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nhenderson

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I just have a couple questions. I realize this is not an anxiety board nor are you all doctors.

I have been doing a lot of research online after I had an emg of my left arm. I looked up some things that were on my results and something that kept coming up was ALS. I knew what ALS was before and have worried about it from time to time due to having muscle twitching which I have had since I can remember.

Ok so getting to what is going on now. So I am a type 1 Diabetic for 17 years. Right after Thanksgiving I noticed numbness, tingling and just a feeling that my pinky and part of my ring finger on the left. I noticed it got worse when I was working and using it, and also when I would bend my elbow it would get worse. Also if I touched my elbow where the ulnar nerve is it was send a shock to my fingers.

So after about a month of this symptom I went to the dr who sent me for an EMG of my left arm. The NCS part of the test showed that there was no Ulnar nerve sensory response to the pinky. Also there was conduction slowing at the elbow. A mild degree of conduction slowing of the ulnar motor nerve at the wrist at guyons canal. The emg was mostly normal except for the FDI muscle at PSW +1 and the Flexor Carpi Ulnaris muscle has PSW +1. The other nerves and muscles tested in my arm were normal. I had an MRI that really did not show anything, an x-ray of my elbow that didn't show any bone issues.

I still have the numbness in my pinky finger, which does sometimes get worse at night. I have not noticed any weakness. My family dr is sending me to an orthopedic dr, I have that appointment tomorrow. Shouldn't I go to a neurologist though? Thank you all. I am a 36 year old female. My name is Nicole.
 
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ShiftKicker

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nhenderson

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I just want to say thank you so much for your time and your reply back. I found this message board by looking up what some of the things on my emg report meant. I got pretty worried that I had two muscles with +1 PSW, but they are ulnar nerve muscles and it does seem to be connected to the Ulnar nerve(possible nerve entrapment). Thank you for the link you posted, I did read it. The Dr that did the emg wrote mild degree of slowing/demyelination of the ulnar motor nerve at the wrist. I was sure that the MRI would show some sort of compression but it did not, so I have been a bit anxious about it. Again thank you so much for replying back to me, hopefully I can get some good answers tomorrow from the ortho dr. I am at a pretty high risk for nerve problems since I am a type 1 Diabetic.
 

nhenderson

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Hey there so I just wanted to come back and let you know how my Ortho appointment went.

So he basically confirmed that I have something called cubital tunnel syndrome. So it can slow down both sensory and motor nerve conduction anywhere along the Ulnar nerve and it can affect muscles depending on how bad the nerve damage is. He told me that is can cause muscles to atrophy and become week in the hand and forearm. One of the most common muscles involved is the FDI which I did have slight abnormal activity at rest and also the FCU can be affected which also had the slight abnormal activity at rest, the rest of the muscle was normal and so was all the other muscles and nerves tested in my left arm.

I only had the EMG on my left arm because that was the only place I had the numbness. The good news is that I did not let this go and I went to find out what was going on so it can be treated right. Mainly the fact that once it causes muscle loss to occur you can't get it all back. He has me wearing this splint at night for the next month and I am to make sure I don't lean my elbow on anything. If the numbness in my ring and little finger does not get better he may do another EMG to see if there are any changes worse/better and I may need to have cubital tunnel release surgery. There maybe some compression of the Ulnar nerve inside my arm that wearing the splint won't help, so he would either reroute the nerve or cut some of I think the tendon or muscle in my arm to make room.

I Just wanted to come back and update because I know that even though I had no other symptoms of ALS after some abnormality on my EMG and then looking it up on the internet it really scared me. So for anyone on looking it is very true that abnormalities on EMGs can mean so many different things, many treatable things at that.

I just wanted to also so thank you to those of you who come to this section and answer questions, your taking your time out to do that and that speaks volumes as to the type of people you are. Before I made a post I read many of the posts on here, and decided to post because I felt you guys would be the best to ask rather then just continue looking stuff up online. :)
 
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ShiftKicker

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Thank you so much for returning to let people know how your appt went. You bring up an excellent point in advising people to keep an open mind- even if it's not ALS, it doesn't mean it isn't something that isn't serious and needs immediate attention to make sure there is not permanent damage. I am glad your doctor was so thorough and was able to (and inclined to) sit down and explain what the issue was and what needed to be done to mitigate symptoms.

