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Neurology (Expert Forum)
Worried about problems for more than 2 months now - Please Help
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Worried about problems for more than 2 months now - Please Help
by MR.BRUNO, Jun 12, 2005 12:00AM
It began after a time of massive emotional stress, 3 mth ago: paresthesia left hand and a feeling of weakness/stiffness in the whole arm. Left arm has seemed get fatiqued faster than the right one; I first noticed it while eating when I was trying to move the fork to the mouth.
Around 6 weeks later in april fascics started in my latissimus to progress all over my entire body within a few days. Esp. both calves are fasciculating non-stop and randomly my pectoralis, back, stomach, biceps, arm,hand, face and neck. A week later I felt generalized fatique and shaky feelings for the most muscles of my body. My muscles seemed to get very shakey esp. while static work/movement i.e. holding newspaper, mainly left side. Paresthesia disappeared completely.
Very weird but ive been able to have a MARKED INCREASE of power with lifting weights (30-60% reps)during the last weeks. 2-3 times running for six miles is still no problem.
I dont see any weakness on my left arm while exercising, but after the training i often note slight aching muscles (forearm/wrist/pectorals)little like tendinitis-ONLY ON THE LEFT SIDE. It seemed left biceps, forearm and esp pectoralis have an increased tone often; feel "stiff".
I ve had 3 neuro-examinations during the last 3 mths with with normal reflexes CT-Scan, 2 EMGs, bloodwork - ALL CLEAN & NORMAL. My neuro said its stress/anxiety related.
I try to believe but esp the stiffness and tone of the left arm are scaring me and I fear a beginning spasticity.
Do you see any reason to be concerned for ALS?
Thank you vey much for reading & best wishes!
Around 6 weeks later in april fascics started in my latissimus to progress all over my entire body within a few days. Esp. both calves are fasciculating non-stop and randomly my pectoralis, back, stomach, biceps, arm,hand, face and neck. A week later I felt generalized fatique and shaky feelings for the most muscles of my body. My muscles seemed to get very shakey esp. while static work/movement i.e. holding newspaper, mainly left side. Paresthesia disappeared completely.
Very weird but ive been able to have a MARKED INCREASE of power with lifting weights (30-60% reps)during the last weeks. 2-3 times running for six miles is still no problem.
I dont see any weakness on my left arm while exercising, but after the training i often note slight aching muscles (forearm/wrist/pectorals)little like tendinitis-ONLY ON THE LEFT SIDE. It seemed left biceps, forearm and esp pectoralis have an increased tone often; feel "stiff".
I ve had 3 neuro-examinations during the last 3 mths with with normal reflexes CT-Scan, 2 EMGs, bloodwork - ALL CLEAN & NORMAL. My neuro said its stress/anxiety related.
I try to believe but esp the stiffness and tone of the left arm are scaring me and I fear a beginning spasticity.
Do you see any reason to be concerned for ALS?
Thank you vey much for reading & best wishes!
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jun 15, 2005 12:00AM
Fasciculations in the absence of fixed muscle weakness and wasting is unlikely to be due to ALS. Rapid onset and widespread fasciculations are more likely to be benign or nonALS realted. Fasciculations can also occur due to pinched nerves, in response to cold, exercise or certain medications, and in some viral diseases of the spinal cord.
Spasticity if present should be identifiable by the neurological examination. A segemental spasticity of only the left arm is unsual, and although ALS can present in a segmental fashion. for the other reasons stated above ALS is unlikely. An MRI of the cervical spine and brain may be useful to ruleout a structural lesion causing the left arm problems, but in the presence of a normal neurological examination, is low yield
THere may be a muskuloskeletal component to the left arm problems, such as, as you mention, tendinitis or ligament/joint problems. An opinioin from a physical medicine specialist or rheumatologist may be helpful
I cannot give you a definite clinicla diagnosis over the internet though, and you may need a formal second opinion
Goodluck
Spasticity if present should be identifiable by the neurological examination. A segemental spasticity of only the left arm is unsual, and although ALS can present in a segmental fashion. for the other reasons stated above ALS is unlikely. An MRI of the cervical spine and brain may be useful to ruleout a structural lesion causing the left arm problems, but in the presence of a normal neurological examination, is low yield
THere may be a muskuloskeletal component to the left arm problems, such as, as you mention, tendinitis or ligament/joint problems. An opinioin from a physical medicine specialist or rheumatologist may be helpful
I cannot give you a definite clinicla diagnosis over the internet though, and you may need a formal second opinion
Goodluck
Sorry to hear about your problems. You are not alone. I've been experiencing the exact same symptoms since Jan/05.
Of note: I also have been under alot of emotional stress. My wife's mother is in the last stages of Bulbar ALS. For the past 11 months, my wife has come home from work and then gone to the hospital to see her mom. I have been stuck at home watching my two boys(4 and 2) after work. We haven't really done anything as a family during that time. I plead with her to take turns with her dad and sister, on visiting her mom, because I need/want her to be around, for me and the kids. If it wasn't for the gym, I'd probably lose it.
I am a 34 year old software developer and I am into weight lifting as well. It all started during a workout. I just finished benching 90lb dumbbells, when I got up to place them on the rack. At that point, it felt that my whole body got up, but all my insides were pulled down( like a massive tear/rip ). No real pain initially, symptoms began a couple days later.
- buring pain down spine from neck to mid-back
- twitching in triceps, forearms, back, neck, shoulders, biceps, legs, calves, etc..
- pain in shoulders, thighs, hamstrings...
- tingling, shock-like sensations down legs, arms and hands
- tremors( shaking ), expecially in hands, fingers
Saw my GP, initially suspected a musculoskeletal problem, prescribed some NSAID. He ordered slew of blood tests and X-rays, ultrasounds. All Blood test NORMAL, Ultrasounds NORMAL, X-RAYS showed slight neck strain. After 1 month, he scheduled neuro appointment. The neuro ran some tests that seemed normal. Requested more blood and urine tests. Both came back NORMAL. Ordered MRI, CT ( possible MS ? ) and EMG. CT of HEAD came back NORMAL, MRI of C-SPINE showed disc herniation C4-C5, some disc degeneration and the EMG came back normal.
( took a month or so off from weight-lifting . After that, slowly went back to the gym. This time, did cardio, warm-ups, cool-downs, lots of stretching, very strict form. I noticed that my strength actually increased progressively. Also noticed increased stiffness, but that was probably due to the strict form and increased reps, and tone, probably due to proper diet( supplements, protein ). At this point, I also took notice of my posture, which was really good. Being around computers 10-12 hours a day, I noticed that I slouched quite a bit. This, I truly believe enhanced my symptoms, as well as the aforementioned stress. )
Note: When I do go to the gym, most, if not all, of my symptoms disappear during the workout.
Went back to my GP, made an appointment with Sports Medecine Doctor( who happens to be the Toronto Argonauts team doctor, as well as the Doctor of choice for the Canadian Olympic Athletes ).
He basically stated that I suffered a traction nerve injury from the neck down, hence all my symptoms below the neck. He ordered Physio for me doing FSM( Frequency Specific Microcurrents ). It's been only 2 weeks, but some pain has alleviated. Another 2 weeks to go. Have began doing neck and back stretches and watching my posture more closely. Also will get the doc to schedule my x-rays and MRI to see any changes.
I hope this in some way points you in some direction. You might have suffered something similar. If you need to talk some more, leave a post.
@ cdibened: really funny, but true - so many of your Sx sounds more than familiar to me! My email is: mr.***@****.
Would be grateful for a talk!