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hatch3

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For the last six weeks I've been aware of mild weakness in my left hand and wrist. I have difficulty clipping my fingernails on my right hand and my wrist starts aching or burning after I hold or grip something as light as an iPad. This follows two years of a worsening thumb tremor, which may or may not be related. I also have sporadic pain -- almost like a cramp -- in my thumb (thenar?) muscle. The aching in the wrist comes and goes depending on my activity.

At the end of December, I saw a hand surgeon who was stumped and merely noted that I seemed to have an issue with my intrinsic hand muscles. Last week I saw a neurologist for an EMG. During the process, she asked if I had any pain in my elbow (not really), and ultimately concluded I had cubital tunnel syndrome. When I asked her about ALS, she said she had ruled it out. (I don't have any other specifics of her report, which was shared with my hand surgeon.)

Her conclusion eased my mind for a few days, but the truth is I don't really have any of the symptoms of ulnar nerve entrapment so I can't help but wonder if it's something else. Should I be seeking a second opinion or should I stop worrying?

(For what it's worth, I've had fasciculations in my calves for about eight years but had "clean" EMGs and don't really think or worry about them. I've detected none in my hands or arms, aside from the twitching thumb.)
 

KarenNWendyn

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The combination of EMG and nerve conduction studies would be sufficient to diagnose a nerve entrapment problem such as cubical tunnel syndrome and to rule out ALS. EMG in ALS has a very characteristic pattern suggesting acute and chronic denervation with reinnervation and without corresponding nerve conduction abnormalities.

Neurologists are trained to look at the big picture of your history, physical exam findings, and tests (in this case EMG and NCS) to come up with a diagnosis.

The history of chronic fasciculations in your calves with clean EMGs is also reassuring.
 

hatch3

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Thank you for your helpful reply. I appreciate you taking the time to respond.
 
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