Strange finger sensation, cramp

longmand

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Dear all,

Firstly, may I say how much I appreciate you taking your time to read this post and provide your feedback.

A month ago I had twiches under my eye which subsided in 3-4 days but left me with some strange feeling on the right side of my face, not painful, just not feeling like the left anymore. 6 days ago I started experiencing a strange sensation in my right hand (dominant) in my ring and little finger, I was advised to go to hospital due to fear of stroke by my GP as I was also having dizzy spells. I had a blood test and CT scan, which resulted in me having high levels of calcium in my blood, but CT scan was clear.

Today I noticed that the side of my hand is cramping constantly underneath the little finger and on the side. This is a constant contraction which I can see moving under my skin.

I read the main thread post about symptoms and it said you need to be failing at general day to day activities or you don’t have ALS. As these fingers are mainly supportive, is that still the case? I can still do most normal things, but they are slightly more difficult, i.e holding a pen and writing.

I hope I’m not wasting anybodies time, and again thank you for reading and taking your time to respond.

Regards
David
 

Nikki J

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Strange sensations point away from als. Als is a disease of the motor ( movement) system not the sensory ( feeling) one

was the cause of the hypercalcemia detected and corrected? Have you have follow up testing to make sure everything is now in balance.
cramping has a number of causes including metabolic imbalances. It is also common with no significant underlying disease.

what is keeping you from holding the pen etc ? The cramp?

if it were als weakness there should be some small movement you can not make even if other muscles help you do most things.

how long has this been happening? It sounds like 6 days? Especially given your diagnosis of hypercalcemia it seems a bit of a leap to end up here?
 

longmand

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Thank you so much for your response.

I have full range of movement in both fingers, but I am struggling to hold a knife while eating. It is as if my dexterity has been affected rather than range of movement, I’m not sure if that makes any sense as it is quite hard to describe.

I have a blood test in 5 days to test for abnormal parathyroid hormone which is for the calcium level anomaly in my blood. My GP doesn’t seem worried and they glance over when I mention the cramping / struggling to hold items (everything is being done over video calls here now in the first instance due to COVID restrictions) but over the last 6 days the stiffness seems to be getting progressively worse. If I could describe it, it’s as if my fingers are locking when I bend them sometimes as well, like a jolt when they move slowly. When I move them quickly it appears to be full range of movement. They also lo like they’re overlapping slightly.

I can’t seem to tie anything else other than ALS to the fingers, which could be health anxiety but I thought I should ask the question anyway just in case it sounded familiar.

The cramp is below the little finger and when I move the fingers up and down and leave them still, the cramp appears underneath and looks as if it pulses under my skin, it is painless.

I am concerned because I just woke up with this 6 days ago and had no reason for it as I haven’t undertaken any strenuous activity in those fingers. I am also concerned because it is only on one small part of my body.
Again thank you for taking the time to respond to my queries!

Thanks

David
 

Nikki J

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If you are consulting Dr Google in your search for reasons perhaps that is why you can’t tie anything other than ALS to your issues. Dr Google is a dreadful diagnostician. There are so many things that can cause hand symptoms and your symptoms do not sound like ALS. Please work with your doctor. once your metabolic problem has been addressed this will likely go away
 

longmand

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Hi Nikki

Just to update you, the ‘locking’ feeling of my fingers has now spread across fifth, forth, third and partially my thumb. Basically when I move my fingers they jolt rather than have a smooth movement, again I can move the fingers everywhere but they tend to jolt into position as they are stiff. No pain experienced at all. There are no cramps in the fingers themselves but under the little finger this is still persistent. My grip strength appears normal, but the fingers lock into position.

I was just going to ask if this can happen, i.e the locking of fingers and that they can spread finger to finger this quickly (day by day basis).

