Concerned about progressive muscle weakness in fingers on both hands

[kevincs]

Hi all,

I've been having some pretty concerning symptoms. A quick background, I'm a 26 y/o male with obstructive sleep apnea that's getting worse over time.

Basically, about a month ago, I started noticing weakness in my left thumb. It was slight, but distinctly there. Over the course of the weeks since, that weakness has spread to my left pinky, left forefinger, right thumb, right ring finger, and right pinky. The rate of progression has increased recently and today, I had trouble squeezing a mustard bottle with my right hand (my right pinky would essentially collapse flat at the 2nd hinge from lack of strength).

I notice this weakness very distinctly in these fingers as I'm typing on my keyboard. When I press down, the hinges have very little support and feel weak. Today, my left thumb started to bend like my left pinky does when I press down on a key.

I'm concerned because there's been no pain so far, and because of the rate of progression on both hands. If there were wrist or elbow pain, I might have thought it was some sort of pinched nerve, etc. However, the lack of that and the appearance of these symptoms in both hands makes me afraid it's ALS.

On another perhaps related note, the muscles in my left calf and knee have gotten weaker also. This has been happening over the course of a few months now. I have pretty frequent feelings of muscle fasciculations, but not much evident twitching.

I'm going to see a neuro real soon, but I'd love to hear your guys thoughts also.

[Jeffrey Kim, M.D.]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I cannot tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

I’m sorry to hear about the symptoms that you are experiencing.  You mentioned that you were undergoing EMG testing.  Hopefully this has been done.  EMG testing will be able to shed light on whether a neuropathy (nerve damage) is present, and can also give clues as to the likelihood of a motor neuron disease such as ALS.  It can also be helpful in determining if there is a disease process in the muscles (myopathy).  If it has not already been done, it may be useful to send a CK level (creatine kinase), which can be elevated if there is damage to the muscles.  

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[kevincs]

I saw my neuro and he said his physical examination was normal. I'm going in for an EMG with him in two weeks tho just to confirm everything is as he said.

[aeonoftime]

Did you see the neurologist yet?  I am having the same thing.  My GP said not to worry because ALS doesn't unset that quickly (in weeks).  Like you though I am concerned that my little finger is struggling with weakness.  I am in Canada so getting my GP to give me neuro referal for just my little finger is going to happen. :-(