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Neurology (Expert Forum)
loss of muscle mass and pain in hands and arms
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
loss of muscle mass and pain in hands and arms
by kayt, Apr 15, 2002 12:00AM
my dad had open heart surgery in june 2001. he had 3 by-passes and a valve replacement(pigs valve. After the surgery he was fine and home for 1 week. After one week his heart was out of sink and had to go back to the hospital and they had to use the paddles on him. Right after they used the paddles he developed drop foot, weakness in his hands and arms and lost extreme muscle mass all over his body. We had emg tests done , spiral spectropscy, lumbar puncture, mri. the emg of the tongue was good, and certain other tests were abnormal and certain other were good, The spiral spectropscy was good. We have gone to 3 neurologists so far and all say it could be als or it could be spinal muscler atrophy but no one said it is. His food drop is no longer he went to therapy and does not have the foot drop. His arms and hands are worst then ever. if he extends his hands out in front of him he can only lift his hands to his knee. Some one had mention to us that maybe it could be monoeuritis multiplex and could be treated with igg shots. We don't know what to do the neurologist just gave dad Ritulek 50 mg to take and he just started talking that drug . Is there any other test that can be made for finding out why he had lost all his muscle mass and can not lift his hands because of no strengh.Please let me know.
Thank you
Thank you
Doctor's Answer
by CCF-Neuro-M.D.-JT, Apr 16, 2002 12:00AM
Very sorry to hear about your father's condition. This is a complex case that requires a very close look at his neurological examination and prior diagnostic workup. Based on the brief and patchy info that you have provided, I can only say that ALS and mononeuritis multiplex are both possiblities. Other possible causes include muscle disorders, inflammatory diseases, paraneoplastic disorders (diseases related to a hidden cancer)and stroke especially if he had a rhythm problem called Afib (although it wouldn't explain all of his symptoms).
The most important thing to do now is find the right diagnosis. And what is absolutely critical in making the right diagnosis in your father's case is the EMG and exam. There is a big difference between mononeuritis multiplex and ALS Hopefully they can figure out what your father has so he can get the appropriate treatment. If you haven't already, get an appointment with a neuromuscular specialist at a major clinical or academic center. Special blood tests for muscle enzymes like CK, aldolase, lactate, thyroid as well as routine chemistry studies are important. A repeat EMG at a high powered center (university or Mayo/Cleveland CLinic) will most likely be necessary. Finally, a biopsy of his muscle may be needed if everything else is indeterminate. If he is in the Cleveland area, Dr. Erik Pioro is our ALS specialist who also does EMGs would be happy to see him. Kerry LEvin and Bob SHields are also neuromuscular specialists who could be of help. Good luck.
The most important thing to do now is find the right diagnosis. And what is absolutely critical in making the right diagnosis in your father's case is the EMG and exam. There is a big difference between mononeuritis multiplex and ALS Hopefully they can figure out what your father has so he can get the appropriate treatment. If you haven't already, get an appointment with a neuromuscular specialist at a major clinical or academic center. Special blood tests for muscle enzymes like CK, aldolase, lactate, thyroid as well as routine chemistry studies are important. A repeat EMG at a high powered center (university or Mayo/Cleveland CLinic) will most likely be necessary. Finally, a biopsy of his muscle may be needed if everything else is indeterminate. If he is in the Cleveland area, Dr. Erik Pioro is our ALS specialist who also does EMGs would be happy to see him. Kerry LEvin and Bob SHields are also neuromuscular specialists who could be of help. Good luck.
Marla