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Neurology (Expert Forum)
muscle twitches,percieved weakness als?
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muscle twitches,percieved weakness als?
by jmomtotc, Mar 21, 2006 12:00AM
hello, I am a 30 yr old female. For about 5 weeks I have been having strange symptoms. Started with right hand having trouble picking up pens and things. Then hand and arm started to feel weak and clumsy. Afer that I started to get twitches in almost every part of my body mostly in my legs but also feet, hands,arms,back, stomach,ribs, face. My leg muscles and arm muscles have started to get crampy like feelings that only last for a few minutes. A few weeks ago my legs felt so heavy I was having trouble moving them but that seems to have gotten better but they still feel weak. The last few nights I have been waking up with a stiff jaw and lips feel loose and hard to control. A little better in morning but still feels strange. I have had some bloodwork done that included thyroid and b12 among other things but all came back normal. Have appointment with neurologist in 2 weeks. Also had neck xray that showed neck muscles are spasming (spine in neck showed straight not curved) My questions are 1. Could als happen this fast? 2. If not Als then what else could this be? 3. Although I have called for earlier neuro appt and told not possible should I insist? 4. Could neck injury cause these symptoms? I should also mention I have felt like I can't breathe a few times(anxiety?) and I also get pains in my fingers lasting a few seconds. I think when doc checked reflexes were normal. One more question 5. What kinds of questions should I ask neurologist. I am a young mother of two and terrified I have this disease. Your comments would be appreciated. THanks
Doctor's Answer
by CCF-Neuro-M.D.-PW, Mar 27, 2006 12:00AM
1) ALS is a rare disease, and even rarer in a 30 year old female, ALS most commonly affects middle age men. The chances are that this is something other than ALS. This would also be quite rapid for ALS.
2) Muscle tiwtches in the absence of objective muscle weakness and wasting are not suggestive of ALS. Twitches that are more widespread when they appear are also not suggestive of ALS. There are other more common causes of muscle twitches of fasciculations such as an overactive thyroid gland, a normal reaction to cold or exercise, certain medication, a pinched nerve, or some spinal cord problems. There is also a benign syndrome of fasciculations with or without cramps.
3) If you are seeing the neurologist within 1-2 weeks that shoud be fine. In some places people have to wait months for a neurologist (outside the US)
4) As above pinched nerves in the neck could cause some twitches in the limbs, and also weakness or clumsines in a limb or heavy 'spastic legs'. You should have this evaluated most probably with an MRI or somatosensory evoked potentials.
5) Just tell the neurologist all your symptoms, and history - he shoudl be able to narrow down the possibilities to a few that he can then order tests for such as MRI. This is not a formal medical opinion, but the chances of you having ALS are extremely slim and I would try to adjust your anxiety accordingly
Good luck
2) Muscle tiwtches in the absence of objective muscle weakness and wasting are not suggestive of ALS. Twitches that are more widespread when they appear are also not suggestive of ALS. There are other more common causes of muscle twitches of fasciculations such as an overactive thyroid gland, a normal reaction to cold or exercise, certain medication, a pinched nerve, or some spinal cord problems. There is also a benign syndrome of fasciculations with or without cramps.
3) If you are seeing the neurologist within 1-2 weeks that shoud be fine. In some places people have to wait months for a neurologist (outside the US)
4) As above pinched nerves in the neck could cause some twitches in the limbs, and also weakness or clumsines in a limb or heavy 'spastic legs'. You should have this evaluated most probably with an MRI or somatosensory evoked potentials.
5) Just tell the neurologist all your symptoms, and history - he shoudl be able to narrow down the possibilities to a few that he can then order tests for such as MRI. This is not a formal medical opinion, but the chances of you having ALS are extremely slim and I would try to adjust your anxiety accordingly
Good luck
Do you notice any speech problems? I feel like I have to make an extra effort to make things sound right but I seem to be the only one to notice a difference. The arm, hand and leg weakness is also starting to affect the things I can do with my kids. It is very frustrating. I am also getting quite a lot of cramping in my calves. Good luck also to you and let me know what happens at your appointment.
Just curious. There's an overwhelming "flavor" in all your posts suggesting that this person or that person needs to look into Lyme disease.