Wartenberg Sign

[ceedath]

I have a positive Wartenberg sign in my left hand. I can't find much literature online. Could this possibly be caused by ALS?

I've had trouble using my left hand and lots of twitches in my left arm, hand, leg, and am noticing a tremor in my left hand.

I have an appointment with a neurologist on Monday, but they don't specialize in ALS.

 

[Nikki J]

Why didn’t you ask the person who did the exam?
it is generally from an isolated hand issue specifically involving the ulnar nerve. Let us know what the neurologist says

 

[ceedath]

I will on Monday when I see them. It'll be my first visit with them.

 

[lgelb]

No, Wartenberg's sign signifies primary ulnar nerve damage as Nikki said.

Any neurologist should be able to diagnose ulnar neuropathy or another local hand issue.

 

[Nikki J]

Then you were testing yourself? Please stop. Even physicians should not attempt self exam

 

[ceedath]

Hi, Nikki, yes that was me testing myself. I studied neuroscience in college and didn't get to med school, so I like to say that I know enough to be dangerous to myself, and I'm not smart enough to reassure myself.

 

[affected]

You cannot test yourself.
Let us know what a doctor says once you have a clinical exam.
We can't really do anything until then.

 

[Bestfriends14]

Studying science in one's undergrad does not give anyone enough info to think they can test themselves and come to any definitive medical conclusion. Leave the testing to the professionals and don't try to think you know more than folks who did go to med school, did do their residency, and did do their fellowship in neurology. Trust in the process and believe what the docs think is going on with you.

Please update once you've had your appointment.

 

[ceedath]

I will. Thank you. I have been so afraid today.

 

[ceedath]

Hi, reporting back. The neurologist said I have some weird things going on and wants a NCV, EMG, MRI, and blood work.

He found brisk reflexes, appreciated the weakness in my pinky, and wants to see if he can find the cause of twitching and cramping in my left leg and arm.

He doesn't think it's specifically ulnar nerve entrapment because I don't have any tingling, numbness, or pain.

He said that ALS usually starts in the proximal limbs and not the extremities, which doesn't seem consistent with what I've read here.

I won't have my tests done until the new year.

 

[affected]

Great news!
Remember that neurologists treat hundreds of conditions and most of them are not terminal.
They now have a plan on what tests to do and you can be sure they would be rushing you in if there was any concern about something terminal.

Enjoy the end of year break as I'm sure there will be a path to health in the new year.

 

[ceedath]

I stopped leaning on my elbow and resting my heavy phone on my pinky and the Wartenberg Sign resolved.

I still have fasciculations, cramping, brisk reflexes, and perceived grip weakness, so I'll still be moving forward with the EMG, MRI, NCV, and blood tests.

I know this should have eased my anxiety but it hasn't.

 

[lgelb]

You are correct that most limb onset in ALS is distal, though there are proximal onset forms.

Ulnar nerve damage takes other forms beyond entrapment., so nothing to hang your hat on either way. But lack of clinical weakness beyond your pinky is a very good sign.

 

[affected]

Let us know after you have all the tests and a diagnosis.
I'm sure it will be something quite simple and treatable.
All the best.

 

[MupstateNY]

He doesn't think it's specifically ulnar nerve entrapment because I don't have any tingling, numbness, or pain.

I had ulnar nerve entrapment but no tingling, numbness or pain. My hand surgeon told me there is an unusual form of carpal tunnel that doesn't involve any pain. If you have trouble getting the EMG scheduled in a reasonable time frame, you might want to do as I did, and schedule one out of town so you can move things along. In my county, all the specialists are completely overwhelmed.

Best of luck to you.