Spot on Thenar eminence? Freak out

[Xina535]

Hi all. I've been away because I've been in he NL and also at the hospital working with a psychotherapist about my worsening mental problems. I may be checking in there soon and will be away for awhile...


Started on Seroquel (sp?) at nights for sleep and am starting Cymbalta tomorrow (just weaned off of Prozac).

Anyway, I am in need of some immediate support or advice about this.,.

My right thumb that has this shrinking problem on the snuff box/first dorsal interrosei and is weaker....I have been having some crazy issues with it lately. Definitely having sensory things like tingles and pulsating TENS unit feelings, with occasional twitching and Thenar eminence soreness/pain when pressed against something and burning tiredness when holding something for long. The tingling is moving now to include the inside of my index finger on the side that faces my thumb. AND I get these ant crawling feelings mainly around my knuckles of my thumb, where it feels like tiny tiny ants are circling around at fast speeds. All comes and goes.

I feel it is getting smaller in general, no dents, but just all around smaller. Tonight I noticed a weird blackish dot on it. I thought it was dirt or something then saw how it didn't wipe away. It looks like a tiny bruise spot. Almost like what you get a day after you get an EMG, but darker. When I press on it, it does not hurt, and it is not a bump.

Any ideas on this? My primary care doctor is away this week on vacation. I tried googling it no luck. I am googling spot on Thenar, nothing. I don't know what words or phrases to use.

[misterjuanperalta]

That dot might be a secondary, unrelated finding. My searches yielded nothing as well. If I find something, I'll post.

[Yuliasir]

Xina, you have sensory issues which is a sign of neuropathy but not MND. As you may know, many of us have this 'bugs' feeling. You have pain there which means that either your inflammatory process is spreading, or, which is more possible (more frequet at least), there is still compression at the elbow level in your ulnar nerve.
Considering how thoroughly you look on your hands, no wonder you spot each and every issue.
as for black dot, it seems like a subcutaneous haemorrage - a small vessel rupture. sometimes it happens. It is called 'petechia'. If you do not have massive petechias, it is just an accident thing, but if you get more of them, you should tell your doctor about this and check your trombocytes level.

Didn't you poke your finger with a needle to check the sensitivity? Some fellows do that, as far as I can remember.

[Xina535]

thanks - the black dot is gone today, just a faint spot today. I looked up the term you gave and it said it usually appears as many, not single, and the pictures looked different than what this looked like. no, i did not poke myself.

but, I did realize that my right (dominant) thenar eminence is generally smaller than my left. I know for a fact it used to be bigger and fatter. My husband sees it and I have pictures that show this too.

Question - if the atrophy of this palm thumb muscle "general" - like just overall smaller - and not focal which I think is the dents (I have no dents) - is that an indication of anything or rule out of something?

There are weird sensory things, yes. I am hanging on to that fact with all of my life. They are spreading out in my hand though a little (palm side). I noticed some of the tingling in my palm side pinky and across my palm. The sensory things mainly in my thumb on both sides, but now that I feel things in other areas....what could be happening? Inflammation spreading!?!? That's scary!

I am really confused about the nerves. I saw a picture of which nerves innervate the hand SENSORY wise, but is that the same as motor innervation?

I read that elbow compression (Cubital syndrome) affects the pinky and ring finger. My problem is mainly my thumb and slowly spreading.

One last important thought which I'd like to check - whatever has been going on in my thumb has been very slowly progressing since 1 year now. I've had the weird grip feeling that long as well, but I still have full strength, from what I can tell. Can we rule out anything sinister after this amount of time? How can something progress so slow like this?

Who should I go to? Yet a different neurologist?

[Xina535]

NO NUMBNESS though. That is important. Weird tingling, crawling and TENS unit like feeling, but no numbness.

[Xina535]

Wasn't sure if I should post a new topic or go from here....

But my right thumb is either realllly fatigued or it is getting weaker because I can hardly hold a cup of tea with my thumb and index finger through that cup hole. I have to support it with my other fingers and left hand.

I tried using my hand squeeze gripper and I can do the same reps in each hand/arm as before, but like with other things (hair dryer), the palm thumb Thenar gets sore and like a hot feeling very fast. I tried the gripper using just my thumbs and index finger on both hands and I saw that my palm thumb Thenar on my right hand turned really red while the other hand just a little red (nowhere like my right side). Then, the right side felt really hot to touch and the left just warm. And of course my right side was sore throughout. Soon after, I felt those pulsating/crawling sensations in my right Thenar but not my left. Came shortly then went away.

