Dent in palm

[londoner]

Hi. Just noticed this dent in my left hand which is the only hand that I've noticed occasionally twitches. One photo shows it relaxed and the other stretched out. Could it be early wasting?

[Ellie]

londoner It is pointless posting photos on the forum asking lay people to comment.

If you are concerned, go to your doctor who can physically examine your hands.

[londoner]

If someone can't or doesn't want to answer because they feel it's just speculation then I can understand that. It's usually a 3 week wait for in person appointments in my area. GPs quite freely admit to knowing very little about MND as they've often never had a patient with the condition. Sometimes people with experience of a condition are just as qualified, if not more qualified, to comment. If someone has some insight based on experience then I don't see it as pointless. If they don't then it probably is pointless and ignoring my question probably makes more sense.

I will of course expect professionals to confirm everything but any information I can share with a doctor who often has only a few minutes to spare is very much appreciated.

[Ellie]

GPs quite freely admit to knowing very little about MND

A GP does not have to know anything about MND to say if a muscle is atrophied or not.

The reason posting photos is pointless is because they are 2D and it's impossible to know how you're flexing or relaxing your muscles.

That is why somebody physically needs to feel and touch your hands, a proper 3D examination.

FWIW, to me, your hands look perfectly normal in those photos but I know nothing.

[londoner]

There's a dent slightly to the left in the hand that has fasciculations, although much less frequently than in other areas. I'll try and give my brain a break for a while with the rubbish that is Eurovision!

[Johnny5]

Many different things can cause your symptoms. It is human nature to jump to the most severe diagnosis right off the bat. Injuries to nerves can have all kinds of strange effects and can come from several locations. Fasciculations will typically follow nerve injuries for a time and then they tend to resolve. Damaged nerves go through a process called Wallerian degeneration from the point of injury where the nerve will die off to the end. When that happens, new growth begins as long as the sheath is intact, and will grow around 1-2 mm per day. In 12-18 months, if the nerve does not reach the targeted muscle and reestablish the neuromuscular connection, the junction will die off. If you get smacked in your funny bone in the elbow, have carpal tunnel syndrome, a shoulder injury, or even cervical myelopathy, the symptoms in your hand can manifest.

Talk to a professional. While this type of discussion board is helpful, none of us can give you a proper diagnosis. ALS can take a long time to diagnose, and I pray you do not have to go through this. The small dent in your hand does not appear to be an issue IMO. But then again, I am not a medical professional.

[londoner]

Many different things can cause your symptoms. It is human nature to jump to the most severe diagnosis right off the bat. Injuries to nerves can have all kinds of strange effects and can come from several locations. Fasciculations will typically follow nerve injuries for a time and then they tend to resolve. Damaged nerves go through a process called Wallerian degeneration from the point of injury where the nerve will die off to the end. When that happens, new growth begins as long as the sheath is intact, and will grow around 1-2 mm per day. In 12-18 months, if the nerve does not reach the targeted muscle and reestablish the neuromuscular connection, the junction will die off. If you get smacked in your funny bone in the elbow, have carpal tunnel syndrome, a shoulder injury, or even cervical myelopathy, the symptoms in your hand can manifest.

Talk to a professional. While this type of discussion board is helpful, none of us can give you a proper diagnosis. ALS can take a long time to diagnose, and I pray you do not have to go through this. The small dent in your hand does not appear to be an issue IMO. But then again, I am not a medical professional.

Thanks for replying. As I have widespread, long term twitching and a family history of MND, they're already taking my symptoms seriously. I just wondered if this is another sign to worry about. I'm sure the neurologist will be able to tell me more in August. It just seems so far away!

[MMG]

Just a bit of kind advice from me. Until you have a firm diagnosis of this awful disease please enjoy your life in blissful ignorance.

I am grateful for a later diagnosis for my husband as our life was still relatively normal before the date of diagnosis.

Everything changed on the day we received the diagnosis, so please try not to worry until you have something to worry about. Easier said than done I know.

If you don't have MND you have wasted time, energy and joy of life for nothing. If you do have it (I hope you don't) you will have the answers at that point.

An early diagnosis makes no difference to the overall outcome - its not like cancer where the outcome improves the earlier you know. So please don't torture yourself.

[Music man's wife]

Chris's MND has always been worse down his right side, what little movement he has now is in two fingers of his left hand.
When he was being diagnosed they pointed out the muscle wastage between his thumb and forefinger, it was very noticeable.
August seems a long way off and it must be torture for you. However let's hope they are ruling MND out, not the opposite.

[Arcadian]

If possible, consider a Physiotherapist appointment (private appointment if necessary) for them to make an assessment (they should check more than just the hand, as well as some reflex tests).
They are not in a position to diagnose, but they can send an email / letter to your GP in medical language for additional medical professional interpretation if there is no simple explanation.
The GP may still refer you on for additional tests if necessary / ambiguity.
It is natural to have concerns, particularly if you feel getting 'timely' appointments with your GP are a challenge. 'Other' medical professionals can help if you feel access to a GP and timescales add additional stress and worry.
If something minor, you get an interpretation sooner and less stress, if something serious it doesn't make much difference in the grand scheme of things (unless making major decisions or about to buy a new house etc.).

I respect that you have sufficient concerns to enquire on a specialist forum and can only guess at any uncertainties and stress on the information journey getting here.
I would explore the in-person medical professional routes first though, even if that is sideways via other medical practitioners so that your GP (and referral if necessary) has a clearly defined overview.