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I Am A 34 Year Old Female On No Existing

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Posted on Sat, 20 Jun 2020
Question: I am a 34 year old female on no existing medications. A few years ago I developed an essential tremor in my left hand. For the past year or so I have experienced upper body weakness around my biceps and shoulders. I put this down to being unfit. I am also prone to what I think is tendonitis in my left bicep as it gets sore occasionally where it meets the shoulder. I had one particularly bad bout of this a few years ago although I did not consult a doctor. Now my left arm is weaker than my right with difficulty in lifting some medium heavy objects up to the side and towards my back. I feel like the top of my left arm on the outside is very weak compared to the right side. This has been going on for about a year. More recently I have noticed the top of my left arm will ache if held up for a few minutes, particularly if I'm holding something up. Now recently I have developed twitches all over my body. They come and go at random from my left arm down to my calves. I googled twitching and now I am extremely worried I have ALS. I am worried my tremor and arm weakness/ bicep tendonitis have been early warning signs for this and I have overlooked them
doctor
Answered by Dr. Dr. Erion Spaho (1 hour later)
Brief Answer:
ALS seems unlikely, other neurological conditions to consider.

Detailed Answer:
Hello and welcome to "Ask a Doctor" service.

I have read your query.

Since your problems started a few years ago, it is very unlikely that the condition responsible for such symptoms to be ALS.

In my opinion, your symptoms may be caused by conditions such as cervical spinal cord compression and/or stenosis.

Multiple sclerosis also may be considered for the differential diagnosis.

In my opinion, you should see a Neurologist and you should get examined further with imaging and functional tests such as MRI of the brain and spinal cord, nerve conduction study, EMG, in order to achieve a correct diagnosis.

I hope you found the answer helpful.

Feel free to ask if you have further questions.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Dr. Erion Spaho (51 minutes later)
Thank you although now I am very worried about the idea it is multiple sclerosis.

Is it possible that my bicep weakness is due to an old injury? I remember a time it became particularly sore and I feel the tendons at the top of my bicep (where it meets the shoulder) are easier to feel and often have a sore point. I can't be sure but I think the tremor may have started aroung this time too. Could they be linked?

I am very worried about the idea of MS or ALS.
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Follow up: Dr. Dr. Erion Spaho (1 hour later)
Also just to be clear I have not had any tingling, pins and needles or numbness
doctor
Answered by Dr. Dr. Erion Spaho (4 hours later)
Brief Answer:
I would explain as follows.

Detailed Answer:
Welcome back.

I didn't say that yours is multiple sclerosis, I think it should be considered and evaluated further because of the twitches all over your body.

If excluded (this is very likely to happen in my opinion) then these twitches may be linked to benign fasciculations syndrome or cervical spine compression.

But, without examinations, we cannot be entirely sure about the presence or the absence of a condition.

Most likely there may be a nerve/cord compression that weakened somewhat the muscles of your left arm.

This predisposes to tendon damage as well.

The opposite also may be true, a tendon damage weakened the muscles due to restricted activity.

Get evaluated further in order to get a correct diagnosis.

I hope this helps.

Regards.


Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4500 Questions

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I Am A 34 Year Old Female On No Existing

Brief Answer: ALS seems unlikely, other neurological conditions to consider. Detailed Answer: Hello and welcome to "Ask a Doctor" service. I have read your query. Since your problems started a few years ago, it is very unlikely that the condition responsible for such symptoms to be ALS. In my opinion, your symptoms may be caused by conditions such as cervical spinal cord compression and/or stenosis. Multiple sclerosis also may be considered for the differential diagnosis. In my opinion, you should see a Neurologist and you should get examined further with imaging and functional tests such as MRI of the brain and spinal cord, nerve conduction study, EMG, in order to achieve a correct diagnosis. I hope you found the answer helpful. Feel free to ask if you have further questions.