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Martavh

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Hi very one again. I posted some months ago to have opinions on weakness and some pain and discomfort on my left leg. I also comented on some type of vibration or tremor that had arisen in both my legs mainly at the back.
I had an MRI that came Black claena and an EMG in November that was clean as well.
Since then, things have gotten worse. That feeling/ tremor/ vibration has spread literally all over my body: face, neck, chest, armas etc. My left leg keeps getting weaker and the dent I presented in my calf is deeper tan before. I can walk on toes and heels but it is difficult tostand on that leg and go down the stairs as i feel my leg is going to give out especial y knee and ankle. Also my thumbs are a bit weak and loose with some pain in my first dorsal interosseus and a bit of atrphy and pain in my thenar eminence. I feel i am more clumsy with my hands now. I also feel that tal king is becoming more difficult. No slurred speech but it is more difficult to pronounce certain words together.
I cant have an appointment with a neuro until september and am scared at the progression of my symptoms.
Could there be any other condicionts that produce these symptoms aparte from ALS?
I always read that fascis in the absence of weakness and atrophy are not important but it is obviously not my case.
Praying is something different and struggling through the summer. Taking lorazepam to ease my mind.
Any comments would be appreciated. Thanks a lot for your precious time. Marta V
 
Hi Marta,

It's not uncommon to have a clean EMG and subsequently feel worse. Stress, anxiety, lack of sleep and in your case a sedating drug, can all play a role in perceived weakness and fatigue, but that is not the same as true weakness (loss of mobility) as we see in ALS.

You can return to your primary physician and ask that person to compare your strength months ago versus now. If there has really been clinical progression, you can discuss next steps, but most likely that will not be the case.

So your comment about fasciculations not being important without weakness and atrophy still stands unless clinical examination shows otherwise.

Best,
Laurie
 
Thank you, Laurie, for your quick answer. I Will try to get hold of my doctor and ask for his opinion as the Last neuro I saw totally dismissed me without even checking my strength or examining me. I Will keep you posted and try to get through this summer as I can.
Thanks for everything once again and I keep you all in my prayers.
Marta V.
 
Hello everyone again.
I finally got to go to my pcp as symptoms have got worse over the summer. Fascics are now constant and everywhere, incuding neck and face. They are a fine tremor felt when I am at rest. Pcp found atrophy in my thumb and loss of bulk in the muscle between thumb and first finger in my left hand. Atrophy of right hand is also starting. There is also weakness. Also he found wasting in my left leg and foot and sent me to neurólogy.
This is the picture now and I guess this is it. Fasciculations , weakness and atrophy in more tan one area equals ALS. I don't have the energy to follow the diagnostic process and keep asking myself why i should do it if nobody can stop symptoms with ALS. I am real y struggling especially when I am with my children. Feel like crying all the time.
Thanks for reading me in these difficult times.
Marta
 
Marta, it is simply not true that fasciculations, weakness and atrophy in more than one area equals ALS. Fascics can be a very subjective thing. Weakness (your view or the PCP's?) and atrophy are related to thousands of diseases and injuries. If your PCP is referring you, ask for another neurologist who can at least specify if you have something treatable, which is still much more likely than ALS.
 
Thanks Laurie. You are always so suppportive and try to put thoughts and assumptions in the right place. I guess I am scared Just for the posibility. I Will keep posting after my viist to the neurologist but I guess that I Will try to find a New neurologist Who specialises in neuromuscular. Wish me luck! Thank you once again.
 
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