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Neurology (Expert Forum)
Fasciculatins and Migrating Symptoms
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Fasciculatins and Migrating Symptoms
by JakeSyd, Apr 01, 2005 12:00AM
I'm a 47 yr. old male. About 60 days ago I awoke with a muscle spasm in R.calf. A few days later I suffered a low back injury after a work out. I could hardly move for about two days the pain was so bad.
Due to my unusual amount of body aches and pains,on impulse, I picked up a medical book and looked up ALS. This was my introduction to the word "fasciculation" - which to my knowledge I had never experienced. Nonetheless, I began worrying that I might have ALS. Oddly, the next night I felt my skin jump in my LR calf - a fasciculation!! Over the next several days they became more frequent and widespread - practically everywhere, head to toe.
Of course, this confirmed my own self diagnoses of ALS. I saw a neurologist who gave me an EMG -results normal. I was relieved but not convinced. My fasciculations decreased greatly, but were still present. Then I started feeling random and migrating tingling and pins and needles. Next, I had mild numbness in my R leg/foot a couplet times, which went away quickly. Then I began feeling heaviness in my R arm which would wax and wane. By now, my fears were MS, since I had no noticable loss of strenth or mass - which I test daily.
My most recent symptoms are a continued feeling of heaviness in both arms and a sensation of loss of strenth with repeated movements. But my raw strenth, which I tested myself, does not change in the midst of these feelings. Now I'm leaning toward Myasthenia Gravis (MG.) I'm driving myself crazy! Can all these symptoms be mentally self inflicted, or do the fit a profile of ALS, MS or MG?
Due to my unusual amount of body aches and pains,on impulse, I picked up a medical book and looked up ALS. This was my introduction to the word "fasciculation" - which to my knowledge I had never experienced. Nonetheless, I began worrying that I might have ALS. Oddly, the next night I felt my skin jump in my LR calf - a fasciculation!! Over the next several days they became more frequent and widespread - practically everywhere, head to toe.
Of course, this confirmed my own self diagnoses of ALS. I saw a neurologist who gave me an EMG -results normal. I was relieved but not convinced. My fasciculations decreased greatly, but were still present. Then I started feeling random and migrating tingling and pins and needles. Next, I had mild numbness in my R leg/foot a couplet times, which went away quickly. Then I began feeling heaviness in my R arm which would wax and wane. By now, my fears were MS, since I had no noticable loss of strenth or mass - which I test daily.
My most recent symptoms are a continued feeling of heaviness in both arms and a sensation of loss of strenth with repeated movements. But my raw strenth, which I tested myself, does not change in the midst of these feelings. Now I'm leaning toward Myasthenia Gravis (MG.) I'm driving myself crazy! Can all these symptoms be mentally self inflicted, or do the fit a profile of ALS, MS or MG?
Doctor's Answer
by CCF-Neuro-M.D.-PW, Apr 04, 2005 12:00AM
I cannot give you a clinical diagnosis over the internet
but I would be wary of self-diagnosing yourself with ALS and worrying about it without heeding the opinions of your doctors first
Fasciculations, muscle twitches, myoclonic jerks etc are all very common and normal in the general population. It is unclear from your description if you even have fasciculations and not little myoclonic jerks.
Fasciculation in the absence of musle wasting and objective muscle weakness is not suggestive of ALS. In fact, benign fasciculations are more commonly widespread. The normal EMG should help reassure you.
None of your symptoms at this time fit any criteria for MS or MG either.
What will probably benefit you most is regular visits to your neurologist or family doctor for reassurance and followup
Good luck
but I would be wary of self-diagnosing yourself with ALS and worrying about it without heeding the opinions of your doctors first
Fasciculations, muscle twitches, myoclonic jerks etc are all very common and normal in the general population. It is unclear from your description if you even have fasciculations and not little myoclonic jerks.
Fasciculation in the absence of musle wasting and objective muscle weakness is not suggestive of ALS. In fact, benign fasciculations are more commonly widespread. The normal EMG should help reassure you.
None of your symptoms at this time fit any criteria for MS or MG either.
What will probably benefit you most is regular visits to your neurologist or family doctor for reassurance and followup
Good luck
After that I started feeling pins and needles sensations as well as tingly and sometimes painful shocking sensations in the extremities. I have also suffered from burning joint pain, mainly in the knees. The pins and needles, shocking sensations, and buring joint pain have gone away entirely over the past month. The paresthesias have calmed down quite a bit and I only seem to notice them in bed.
All my other symptoms still remain and are causing me great concern. I have read about organic chemicals causing PD, ALS, MS, and all types of neuropathy. I have no weakness in my muscles but I now feel tired all the time. This may be due to the fact that it is hard for me to fall asleep now.
I have seen a doctor who thinks it is just some type of anxiety disorder. (anxiety does worsen my symptoms) He prescribed me Klonopin which relieved some of my anxiety but didn't help my symptoms at all. I quit taking it about two mos ago because I thought it might mask my tremor symptoms. I am now waiting for a Neurologist referral which is taking forever, as I only have health insurance though the VA.
I told my PCP that they better give me an EMG and an MRI but she can't do much about the beurocracy there. The only neurology exam I have had was with her and it was not very impressive. She didn't even check for Babinski's sign. I hope I just have BFS, toxic neuropathy, or something else I might be able to just accept and live with.
Lately I have been reading about "migrating fasics" being indicative of malignant MND's. My fasciculations have been of this type from the beginning.
I have also read that although rare, sometimes fasciculations can happen for six mos or more before muscle weakness sets in for ALS.
I am scared and confused because my symptoms seem to cross the spectrum of many MND's (some symptoms of many of the diseases). Sometimes I even think PD when my fingers twitch at rest. This only happens occassionaly, but it does happen.
My gait seems fine, although I can't seem to balance on one leg as good as I used to. My arm muscles spasm when I lean against something, and my legs muscles spasm when I extend them or press them against someting rigid (isometric tremor?).
Sometimes when I hold a pen inbetween two fingers (like a smoker holds a cigarette) my fingers jerk all over the place. When my hands are on the keyboard of the computer they all tremor like crazy when I lift them up separately.
Any help and/or guidance would be appreciated as I am scared to death.