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Noticed shakes in index finger when extended and frozen when curled. Any thoughts?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Practicing since : 1994
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Hi there,

Over the past couple of weeks I have begun to notice that whenever my left index finger is extended it shakes almost uncontrollably. Sometimes it shakes all the way up my arm. I am not losing any grip and seem to have full strength in general, although the past couple days I have noticed that my finger when curled (typing for example) will all of a sudden go limp for a minute or frozen and I can’t move it, or when I open a door handle or something like that.
I have now been focusing on this and see myself holding my index finger out multiple times a day and seeing if it still shakes – which it does. I am petrified this is ALS. I do have minor twitching elsewhere on my body but am very worried.
What are your thoughts on this?

Thank you.
Posted Mon, 10 Dec 2012 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 5 hours later
Hi,

Thank you for posting your query.

First of all, I wish to reassure you that your current symptoms are not suggestive of fatigue or stress related. This is likely to get better with rest and relaxation.

Regarding your twitchings elsewhere in the body, they are most likely benign fasciculations.

Definite clinical signs of ALS include wasting (thinning) of muscles, extensive fasciculations, spasticity, slurred speech, difficulty swallowing, etc. These symptoms tend to progress over time.

I hope it clarifies. Please get back if you have any more queries.

Wishing you good health,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad
Above answer was peer-reviewed by
 
Follow-up: Noticed shakes in index finger when extended and frozen when curled. Any thoughts? 48 minutes later
Thank you. I seem to be focusing on this finger now and it always feels sore at times. It definitely shakes/tremors when I fully extend it and like I said, will seem to lock once in a while for just a few seconds. As I mentioned, I am very worried about it being ALS as I made the critical error of googling this online. I do have full strength except for the few seconds where I seem to lose ability to move the finger. Is it possible it is now getting sore from me purposely extending it over and over trying to test it out?
Thanks again for your help - it is much appreciated. XXXXXXX
 
 
Answered by Dr. Sudhir Kumar 4 hours later
Hi,
Thank you for getting back with more details.
Your guess is correct. The soreness is related to repeated movements of the finger.
As I mentioned earlier, your problem does not seem to be ALS (this is based on the findings of more than 500 patients that I have personally seen with ALS).
If you are really anxious, then, you can get an EMG study (electromyography) done after a neurology consultation.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Noticed shakes in index finger when extended and frozen when curled. Any thoughts? 11 hours later
Thank you. I am a bit stumped though as to why my finger will just lock and not be able to be moved for a few seconds. This only seems to happen a few times a day, not even, but I do feel reassured that my symptoms do not sound like ALS. I do have full strength otherwise.
Thank you.
 
 
Answered by Dr. Sudhir Kumar 7 hours later
Thank you for getting back.

The finger getting locked for a few seconds could also be due to transient muscle cramps. In any case, there is no need to worry about it, as it is not a symptom of any serious neurological disease.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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