I appreciate you saying about speaking with my doctor but the fingers now don’t allow me to type effectively (which hinders my work) and seems a bit extreme for an overactive thyroid. My doctors have said it’s nothing to worry about but seem fixated on the calcium rather than the symptoms I’m having. I have another call booked with a different GP today to see if there’s anything that they can do.

Thank you again for reading
Regards
David
 

lgelb

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No, the pattern of spread you describe is not like ALS. You didn't say how high your calcium was, but either the hypercalcemia itself or one of the diseases that causes it, could relate to the stiffness. Keep working with your medical team, but certainly report these new symptoms.

BTW, what they are concerned about is one of those possible high calcium causes, a problem with the parathyroid glands, not the "regular" thyroid gland, which is not associated with calcium levels. Lab tests and possibly imaging should reveal more information.

Best,
Laurie
 

longmand

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Thank you for your response Laurie. Apologies for not reporting on my calcium level, on Monday 28th September the blood test revealed a level of 2.7 in my blood. I have been taking phosphorus tablets as prescribed by the hospital - 500mg @ 3 x per day for 5 days. My symptoms haven’t subsided in terms of stiffness, they are getting worse, however I am no longer dizzy.

I failed to mention previously but I had cramp in my forth toe. I went for a walk earlier in the week and still have persistant muscle ache in my hamstring and calf area, again on the right hand side of my body. Unsure if this is related as it is painful, whereas the hand is not.

Correct I’m being tested for parathyroid levels on Wednesday next week. My only concern is there is only fatigue / cramping on the right hand side of my body.

Best,
David
 

lgelb

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For those not on the metric system, that's 10.8 mg/dl. Not super alarming and here we would not be piling on phosphorus, though certainly worth drawing a PTH.

Do you stay hydrated usually/at the time your bloods were drawn? Dehydration can increase calcium levels. You could try a little more non-alcoholic, non-caffeinated drinking.

Whenever I hear of stiffness or cramps on one side, I think about sleeping position/support, and silly stuff like literally sleeping on your hand, so I would look at those, and any other activity like using your phone or Zooming for work that might entail an angled position or pressure points.
 

longmand

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Hi Laurie
I was dehydrated when I went to the hospital and they had me on an IV to replenish my fluids which I found unusual. While I don’t consider myself the best at drinking water, I wouldn’t have considered myself dehydrated, unless I’m just unaware of it myself.

My question really is that I can still grip with these fingers, and I can still use them to some degree such as holding the knife but it feels weaker. I read the main post and it said that ALS makes these things impossible. Is it that it would one day you wake up and are unable to do it, or is it a gradual determination of the nerve/muscle (finger, arm etc).

I am only 29-M with no history of ALS in my family, which makes this all very surreal for me at the moment but I’m struggling to shake anything else, especially as the calcium levels are not exceedingly high either.

I will try to stay off my phone a little more as those fingers are the main supports for my phone when I am using it.

As for sleeping I haven’t been getting much of that recently due to anxiety! I don’t tend to stick to one side when I sleep.
 

lgelb

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I can't imagine how you jumped to ALS from stiff fingers. If you read the accounts here, you will see that ALS starts far more, well, functionally, for lack of a better word. You will have read the phrase that it's about failing, not feeling. We have relatively few "could it be" people who end up in the "yes, it is" section because for all the clickbait saying otherwise, ALS is usually fairly obviously a serious condition before the EMG confirms it, so most people who arrive here with ALS are already diagnosed. If you have any MND, it sounds more like PLS, which is even rarer, but also at the bottom of the list.

Let's forget about the mildly high calcium level for a moment -- it is not necessarily related to your fingers.

Try to have a visit, live or virtual, whatever's safe, where you focus on your fingers and see what is recommended. The possibilities range from an electrolyte imbalance to arthritis to injury to a systemic illness. Most docs wouldn't have ALS on the differential at this point at all.

