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Neurology (Expert Forum)
Tremor, Fasciculations, and Tingling
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Tremor, Fasciculations, and Tingling
by Dasobel, Jun 27, 2006 12:00AM
Two months ago, during a stressful period, I began having transient pain in my hands, arms, and jaw.After a few days, I noticed fasciculations in feet and calves, myoclonic jerks, and misc. twitches--all in the span of maybe 5 days. I went online, read about "twitches and ALS", and convinced myself I had ALS. I was terrified, and experienced an extreme traumatic reaction--strong anxiety, shaking all over, greatly exaggerated startle, etc.Twice,I felt burning paraethesia's for about 30 seconds (arm).I completely freaked myself out.I guess what they used to call a "nervous breakdown."
Visits to two neuros and two clean EMGs convinced me I didn't have ALS,I calmed down, and my symptoms began to subside over a period of a week or two--with a few exceptions.
1)Tremor--I have had a fine postural and action tremor (simple, not intentional) ever since, mainly in hands and arms, but also head buzzes upon waking, and when I lift weights I can feel head and leg tremors during certain motions.
2)Fasciculations-- never fully went away, though much less. In feet/calves mostly, two twitchy hot spots on lips.
3) Tingling-- Mostly in feet, but also hands, arm.
4) Mildly exagerated startle-- nothing like it was, but not normal.
Nothing else. No visuals, weakness, fatigue, gait, coordination, etc.
I have thought maybe I have PTSD due to my traumatic episode, or maybe the onset of essential tremor--my tremor does fit ET well, and I've read BFS and tingling can be comorbid with ET.
But what about MS? Onset was sudden. Does MS usually present w/ tremor/fasc., w/some tingles?
Visits to two neuros and two clean EMGs convinced me I didn't have ALS,I calmed down, and my symptoms began to subside over a period of a week or two--with a few exceptions.
1)Tremor--I have had a fine postural and action tremor (simple, not intentional) ever since, mainly in hands and arms, but also head buzzes upon waking, and when I lift weights I can feel head and leg tremors during certain motions.
2)Fasciculations-- never fully went away, though much less. In feet/calves mostly, two twitchy hot spots on lips.
3) Tingling-- Mostly in feet, but also hands, arm.
4) Mildly exagerated startle-- nothing like it was, but not normal.
Nothing else. No visuals, weakness, fatigue, gait, coordination, etc.
I have thought maybe I have PTSD due to my traumatic episode, or maybe the onset of essential tremor--my tremor does fit ET well, and I've read BFS and tingling can be comorbid with ET.
But what about MS? Onset was sudden. Does MS usually present w/ tremor/fasc., w/some tingles?
Doctor's Answer
by CCF-Neuro-M.D.-PW, Jun 28, 2006 12:00AM
I cannot give you a formal clinical opinoin over the internet as this site is purely educational.
In general, MS presents with discrete episodes of neurologicval dysfunction - most commonly loss of vision in one eye, weakness or clumsiness of a limb on one side of the body, double vision, or spasticity in the legs with inability to walk. This does not sound like your symptoms you describe in your post. In MS these symtppms last for a few weeks then subside but may recur later at or another location in the nervous system. There is almost always signs on the MRI scan.
Tremor is relatively common in MS, but in the advanced stages, and is more coarse rather than the fine tremor of essential or physiological tremor, and is called a 'rubral tremor'.
Discuss your anxieties over your symptoms with your doctor - he willbe able to either reassure you or investiage where appropriate
Good luck
In general, MS presents with discrete episodes of neurologicval dysfunction - most commonly loss of vision in one eye, weakness or clumsiness of a limb on one side of the body, double vision, or spasticity in the legs with inability to walk. This does not sound like your symptoms you describe in your post. In MS these symtppms last for a few weeks then subside but may recur later at or another location in the nervous system. There is almost always signs on the MRI scan.
Tremor is relatively common in MS, but in the advanced stages, and is more coarse rather than the fine tremor of essential or physiological tremor, and is called a 'rubral tremor'.
Discuss your anxieties over your symptoms with your doctor - he willbe able to either reassure you or investiage where appropriate
Good luck
I am not a doctor-- but based on my own consultations with neuros, and on heavens knows how much I've read about it, you DO NOT have ALS. Believe your doctor. The muscle jerks you describe are called myoclonics, and they have NO place in ALS presentation. Other twitches, like more "regular" and fine ones you may see in your calves and feet especially (or your eye twitch), are fasciculations, and in the absence of other serious symptoms (like clinical weakness or muscle atrophy) are benign. There is an entire syndrome known as Benign Fasciculation Syndrome (BFS) presenting with exactly your symptoms, and strongly linked to stress, and FAR more common than ALS
ALS fasciculations occur in a withered, atrophied muscle group, and at the END STAGE; and don't occur all over your body or in unaffected muscle groups. An example would be someone where ALS began in one hand (it begins unilaterally, usually just in one limb on one side)-- after a long period of weakness and dwindling ability to use the hand for basic activities, the diminished, visibly diminished muscles would twitch (in one spot) continuously until they "died out."
On top of all that, your clean EMG should reassure you even more.
I know it's scary, but you've got to trust your doc and stop surfing ALS sites; you ain't got it. Hang in there, you'll be ok!
Also, if you wish to address something to the forum admin, use the CONTACT button at the top of the page. They don't routinely look in the forums at the questions/comments themselves.
suffered through these symptoms and continuous doctor appts to all kinds of specialist that had me take various blood tests and
MRIS ultrasounds, endoscopy etc etc etc. need i go on. i became so discusted that i knew i had to be my own physician and through prayer and research on my own believed that i had candida in the lining of my gut and was causing all these weird symptoms. i realized this after taking a questionaire test i found on the candida free website. as there is not actual diagnostic test for candida, as we all have normal candida in our stomach, but an overgrowth can cause serious problems.
I was initially diagnosed by my GI doctor with irritable bowel syndrome which is ridiculous as irritable bowel is lower bowel