Muscle wasting

[Hope]

I am wondering if someone can please explain muscle wasting to me? I have very obvious (to me) wasting almost everywhere. This was noticeable when I was diagnosed yet my neurologist wrote ‘no obvious signs of muscle wasting’ in his report. My limbs are not different sizes and I am still fully mobile and have full use of my arms and hands. I have no cramps, fasciculations, pain etc, just indentations along my limbs. Is this muscle wasting or something else?

[PeterPan]

Hope Obviously can’t give you a medical explanation, but my experience is that really significant muscle wasting goes hand in hand with loss of function. My arms became progressively weaker to the point where I can’t move them. They now look like skin and bones and muscles have wasted away. Same thing is now happening to my legs. If you have full functionality that (to me) would explain why the neurologist didn’t note any significant change.

[Ellie]

The explanation for muscle wasting in ALS is: when the motor neurons can no longer send impulses to the muscles, the muscles begin to waste away (atrophy), causing increased muscle weakness.

Without physically seeing and examining your legs, it’s very difficult to say if you have muscle wasting - maybe it is wasting, maybe it’s a redistribution of fat…

It is possible to have localised wasting (atrophy) and still have function because nearby unaffected muscles can compensate for their neighbours, at least for a while. This can explain why some people with ALS who were ticking along nicely, can experience a ‘sudden’ loss of function when the viable muscle fails.

One would expect a Neurologist to know muscle wasting (atrophy) when presented with it… xx

[Hope]

PeterPan thank you, that is helpful.

[Hope]

Ellie thank you. If it is fat redistribution then it’s all gone to my stomach 🤣

[AngieCanuck]

I’ve noticed some wasting in my left leg. I measured my thighs when I was diagnosed and they were the same size, and now as my left leg is becoming more immobile it seems to have shrunk! It is 2 inches smaller than the right and not sure if it’s because my right leg is doing all the work and getting larger? Hard to say!

[TinyLady]

I was told I had no muscle wasting and I definitely do have it as another neurologist and other health professionals have commented. It is fairly limited and in the areas where function is gone or severely limited.

The reason I think I was told I had none was because I was fully dressed in jeans and a long sleeved top each time I was examined.....

[Arcadian]

Here's my left hand with atrophy between thumb and finger and between the hand knuckles (interossei), then the right elbow that 'went' within a month. I'm right hand dominant and the round lumpy outer elbow muscle loss (brachial radialis)? is significant.
It was the loss of right arm elbow area and a physio report that got the doctors interested in "concern for serious neurological disease" regarding hospital referrals.
Prior to that I was 5 days off localised left ulnal nerve surgery when the right arm problem occured.
I'd already had electroconductive and EMG tests on left arm that indicated problems, when I asked why they weren't doing the right arm due to similar pain for months, I got admitted for a neck MRI (that indicated no spinal problems).
Most of my medical notes reference the muscle atrophy betwenn doctors / consultants / hospitals and associated fasciculations / pain.