What do you think?

[DPCJ2]

I am a 29 year old male with a pregnant wife and am very concerned. Noticed my right ring finger twitching in March. It stopped for about a month. I now have fasciculations in my right ring finger and one of my thumb muscles. I noticed today that I have a few fasciculations in my left foot and get a periodic one in my leg now and then. I don't seem to notice much, if any, weakness. Some days are better than others. I went to a neurologist and he did EMG and NCS. He said it seemed like a post ganglionic nerve injury and likely a brachial plexus injury in my right arm. However, at that time I hadn't noticed the fasciculations in my left foot. It seems much better in the morning when I wake up and seems to get worse during the day. Typing at the keyboard and using a mouse makes it worse than anything. I also saw an ortho-hand surgeon after the neurologist said it was a plexus injury and he agreed. I notice I can't flare my toes in my left foot very well at all whereas in the right, I have no problem. I honestly don't know if I was ever able to though. I have no problems with strength in flexing my toes at all and don't seem to have any problem with my grip in my hands. The thing is that now that I notice the stuff going on the left foot, it doesn't seem like it could possibly be a plexus injury. I am now wondering if I have them in my left hand too. I am obviously very concerned. What do you think?

 

[wright]

Hey there

Let me guess: you saw a few twitches . . . googled muscle twitches . . . and the search came-up with nothing but ALS this and ALS that. If two docs said you have a nerve or two from the brachial plexus that is irritated, then I would believe them. Most everyone on the planet twitches and you are no exception. The twitching you now see in your feet have most likely always been there, but you are now noticing them because of your anxiety. You just had a clean EMG . . . you have no weakness . . . and once again, you were told by two physicians that in essence, you are fine. Go with that and try to relax. If anything changes or gets worse, then give them another call. Remember however, that stress and anxiety can make twitching worse, so please keep that in mind. Take care and I wish you and your pregnant wife all the best.

P.S. You don't have muscles in your fingers, so I think you're really over-analyzing things if you think you have fasiculations in them.

 

[sdsyd]

Hi DP..

Those sound like pretty concerning symptoms, especially if you have had 2 docs give you the same diagnosis. You are young to be having symptoms that affect your ability to function in your daily life. I'm sure having a little one on the way makes you want to hurry up and get better so you can enjoy- and help!

I don't know what to tell you as far as your lower body symptoms, or if they relate to your upper body symptoms- leave that up to the doctors. BUT- speaking from first hand experience- brachial plexus injuries can be VERY debilitating. The brachial plexus is a BUNDLE of nerves that service the ENTIRE arm. I'm sorry you have to experience it. What did they recommend for treatment?
My advice would be to request physical therapy or to see any therapist specializing in hands/arms. (OT's are also able to become certified in hand therapy) but for this injury I would want to be in the hands of a Certified Hand Therapist.

Where I work, we are just finishing up with a lady who we have been working with for 7 months after this type of injury. It was a severe injury she recieved in a fall. When she began treatment, she had literally a "dead arm"- no movement except for minimally in her shoulder. I am happy to say, she now can complete even fine motor tasks, like tying her shoes. Our main treatments consisted of electrical stimulation (PENS) followed by intense range of motion exercises. Anyhow- I would check further into this and know that it IS possible to recover after a brachial plexus injury. Find someone who BELIEVES in what they are doing to help you and you should see results ( even if small at first) within just a few treatments. Just don't give up! Be persistant with the docs and let them know how much it's interfering with things and concerning you. No need to be a tough guy- LOL. Sometimes people worry about their symptoms and then go to a Dr. and downplay them. Human nature I guess. But HURRY and call them and ask for treatment for your injury-sometimes if they've already seen you in the office they can just refer you to a therapist. The sooner you treat this injury- the better your chances of healing from it are.

And by the way- Despite what Wright said-there ARE muscles for your fingers ( located in your palm) that would cause them to twitch/tremor--- OF COURSE!
One more question though- did they ever mention TOS ( Thoracic Outlet Syndrome)?

