Curious about hand coordination

    
      Re: Curious about hand coordination
    


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Posted by CCF Neurology MD on September 18, 1997 at 22:15:03:

In Reply to: Curious about hand coordination posted by R on September 13, 1997 at 23:50:23:

: I went to a neurologist several years ago concerning lack of coordination, strength and fine motor control in my left hand.  During examination,with my eyes closed, I was able to name a bottle cap in my hand but not a dice.  I am usually unable to tell what is in my left pocket especially coins, etc.  I need to see what it is.  I always use my right hand to lift and hold things that have any weight.  I often forget if I am holding something in that hand until I see it there.  There are two small brown spots on the palm of that hand (like little birthmarks right in my skin) that became evident in my twenties.  At rest, that hand always seems to want to close with my thumb across the palm.  Anyway, that hand has always been a little odd and does not affect my abilities in any way (except that I have to concentrate a bit more) and my school aptitude tests showed that with my fine motor scores I would never make a watchmaker!  The neurologist's conclusion was that its just the way I was born. An EEG was done but since he did not discuss the results, I assume that it was quite normal.  That answer is okay (it was my GP who was concerned about it not me so much) but sometimes I get curious about what the being born that way means.  Also, since then I have been diagnosed with EDSIII.  Could this be related at all?  My fingers hyperextend a bit but not as much as my major joints.  BTW, I am able to type quite well but doing up buttons takes a long time.  Go figure.
   Thank you,
     Just Curious
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Dear R:
I would like to complement you on such a precise description of your symptoms. Incoordination, loss of dexterity, and some decrease in discriminative sensation in one hand commonly implies a problem in the cerebral cortex, and less commonly a problem in the cervical (neck) spinal cord/brainstem. A problem in the peripheral nerves, spinal roots, or in the brachial plexus (bunch of nerves behind the collarbone) is possible but unlikely. It is difficult to say if this problem is related to the Ehlers-Danlos syndrome type III - a possibility that cannot be ruled out. The commonest neurological complications of the EDS are cerebrovascular, such as aneurysms, vascular malformations, dysplasia (narrowing/beading), or dissection (tearing). These could lead to strokes, hemorrhages, or compression of nervous system structures, often at an early age. These neurological complications are common in the severe type IV variant of EDS, and much less so in less severe variants. Other neurological complications include dislocations of the upper cervical spine, and very occasionally neuropathy/brachial plexopathy. The fact that your symptoms are long-standing and non-progressive is very reassuring. It might indeed be from a static 'birth defect' as your neurologist suggested. Imaging of your brain and neck with MRI, and also possibly of the blood vessels going to the brain with MRA, would be a non-invasive way of reasonably excluding a major or life-threatening vascular or compressive problem; it might potentially be indicated in your case.
If you live near Cleveland and wish to have a second opinion, you are welcome to see any of the neurologists at the Cleveland Clinic. I would recommend Dr. Anthony Furlan, Dr. Cathy Sila, or Dr. Judith Hinchey, who are internationally renowned cerebrovascular experts.
The number to call for appointments is [phone], or [phone] toll free.
Good luck!
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condition.