Thanks again
 

nhenderson

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So I know I can't start a new thread but I just wanted to come back again with some updates that may also help others who worry about if they have ALS. For the last few weeks, I was still a bit worried so I did go ahead and see a neurologist, to learn more and put my mind at ease. She pretty much confirmed my issues are related to Ulnar nerve damage and likely nothing else. This was after she did an exam on me and reviewed the EMG of my left arm. Also she explained in order to even diagnose ALS all other things would need ruled out plus I would have to have more areas tested and she doesn't see the need for that now. She said she'd do it if it would help ease my mind, but at this point I am not going to because I don't have weakness, or failures and really no reason to believe I have ALS.

I have experienced twitching all over in the past on and off for years never really thought much about it. Didn't think about it until I started having the nerve issue, then I had the EMG of my left arm. The only reason ALS became a fear is because I had two muscles with +1 PSW, everything thing else for the needle part was normal, even the two muscles all other values were normal. I also have slowed Ulnar motor nerve conduction at the elbow and wrist. Also the absent sensory response but I knew the sensory would not be ALS. All other muscles and nerves tested in my left arm were 100% normal. Still at that point after looking up what PSW meant cause I didn't know I started worrying about ALS and could this be picking it up early.

I went to the Ortho dr. and he diagnosed Cubital Tunnel, so something has compressed or is still compressing my ulnar nerve causing damage to the nerve. Still I didn't 100% believe him and that was why I decided to see a neurologist. I started noticing muscle cramps mostly in my calfs, hams and abs, and a good deal of twitching months ago but I am a nurse and I figured I was just over working myself. That could be true because I did work a lot of double shifts, all different shifts and would work long stretches of days at a time. The twitching is all over the place even my tongue and I have some twitching somewhere in my body everyday. I even get a burning feeling in my arms when I am say cleaning the windows etc.

The neurologist was going thru past blood work, and I have a lot because I am a Type 1 Diabetic. She seen that in Oct. my Magnesium level was low, somehow between switching GP and the endo leaving this was missed and never treated. She was certain that I likely have had a Magnesium deficiency for probably months or more. She also said that other vitamin deficiencies can also cause symptoms like muscle cramps, twitching even weakness and fatigue. She also checked B vitamins and vitamin D. My vitamin D is also low. I have had low iron for the last few years. This my very well all be related to another medication that I take.

I am also on Prilosec which can cause all of the low mineral/vitamin deficiencies. Now I have been on Magnesium and Vit D and I am already noticing less twitching. So I just wanted to come back to not only update but also when these good people on this site tell you you likely do not have ALS give some thought to what they are saying. Go investigate other causes and find out what is going on and if and how it can be treated. Like I have read so many before say that there are so many many reasons for things to show up on EMG and also to have other muscle type symptoms. In most cases the cause can be treated, and it is not ALS. In my case I now am on Vit D, Magnesium and will go off of Prilosec. As for my nerve issue it will just take time, splinting and rest. I hope I can avoid surgery.

Lastly, like so many who come here I have anxiety and it is mostly health related. It can be scary, there are a lot of scary illnesses out there however spending all your time like I was worrying about having something like ALS is wasting your precious time and we all have only a certain amount of it on this earth anyway healthy or not. Those of us that have a real struggle with worry that we are always dying when we really are not. I say this because we aren't living and enjoying life when we are so focused on our worries. So just perspective and if you really are someone who just can't seem to relax and let some of it go then seeking treatment for Anxiety is a must. Believe me I feel so much better now that I have and I am on medication for my Anxiety. I really hope this was ok to post. I hope this can help people who come here worried and for those who have to be here thank you for even taking the time that you do to come her and read these posts and answer worried people.
 
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