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xyz14

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I am 28 years old male. Not athletic type, seldom excersice. My right hand is dominant.

I recently have issues with my right leg/foot and right hand/arm. I am particullary concerned about my right hand/arm.

symptom timeline:
Right leg/knee/foot:
Late December, I had pain near the sitting bone and the hip joint on the right side. The pain near the sitting bone often radiated to the lower leg through, especially when lying down. I felt like the muscle of my right leg is weaker than the left one. I can walk but I feel I don't have good control of my right foot, every now and then, my right foot might scratch or trip the carpet.

Late January, after taking some Advil and Mobic (both are NSAID), I think the pain is gone. But I still don't think I have good control of the right leg, such as scratching the carpet sometimes. When walking, my right knee also get tired and stiff very quickly.

Right hand/arm:
Early January, I have tingling of my right pinky and ring fingers.

Mid January, I have pain around my elbow. I feel I don't have good control of the right fingers. When I press the wrong key more often than before.

Late January, the tingling of the pinky and ring fingers have improved but still exist. What begins to scare me is my right upper arm. It seems that the muscle of my right upper arm is not as strong as the left one. I sometimes feel twichy in the upper arm and elbow area as well. When I hold my fist really tight (I mean really really really tight), my right hand and arm begin to shake, which does not happen to my left side. I have the sensation that my right arm wants to shake/move but I can't confirm it visually since I am wearing long sleeve shirt. I think I can pass those "clinical weakness" tests: I can lift a 25lb fitness gear with either my left or right arm, even though that requires considerable effort. But I still feel my right arm/hand is weaker than the left and the twitchy feeling makes me uncomfortable.

Additionally, I often found my right hand colder than the left one and the back skin of my right hand is very rough and patchy compared to the left.

Are these early signs of ALS or MS?
 

xyz14

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Clarification:
When I say "I have the sensation that my right arm wants to shake/move but I can't confirm it visually since I am wearing long sleeve shirt.", I mean the senstation happens in every day life, not limiting to the case when I hold my fist tightly.
 

ottawa girl

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Please see your doctor. I realize this sounds lame... But it's the best thing. I think the quick answer to your ALS question, based on my limited experience, is no. I know even less about MS.

If you been been checked out, what are the findings?
 

xyz14

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I have not been checked yet. I have an appointment with a neurologist on Feb 18. Do you think the neurologist will do an EMG during the first appointment?
 

HelenL

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There are so many other things that it could be, I would definitely look elsewhere tor your answer until you get some testing. Have you looked at sciatic nerved for your hip/leg pain? It can be very debillitating and cause weakness... It also seems to me that your issues are happening in too many areas too soon...

I would also suggest looking at vitamin deficiencies such as D3, B12 and magnesium. Or potassium.

Good luck and keep us posted.
 

ottawa girl

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My first neuro sent me to second neuro for EMG. The week in between, they did catscan & MRI, blood work up etc.
Got results and diagnosis immediately following EMG. Not sure how the system works in your neck of the woods, but I can only imagine they will do the test if they deem it necessary.

Good luck on the 18th and let us know.
 

vickim

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Usually the first appt involves complete history, physical exam, relfexes, balance and strength. In my case they drew lots of blood for all sorts of tests, lymes, vitamin defencancy, lupus, just about any abnormality you can think of. Then the more extensive tests came later over a 5 year period. Be prepared for a long process, but you maybe lucky which I hope you are and they find something simple right away. Don't worry until you have to. Good luck.
 

xyz14

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Yes that is definitely going to be a long process. In the mean time, do you guys have any suggestions for my hand/arm symptoms?
 

ottawa girl

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Tingling is not a symptom of ALS.

I had hand cramping & spasms intermittently for over a year before I saw my GP. I was also dropping lots of things, could not button, and especially tiny objects, I could not pick up. You don't have anything like that. It's only a few weeks before your appointment, so try not to fret. I know it's not easy, but it is possible by focusing on other things.
 

xyz14

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This interesting (also worrying) thing is that I have tingling of pinky and ring figure in early January but that tingling have improve so much that it is virtually gone.
 

Ms. Pie

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As was said, tingling is not a symptom of ALS. Have you considered spinal issues? That's what it sounds like to me.
 

xyz14

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I have a friend's friend who specialized in pain management. Today I asked for a favor and he did an EMG and NCV for me.

Summary of Findings
Needle EMG examination was performed with a disposable monopolar needle electrode on selected muscles of the right upper extremity and the right lower extremity and related paraspinal muscles. Study revealed no signs of membrane instability. The bilateral ulnar motor unit action potential revealed normal distal latency, normal amplitude and decreased conduction velocity.
Impression
The electodiagnostic study reveals no evidence of cervical radiculopath lumbosacral plexopathy at this time.

For the NCV, he say something like "slow but symmetrical".

He said I am unlikely to have ALS but he did not quite figure out the cause of my symptom yet. I also just got the lyme disease is negative from bloodwork.

My questions are:
Do I need an ALS specialist (my friend's friend only specialize in pain management) to perform an accurate EMG?
What does "decreased conduction velocity" suggests?
 

ottawa girl

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See a doctor. Your own.
 
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