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hand weakness

  i am a 59 yr old male.  in oct my right hand started getting weak, than my
  left hand, my fingers got very limp and will not open out straight.
  also my feet are tender on the bottoms.
  in nov.i had a mri on c3, it was normal for my age. i had an ea nerve test,an emg, nc motor/f wave all were normal, one blood test showed high antibody level so the doctor put me on gamma goblin for 5 days.  i still cannot straighten my fingers out straight, or extend my hands up, if i lift very much my fingers just go limp. i get tired easy.  i haven't been ill at all in the past and quite active.
  i'm scheduled to have a muscle biopsy next week. what do you think this might be?
Thanks for your question.  There are number of possible neurological
explanations for your symptoms, and a reasonable way to discuss/understand
your prior neurological work-up is to attempt to isolate the problem to
one or more of the following segments: muscle, neuro-muscular junction/synapse,
peripheral nerve, spinal cord, cerebral hemispheres.  Because of the initial
distal and rapidly progressive development of symptoms (bilateral weakness
in hands) one would consider a Peripheral Neuropathy.  It is of interest
that most/all the weakness described in your message are related to the
extensor muscle groups (which are innervated by the Radial Nerve).  The
bilateral and gradual presentation of your symptoms make the possibility of
a vascular event in the cerebral hemispheres (e.g. a stroke) less likely,
however, more insidious hemispheric processes are possible, and distal
limb weakness can result from hemispheric impairments.  Myopathies (diseases
of the muscle) rarely present with distal weakness, so the yield from your
scheduled muscle biopsy can be negative.  If your hand weakness continues
to worsen, your physician should consider a repeat EMG/NCS study.
I hope this information is helpful.  Best of luck.
This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.

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