Indication if anything like inflammation or something or is this expected in a wasting muscle?

[leroyb]

I have everything you say but switch hands. My thenar has been like this for nearly a year now. No loss of grip or other strength.

19 months in now. I think my case is going to be a PubMed article.

[Xina535]

Ok, a million questions.

no loss of grip, but do you have a weakened grip?

did you have a black/dark red spot show up then leave?

what kind of twitching do you have in the thenar or hand? Mine is a twitch or two here and there, every couple hours or so. But my upper arms/shoulders both twitch way more. More that I can feel than you can see (in upper arms/shoulders - I can see and feel the ones in my hand).

do you have sensory stuff too?


That scared me about thinking you will be in PubMed

[leroyb]

A tiny bit. We have a coal scuttle that we fill for the fire and I have carried it in for the last year by pinching a flat part at the top of it between index and thumb on left hand. Sometimes I don't make it all the way in now. That's all I can think of.

In October my thumb area became quite painful when gripping a golf club and the thumb joint felt loose and weak but this is gone now and my golf grip is fine ??

Red spots and blotches come and go all the time.

Yes, crawling and TENS sensation especially after exercising them heavily.

I don't really have much twitching at all anymore in my hand.

[Xina535]

Ok about the TENS unit feeling. Mine comes and goes over the middle of my palm thumb Thenar and the side of my index finger (inside, towards thumb). I get tingling on the tip of my thumb and in some other spots.

Tonight I put a TENS unit on it, and I had the pads on the same spots on my left and right hand and arm, both at level 15. My left arm/fingers were moving a lot more than my right. My left thumb, index and middle fingers were moving quite drastically while my right hand wasn't moving that much, mainly thumb and middle finger but not the index finger at all. I had to turn up my right hand TENS pad up to 20 to get the same result as my left.

This scares the he*l out of me!!! Can anyone please tell me something reassuring about this?!?!

I just read this about uneven twitching and I'm freaking out!
http://www.jdssportcoaching.com/default ... obus-faqs/

[Yuliasir]

XIna,
when you have different gripper force results on right and left hands, does it wonder you? Same for TENS, I think, more muscles - more stimulation to move, less bulky hand - less stimulation to move.

[Xina535]

Yes but I thought maybe I was just imagining things, but now the TENS confirmed that there are "less muscle fibers firing"...

Anything good about this? This is devervation right? could this result happen if a nerve were only pinched?

[Yuliasir]

I really dont know. For me it looks not like "less fiber firing" but like more stimulation is necessary to move dominant hand just mecause it has more muscle mass, therefore just physically it is harder to cause movement.
Ask physiotherapist specialist. Even if this is due to denervation, compression is still reason no.1

[Xina535]

You mean like the opposite?....like because I have more muscle in my right hand it requires more TENS power?
That makes sense but it's not bigger, it's smaller and I'm having problems holding things with my thumb and index finger. Doesn't help my anxiety that I'm having constant twitching in both upper arms/shoulders. I need a different neuro and thorough EMG, not like the ones I've had so far with just this one muscle here and that muscle there. Will call a private neuro tomorrow.

I read somewhere today that fasciculations can be described by patients like "ants crawling under the skin". I've described my hand sensations like that, and thought this meant "sensory" which should be absent in MND. I've always wondered if the sensations like vibrations and ant crawling could be tiny tiny fasciculations....now my hope is diminishing.

[German2]

Hi Xina,

I will answer one of your questions: Yes, if you have sulcus problems, then the thenar is also involved. I have an approved sulcus ulnar nerve syndrom left side and my left thumb is defenitively weaker than my right one. My thumb nuckles and thenars on both sides got thinner during the last 2,5 years (but completely symmetrical). My sulcus on the right side is questionable. This sulcus nerve is partly sensitive and partly motor nerve. It is both. When measuring NCV it can be differentiated. In my case sometimes the motor part is bad, sometimes the sensible part (I think this is due to different performers). But I definitively have more motoric problems, you seems to have more sensible issues. Hope that the medication helps you to cope with all those symptoms. This is definitely better than to freak out...