Question about Atrophy

[MarkR]

Hi everyone. I had made a post on here some time ago (in January or February I think) regarding fasics. I guess I arrived at the forum the way that many people do, via Dr. Google.

The good news was that I finally got in to see a neuro and had a clean EMG and he ruled it benign. (Not here to question that at the time though!)

Since then they had pretty much faded away along with the spontaneous limb jerking. Recently though things have come back starting with a tired / weak feeling when going up stairs body wide fasics (when sitting/laying) and limb jerking again very focused in my left calf (which is where this all started up again.) Now its only a feeling, not a true weakness, just describing situation.

My question is this because the left calf looks smaller than the other and I've taken a picture to illustrate. Is this atrophy?

Admittedly I have been FAR less active than I should be, having lost my job due to a pretty huge lay off. I mean really spending a LOT of time in front of the computer (job hunting or after doing that for hours gaming sometimes.) Wondering if that could have caused this if what it is.

Now I am not trying to get a diagnosis of anything here. The fact is being laid off and not having insurance its almost impossible for me to afford anything now neuro or neuro test related. I just don't know where else to turn to have anyone with some knowledge look at this.

In the pictures I put my feet at about 90 degrees out to get the the best side facing shot possible, the calf on the right in the picture is actually the left (since I was leaning over to get this with my iphone.) Definitely not asymmetrical but is it atrophy?

 

[MarkR]

Sorry for some reason the image insert didnt appear correctly in my post.

imageshack.us/photo/my-images/543/img5249highlight.jpg
imageshack.us/photo/my-images/259/img6807highlight.jpg

 

[trfogey]

Congratulations, you've discovered that your body, like that of everyone else, is asymmetrical.

If you are not having weakness in that leg and your previous EMG was clean, you don't need to worry about ALS. In a large muscle such as your calf, an EMG would pick up lower motor neuron damage months or even years before atrophy occurred and you would have noticed real weakness and problems using those muscles before the atrophy occurred as well.

Don't fall into the trap of using your current financial situation as an excuse to diagnose yourself via the Internet -- and yes, that is what you are doing. You were cleared by a neuro once already. Move on with your life.

 

[olly]

hi mark.
unfortunatly i can not see your photos but agree with trfogey that its probably normal.
my left lower leg is thinner than my right...........but i do have clinical weakness and hypotonia there thats why i have disuse atrophy.
as for the limb jerking (myoclonus)i do get that in both arms,legs and torso......not at the same time.
odd jerks can be benign,especially if its just in the legs......restless leg syndrome or it can be caused by stress.

if these are your only symptoms and no definate weakness then you are probably ok.
if things develop then try to see a doctor,i am sure there is a system set up for those with no insurance and on a lower income or just go to a+e if you can not wait.
but honestly,nothing jumps out as being sinister.

take good care.

 

[Lobster]

Long time ago I read that some professional cyclists have an inch and a half difference in the circumference of their upper legs... we all have a dominant side...

Well, I guess if your parts still work you still have a dominant side. Nothing much works on me anymore.

Clean EMG = no ALS.

 

[tayls7]

Hi Mark, As you are being told above please don't fall into the same trap that many of us have. A year ago, what started as drop foot progressed quickly and during that time I was told I had atrophy in my right buttocks and shin. A few internet searches and the ALS panic began. As weakness progressed and doctors couldn't immediately tell me what was wrong I was sure I had this awful disease. I too found this site and some wonderful people here tried to help keep my mind clear. A short while later I was diagnosed with GBS, the atrophy was completely unrelated (turned out to be a combination of two fused vertebrae and a large cyst wrapped around a nerve). My GBS has came and gone and the back and leg problem continue but frankly relative to what the people on this site deal with it is nothing. So please don't panic, with a clean EMG, ALS is not the problem. Take care and enjoy every day.

 

[pmbenb83]

Hi Mark,
I'm so glad that you had a clean EMG. That is wonderful news for you. I wanted to let you know what my husband's atrophy looked like. It wasn't that an arm or leg was smaller than another, rather a chunk of muscle was missing (looked like it was shaved off) his right shoulder blade area on his back. Certain arm movements were lost due to this chunk of muscle atrophied. After 4 years, both of his shoulders and back are just bony looking. Now his legs are getting weaker and his right calf is missing a chunk, and he is walking very short distances, about 10-20 feet.

I'm sure being out of work is playing a huge part of your fasciculations. Keep your chin up, you're not alone in the job search arena. I hope good things will be right around the corner for you. Hang in there!

 

[MarkR]

Hi Everyone,
I wanted to take a second to say thank you to all who read and responded to my post.

I did a lot more reading on the stickies in the forum after I posted, I think some of that information was not here when I had originally visited the forums earlier this year.

Logically think that it is prob due to having sat around much in the recent months. But then there is always that nagging question in the back of my head I guess. I had really let it all go after the neuro visit / EMG in feb but then the fasics started again and I noticed the size diff in the shower one day.

So if I understand it correctly (from your responses and the technical info in the stickies), an EMG done in approx early Feb of this year would have detected if there were even sub clinical signs pointing to LMN issues or denervation? And if that was the case those issues and / or weakness would present before atrophy if the atrophy was due to one of these issues? (I had EMG/NCV in all four extremities at the time.)

Again I thank you all for taking the time to view my post and help me understand things.

Also where is a good place where I can find information on events such as a walk for ALS or ways that I can do something to help out in my area? I would really like to do something (but I can't give a flat out donation due to my current financial situation.)

 

[trfogey]

So if I understand it correctly (from your responses and the technical info in the stickies), an EMG done in approx early Feb of this year would have detected if there were even sub clinical signs pointing to LMN issues or denervation? And if that was the case those issues and / or weakness would present before atrophy if the atrophy was due to one of these issues? (I had EMG/NCV in all four extremities at the time.)

If your fasciculations earlier this had been the result of ALS, the EMG would have revealed a pattern of active and chronic denervation and reinnervation, where some lower motor neuron death (causing the denervation) and the body's attempts to repair that denervation (both successful and unsuccessful) would have showed up on the EMG. It is the denervation that causes first the weakness and then the atrophy.

Denervation causes paralysis of muscle fibers -- they can't move purposefully because the denervation has disconnected them from the nervous system. Because they can't be moved purposefully, they cannot contribute their normal share of the workload when the larger muscle that they are a part of needs to do work, which shows up as weakness in the larger muscle. Finally, since those muscle fibers are no longer working, the body begins to reclaim their component materials for reuse elsewhere in the body or for disposal. This reclamation project shows up as atrophy and occurs over time, so it shows up much later than the denervation and the weakness/paralysis.

No denervation --> no paralysis --> no weakness --> no atrophy --> no ALS. In short, if your symptoms have been present for nearly a year and you don't have some substantial disability in the part of the body where the symptoms began (caused by paralysis), then the chances are remote that you have ALS.

Also where is a good place where I can find information on events such as a walk for ALS or ways that I can do something to help out in my area? I would really like to do something (but I can't give a flat out donation due to my current financial situation.)

If you click the Other Resources link at the bottom of this page, it will take you to a page where you can find links to the websites of various organizations that help in the fight against ALS.

 

[notme]

Trust me, when there is atrophy--there is significant loss of function. And that atrophy happens months after the loss of use (or it did in my case) I lost the use of my areas at least 6 months before the atrophy