Upper arm symptoms/waiting on EMG

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lllearn

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Hi,

I promise I’ve read the sticky MANY times. I saw my PCP yesterday, and a neurologist today for the following symptoms:

-tingling in my left (non-dominant) hand that came on very quickly but then resolved about 24 hours later (I know this is a sensory symptom but since it set this situation in motion, I wanted to include it)
-at the same time that the above resolved, I started having cramping/tightness/spasms in my upper arm on the same side… no trauma/injury or exercise or action induced this
-some twitching in the same area
-slight tremor in left hand, only noticeable when is arm is outstretched/unsupported
-shaking/quivering in arm when it is outstretched or being used (even lifting normal items)
-some stiffness in hand and fingers but does not impact function/use

Both exams did not reveal clinical weakness. Sensation was normal.

The neurologist’s report indicated that I had reflexes 1-2 symmetrically. He did have to test one in my left arm 2x. The scale says 1 is diminished which is concerning me. He didn’t mention any of this in person. He didn’t say much actually, and said we should do an EMG in 3 weeks. They couldn’t actually get me in for 5 so it’s not until March. I asked him if there was anything serious to be concerned with and he said “it’s just a process with steps at this point.” He prescribed me a wrist splint and said it might be nerve entrapment at the wrist (I’m assuming that’s carpal tunnel?) I just didn’t think that I could have carpal tunnel without pain, the tingling hasn’t returned, and extending up to my upper arm nearly to the shoulder? The most reassuring thing he said was “if things resolve before the EMG, cancel it, it’s not comfortable.”

I’m also going to see an orthopedic doctor this afternoon.

I know the absence of clinical weakness and the fact that I’ve had no failures should be reassuring but the reflexes on the note threw me a bit and the fact that he ordered an EMG after what I thought he would say would be a normal clinical exam. Carpal tunnel seems like a stretch given that my hand and wrist seem ok? It’s my upper arm issues that are most troubling. Any thoughts?
 

Nikki J

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Emgs ( and ncs which is typically done at the same time) look for many things. Did the neurologist say they were looking for ALS? Unless it was because you asked it doesn’t sound like it would be on their minds. A limb affected by ALS will be weak with hyperreflexia. You are not weak you say and were mildly hyporeflexic. Let the doctor do their job but do not worry in the meantime
 

lllearn

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Thank you for your response. I didn’t bring up ALS and neither did he.

Thanks for the info on the reflexes. That’s helpful.

Just had my visit with orthopedics and he said X-rays were fine, he did an u/s of my wrist and said the nerve is not enlarged and it looks normal so he doesn’t suspect carpal tunnel but encouraged me to use the prescribed split and “wait and see”. He did an u/s of the upper arm as well and said that structurally, it all looks fine.

Well, should I have the EMG in March and there’s anything to report, I will, if not then assume there was nothing to report.
 
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