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Neurology (Expert Forum)
using muscle tissue to restore use of movement in affected hand
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using muscle tissue to restore use of movement in affected hand
by fourthechildren, May 16, 2006 12:00AM
Dear Dr.
First thankyou so much for your time. my questions is very general. Resently my mentor who is dr himself believes that he has ALS. And has had symptoms for 2 1/2 years. He has has muscle wasting between the thumb and index fingerwhich has made grasping to hold his pen to write. The only test that have been preformed are heavy metal blood work . And his dr based on his symptoms have told him that he has ALS that there are no other test to be done and that he has only 2 years because he already has used the 2 1/2 . He has also preformed a surgical proceedure inwhich he has removed muscle from the arm to somehow correct the grasping problem. Have you every heard of this being done ? Because i would think that if Als was present How would this help? Would you be ok with a diagnios without any other testing? I guess you can say im in deniel because i believe it is something else or that we would be in worse shape.Extreme triedness is a main complaint. Lyme has been ruled out because of the lyme vac. i should say tht the symptoms appeared when a major life changes has occured and continues you to transform. He is in his late 50. Depression is his area of expertise so he feels he would know I would say if this was a pt of his and the RX was this wayhe would not accept it . So im not sure why this has got him . HE has lost weight. Im trying to encourage him to go see an expert. Please help . I know you can not Rx but do you think we should explore other ave or should i let it go and let him go threw the grieving process. thank you for your time
First thankyou so much for your time. my questions is very general. Resently my mentor who is dr himself believes that he has ALS. And has had symptoms for 2 1/2 years. He has has muscle wasting between the thumb and index fingerwhich has made grasping to hold his pen to write. The only test that have been preformed are heavy metal blood work . And his dr based on his symptoms have told him that he has ALS that there are no other test to be done and that he has only 2 years because he already has used the 2 1/2 . He has also preformed a surgical proceedure inwhich he has removed muscle from the arm to somehow correct the grasping problem. Have you every heard of this being done ? Because i would think that if Als was present How would this help? Would you be ok with a diagnios without any other testing? I guess you can say im in deniel because i believe it is something else or that we would be in worse shape.Extreme triedness is a main complaint. Lyme has been ruled out because of the lyme vac. i should say tht the symptoms appeared when a major life changes has occured and continues you to transform. He is in his late 50. Depression is his area of expertise so he feels he would know I would say if this was a pt of his and the RX was this wayhe would not accept it . So im not sure why this has got him . HE has lost weight. Im trying to encourage him to go see an expert. Please help . I know you can not Rx but do you think we should explore other ave or should i let it go and let him go threw the grieving process. thank you for your time
Doctor's Answer
by CCF-Neuro-M.D.-PW, May 23, 2006 12:00AM
I cannot give you a clinical diagnosis over the internet as this wbsite is purely educational
Obviously it is not good to ruminate on having a disease without evidence of the disease being present. ALS has specific diagnostic criteria which sould be met before a diagnosis is made - that is, evidence of a disorder of the upper and lower motor neurons in at least 3 limbs for definte ALS. Evidence of muscle wasting/weakness, and EMG abormalities provide objective evidence. Wasting of just one muscle between the thumb and index finger (the 1st dorsal interosseous muscle) on one side could just be due to a pinched nerve in the neck or an ulnar nerve neuropathy.
Seeing a neurologist in order to obtain a good neurological examination and EMG exam would be reccmomended.
Good luck
Obviously it is not good to ruminate on having a disease without evidence of the disease being present. ALS has specific diagnostic criteria which sould be met before a diagnosis is made - that is, evidence of a disorder of the upper and lower motor neurons in at least 3 limbs for definte ALS. Evidence of muscle wasting/weakness, and EMG abormalities provide objective evidence. Wasting of just one muscle between the thumb and index finger (the 1st dorsal interosseous muscle) on one side could just be due to a pinched nerve in the neck or an ulnar nerve neuropathy.
Seeing a neurologist in order to obtain a good neurological examination and EMG exam would be reccmomended.
Good luck