Good luck with everything and let us know what you find out.
Cindy

 

[hardy42]

I'm not seeing the seriousness here. The guy said he had a few twitches with NO weakness. What is so serious about that? And Wright didn't say that fingers don't have muscles that make them move. The guy has a freakin' Ph.D. I think he knows that there are muscles somewhere that move your fingers. All he said was that you don't have muscles in your fingers.

Listen DPCJ2. If all you have is twitching, all you need to do is relax. Simple as that. Get off of the internet and stop self-diagnosing yourself and go look forward to your new child.

 

[CindyM]

Well, I am sure anybody who comes here looking for medical advice from people they have never met and who are not physicians, knows to take our advice for what it is worth. We have this debate all the time and the question really boils down to this: when is it time to worry?

Looking at it logically, anybody who says, "You are fine." is probably right in that even if the worrier is dying of ALS, it won't happen today. And anybody who says, "You should go see a doctor" is also correct. Some things you want to get treatment for.

For exactly two years now, I have been asking myself when it is time to worry. I am glad I decided NOT to worry 24 months ago, and now that it appears that it is indeed time, worrying seems like a waste of time and effort. :-D

JMO. Cindy

 

[patricia1]

This is a very stressful time in your life There are big changes happening for you.

Becoming a father can be very scary for some men.
I cant tell you how many fathers to be have came ino my office thinking they were having heart attackes because of chest pain heart racing . Colon cancer because of diarrrhea. Brain tumors because of headaches, and yes ALS because of twitching.
Your stressing out because of a big change in your life. This is not unusual to feel this way.
Everything will fall into place when the baby comes and you adjust to your new wonderful life.

Pat1

 

[sdsyd]

Didn't mean to upset anyone.
I was solely addressing his brachial plexus injury. These can be very serious, especially if left untreated- which is probably why he was referred to an orthopedic surgeon. It's not something to sweep under the rug and shrug off. Brachial plexus injuries are generally a "big deal". Occassionally they heal on their own, especially if they are from compression. ( if this is the case he needs to know how to avoid getting another one) More times than not they can continue to get worse. Like I said it's a bundle of nerves basically near your armpit that service the ENTIRE arm. If you injure the nerves that operate the muscles in your arm/hand- you are bound to have some odd symptoms there. But I don't believe he is over-analyzing things if he thinks he has twitches in his finger. When people recover from strokes- we LOOK for muscle twitches there as a sign of recovery- and then we Strengthen the intrinsic muscles of the hand so they can regain movement and function- specifically isolating the muscles that control each finger. I don't want the guy to think he's nuts if he does have twitches in his fingers- and I don't want him to leave that injury untreated- he has options to HEAL it- unlike other things that are irreversible- like MND.

I do agree, if he doesn't have signs of weakness - he shouldn't panic about ALS.

 

[DPCJ2]

Thanks for your responses. The twiches in my left foot are deffinately worse now. The muscle on the side of my foot twitches pulling my big toe away from the other toes. I also get periodic twitches in my left calve and it is starting to feel a little crampy/achy. While I don't doubt stress can cause very significant symptoms, I know this isn't my case. I really had very little stress until after the symptoms had already started. With the new stuff in my left foot, I am going back to the neurologist next week. Thanks again...I'm sure you are all very familial with people on here worrying a ton by now.

ps. Sorry...my "finger" was visibly twitching but the muscles were the interosseus muscles in the hand.

 

[DPCJ2]

sorry for the typos.... "familiar, etc"

 

[wright]

Hello again DPCJ2

It probably is best that you call your neuro in light of your changing symptoms, again to ease your mind. We simply don't want you to jump to any conclusions, which will undoubtedly make you worry more. Keep us posted.

sdsyd: I don't think anyone is mad at you all. I'm sure DPCJ2 welcomed your words and insight and you undoubtedly posted them because you wanted to help. I have read a few of your other posts and you seem very well informed. Keep up the good work.

Take care all.