The fact that you came up dehydrated, by their account, and didn't know about it makes me more warm and fuzzy about the electrolyte possibility, which isn't always seen in bloodwork. That, coupled with lack of sleep, suggests working on hydration, diet, sleep, stress, the boring stuff that much more often relates to what's going on than an esoteric disease, least of all ALS.
 

longmand

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Thank you for your response. Basically I panicked when I started seeing visible cramping without pain down the side of my hand which seems to react when I move the fingers. It is seemingly non-stop at the moment regardless of how I hold my hand. I can still write but it is difficult and the little finger doesn’t seem to know where it wants to go if that makes sense when I hold the pen/knife etc. I was able to hold hair clippers and cut my dads hair earlier.

I appreciate the advice you have given and I’ll stay active on here to document the progress with my symptoms as it may help others who are having similar.

I also apologise for any upset I may have caused if I have overreacted as I understand people on here are truly suffering. I was initially reluctant to post but after reading pretty much every ‘could it be’ I couldn’t see anything that fit.

Best
David
 

longmand

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Hi Laurie,

I think I need to work on my terminology slightly better. When I said cramp I meant muscle twitching, it is painless and I can’t feel it, I can just see it under my skin constantly. I believe the muscle this twitching is in is called the Hypothenar. The little finger seems to be getting worse from a fine motor point of view, I can still stretch all my fingers out in a line comparable to my left hand, move the little finger up and down but with a ‘lock’ as it gets slightly closer to full bend/close against my palm, but for example passing a coin between my fourth / fifth fingers is now difficult, I can do it with my left hand but the right hand it is not easy and it drops.

I can still write, ish, but the little finger has a mind of its own and just can’t make its mind up where it wants to stay still. It’s not as if the little finger is dominant in writing so it’s not the best test for it. It also twitches when I bend it and it ‘locks’ in place. Again painlessly.

I can still touch my little finger to my thumb, I’m not sure if this is of any relevance.

I have had cramp down my right leg for sometime and it feels weaker than my left leg, but as I’ve only had symptoms for about 8 days in the hand, I’m not sure if this would be related either.

I don’t want to waste my GP/specialists time by telling them I think I may have ALS when I don’t, so if I’m being a hypochondriac please let me know!

Thanks again for your time
David
 

lgelb

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It is never productive to broach a self-diagnosis when beginning a conversation with a physician. S/he then feels obligated to tailor the conversation, and sometimes the exam, to that topic. It is less productive. But if you are going to be distressed if it isn't addressed directly, slip in the question at the end.

Let them do their job, which is to evaluate and diagnose you. In many cases, it helps to have emailed, uploaded or otherwise provided a summary sheet of the durations of symptoms, what makes them worse or better, etc., so you don't have to take all the time with that.

Feel free to stop back by if/when there is any diagnostic evidence of a motor neuron disorder.
 

longmand

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Hi Laurie,

I had bloodwork done a few weeks back and they checked for about 20 different things, all came back normal including CK and electrolytes. The only anomaly was a slightly low level of parathyroid hormone but this could have been related to the calcium issue I had recently (calcium level returned to normal).

My right hand is exactly as it was since I last posted, apart from I’m starting to get very minor cramps under my right thumb (maybe this is from all the phone / typing as I need it for work). Stiffness in the hand seems to be less prominent when I sleep 6-7 hours but more prominent when I sleep and wake up in short periods e.g 1 hour. I still have full strength in this hand and can pass objects between the little and forth fingers with relatively no difficulty, but if I put my thumb and these two fingers together it does feel a bit crampy in the thumb compared to the left which feels normal.

About a week after I posted on here, I noticed a ‘drop’ in my right shoulder which feels like it isn’t self supporting, hard to explain. I can still raise and move my arm the same as the left arm, apart from putting it right behind my back and reaching my shoulder blades which causes me some joint / muscle pain which takes a day to subside when attempting to do so. Left arm can do this with ease and no pain.

My doctor has referred me to a neurologist and I have an appointment on the 11th November. This post is mainly for me to document progress.

Best
David
 
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