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Neurology (Expert Forum)
Early symptons of ALS?
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Early symptons of ALS?
by JK498, Feb 21, 2004 12:00AM
34 yr old Male. On about January 17 noticed muscle twitching all over body. Over next few days, left leg had sensations of tingling, mild numbness and sense that muscles especially the calf were quivering almost constantly. Left leg felt to be not operating normally when I would walk. Additionally, have felt intermittent tingling in left arm and at times a dull aching sensation. 1/21 my CK level was 850 and 1/23 was still in 800’s. 1/27 EMG/NCS of both arms. Results of EMG,“Mild bilateral carpal tunnel syndrome” and “No other EMG abnormality”. 1/29 CK level 367. 2/4 EMG/NCS of left leg. Summary results, “The nerve conduction studies of left lower extremity were normal. Needle exam showed two single fasciculations in left medial gastrocnemius with normal motor unit potentials. Needle exam of remaining muscles was normal. No fibrillation was detected in left lumbosacral paraspinal muscles, but relaxation was poor.” Clinical interpretation was,“EMG of left lower extremity was normal.” 2/10 CK was 237. On 2/12 I visited a neurologist for an office exam and to review test findings. He concluded that I do not have ALS.
Symtpons persist, muscle twitching, tingling/numbness in left arm and most notably sensations in left leg and feeling that it is going to give out(no clear weakness but wonder if problem in leg could be early signs of weakness).
1)Should I be concerned about ALS?
2)Were the EMG's done too early to detect ALS?
3)Could carpal tunnel been misdiagnosed and actually be early ALS signs?
4)Can benign fasics be clearly distinguished from non-benign as in EMG of leg?
Symtpons persist, muscle twitching, tingling/numbness in left arm and most notably sensations in left leg and feeling that it is going to give out(no clear weakness but wonder if problem in leg could be early signs of weakness).
1)Should I be concerned about ALS?
2)Were the EMG's done too early to detect ALS?
3)Could carpal tunnel been misdiagnosed and actually be early ALS signs?
4)Can benign fasics be clearly distinguished from non-benign as in EMG of leg?
Doctor's Answer
by CCF-Neuro-M.D.-CS, Feb 22, 2004 12:00AM
Prior to this starting did you participate in strenous excerise, or have a viral illness. If so, these could be causes for the fasciculations and elevated muscle enzymes. The EMG findings of carpel tunnel are different then ALS. Fasciculations in benign states and disease states look the same. If an EMG is done early in the disease, it may not show all of the features of ALS, but would be suggestive. The fact that your EMG only showed fasciculations in one muscle, and the remainder was normal goes against ALS. ALS onset at your age would be unusual. I would recommend investigating why your muscle enzymes were elevated, before continuing to investigate the ALS diagnosis. However, if you are still concerned about the diagnosis, then a consultation with a neuromuscular specialist is recommended. Good luck.
Member Comments (2)
by kwag, Feb 21, 2004 12:00AM
I have had the exact symptoms as you. I still do to some degree. It is worse at times and then better. zi have found that eating no sugar, no bread or potatos, no choclate, no pop to drink, drink lots of pure water, take whole food vitamins, take calcium/magnesium, take cod liver oil, and probiotics. Try to go to bed earlier and get good rest. No caffiene!!! Your body is telling you something. Please listen. My symptoms started at age 37. I do feel better now, thank God. I pray over any supplements that i take and the food i eat and before i sleep. I ask God to bless my efforts and I blieve He does., God bless