. BOTH hands. My right hand (dominant hand) is really struggling. Im having trouble writing, braiding my daughters hair, putting lids on cups, zipping, tying shoes, etc. My hands basically feel like they are getting stuck when I go to use them. Like I can start the task and then they get stiff or just fail. I hope that makes sense. I have read so much about weakness being the first sign (even if not a failure) that it has me concerned. I went to a neuro today who basically used my age and a very basic test (did babinski (negative), made me walk in straight line, tip toes and heel, had me squeeze fingers and follow light, hold arms out with eyes closed) and that’s about it. My husband described him as “a grumpy old man.” I feel he didn’t take my hand issues seriously. He did schedule me for an mri and an emg/nerve conduction. My questions are:
does anyone have a similar story?
would a pinched nerve show up on mri and cause an abnormal emg?
 

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Hi Jessica-

Have a read here: Important - READ BEFORE POSTING! Answers to common concerns about possible symptoms

Sensory issues like tingling and numbness generally point away from motor neuron disease. MRIs, nerve conduction and emg tests do pick up all sorts of issues, so it's a logical step for your neuro to refer you for such. While the wait may be difficult, these are the tests that will guide the neuro in next steps. Unfortunately, you will have to wait for these, not sure when you're scheduled. Again, the sensory issues indicate something other than ALS/MND.

Please let us know how things go, and I hope you don't have to wait too long.
 

Jessicamitche11

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Thank you. I got the mri scheduled for Wednesday and emg for Thursday so not that long to wait. I definitely think the neuro heard tingling/numbness on left side and then didn’t even listen to my complaint of my right hand. At this point, the lack of fine motor skills is my chief complaint. Do you know what major things they are looking for on the clinical neuro exam that would raise concern This early?
 

Jessicamitche11

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So my mri of brain and Cspine were clear and he said emg and nerve conduction were 100% normal. That was reassuring but seems hand onset isn’t completely ruled out by emg? Is that true?
 

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Not true at all. Not sure where you heard that. Any issues, in any part of the body, will be picked up by an EMG. The great news is, there are several factors that have cleared you of having ALS- lack of symptoms, clean clinical exam, and clean EMG. That is fantastic news; congrats to you!

All the best to you take care and stay safe.
 

Jessicamitche11

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I guess I should rephrase. I have read several patient stories that first noticed symptoms in hand dexterity, had emg normal then a few months later symptoms persisted and new emg showed issues.
 

Bestfriends14

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Having trouble doing something and truly not being able to do something, are two different things. You "having trouble" braiding hair, zipping, or putting lids on cups is entirely different than not being able to do them at all. Honestly, you've been cleared a few different ways of having ALS. That's something to celebrate, not continue to look for reasons to have.

Again, best of luck to you and a huge congrats on no ALS.
 

lgelb

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There can be many reasons to perceive difficulty in using your hands. A referral to a hand therapist for evaluation seems reasonable. Whenever I hear that one hand's issues have become another's, in the absence of a nerve or muscle problem, I think about overuse injuries or some kind of ergonomic issue. These are not always visible on tests. Having two small kids does raise that possibility, and if so, therapy can help.

The good news is that there is no reason to worry about ALS, so time to stop reading about it.

Best,
Laurie
 

Jessicamitche11

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I appreciate the responses I have received but had a few follow up questions. My right hand/grip weakness/stiffness/coordination issues seem to be getting worse. I have not injured my hand in any way. I feel pain in my forearm and elbow which makes me believe that I’m overcompensating while trying to turn my hand to continue to do my normal tasks. It seems to be spreading up into my right arm with stiffness and weakness around bicep. In addition, I now feel my right foot could be described as heavy and slightly difficult to move. I first noticed symptoms with my hand on 10/22 so this is all very fast. I went back for my neuro follow up and he was not helpful at all. I showed him what I thought could be atrophy on my right hand muscle. He felt around a lot and then had me take off my shirt to look at shoulders which I thought was very strange. I asked if everything was okay and he changed the subject to look at mri which he already told me was clear. I felt like he noticed something and then was trying to cover it by telling me it was an mri issue. I had an emg conducted. The only thing they gave me was a sheet saying it was a normal study in the impression box. That’s it. No data table or anything else. That’s literally all it said. With my symptoms seeming to spread, I’m at a loss and my neurologist/emg doctor says they don’t have anything else to give me. Has anyone experienced this or have any ideas of where to go next?
Thank you
 

Bestfriends14

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Please post the summary/conclusion part of the EMG, with all identifying info removed. Your symptoms are not at all ALS, but if we see the conclusion part, we can tell you what it means. On a side note, no doctor is going to risk their career trying to hide a diagnosis from you. Please post your EMG conclusion
 

Jessicamitche11

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All it says is “both the ncv and emg of all four extremities were normal. This is a normal study.” That’s all I got
 

Bestfriends14

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Then that's what it means- your EMG is normal; congrats to you! That's reason to celebrate, not fret about. Clean EMG, clean clinical exam, and no ALS symptoms means you can let ALS go.

Best of luck to you. Enjoy your health and long life ahead of you.

Take good care.
 
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