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Neurology (Expert Forum)
Leg twitching at night / pain during day
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Leg twitching at night / pain during day
by SouthernKB, Jan 04, 2007 12:00AM
I am a healthy male age 36. All of the following began suddenly. I began having strange leg pains at night approx. 2 months ago. After 2 nights of cramp type pains and tightness in right leg, I began to have twitches and vibration type sensations in my right calf for the next week. I went to a spine specialist on the advice of my family doctor. He did a complete MRI of head, neck, back, and lumbar area. The only abnormal finding was a moderately herniated disk at L5-S1 with nerve involvment. I have a history of lower back spasms with pain about twice a year. He diagnosed me with sciatica and sent me for physical therapy. The twitching has now spread to my other calf and I have soreness in my left foot and calf during the day along with the right calf. My legs become very tight during the day if I do much walking such as Christmas shopping. The twitching sensations wake me up around 4:00 AM every morning. Some days it feels like I have bugs in my left leg trying to escape. If I move my legs alot or get up and walk around things calm down a good bit. I have very little twitching during the day, maybe 10 times and occasionaly(4 times a week) my legs will jerk at the same time for no reason. I have also recently experienced some pain in my buttocks and my lower back with a 24 hour episode of twitching in my buttocks. I do not have any true weakness in legs. 1. Could this all be related to the diagnosis of sciatica and a herniated disk? 2. Will EMG verify sciatica? 3. Can a herniated disk lead to RLS? 4. Should I be concerned about ALS or MS? Thank You!
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jan 26, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
The symptoms that you describe could all be possibly related to your L5-S1 disc herniation. When a disc herniates out the vertebral column it can compress nerve roots as they exit the spinal column. The region of the body that you feel the pain is the area of the body that the compress nerve serves (called a dermatome) The dermatome that corresponds to a disc problem at L5-S1 is in the Calve region. In addition to pain from the compressed nerve (dermatome) you can also get pain in the local area of the compression (low back pain) and along the length of the nerve (from the buttocks, down the leg to the ankle). The diagnosis of sciatica is anything that may be disturbing the nerve, on of which causes is a hernitated disc with nerve root compression (also called a radiculopathy). I would suggest an EMG to evaluate what is going on. It is unclear to me why you would have associated twitching with a radiculopathy, or maybe the twitching is incidental? (the EMG will help sort this out). Restless legs syndrome (RLS) is not caused by herniated discs. This is thought to be relates to dopamine (a neurotransmitter) in some way (not completely understood). The symptoms that you describe may be related to RLS (the bugs in the legs part that gets better with walking around). You should have iron tests done since iron deficiency can mimic RLS. The treatments of RLS include Requip, neurontin, and narcotics (used rarely). Given the symptoms that you have described thus far, I would not be concerned about ALS or MS, but I would recommend that you get the EMG to further characterize what is going on.
I hope this has been helpful.
The symptoms that you describe could all be possibly related to your L5-S1 disc herniation. When a disc herniates out the vertebral column it can compress nerve roots as they exit the spinal column. The region of the body that you feel the pain is the area of the body that the compress nerve serves (called a dermatome) The dermatome that corresponds to a disc problem at L5-S1 is in the Calve region. In addition to pain from the compressed nerve (dermatome) you can also get pain in the local area of the compression (low back pain) and along the length of the nerve (from the buttocks, down the leg to the ankle). The diagnosis of sciatica is anything that may be disturbing the nerve, on of which causes is a hernitated disc with nerve root compression (also called a radiculopathy). I would suggest an EMG to evaluate what is going on. It is unclear to me why you would have associated twitching with a radiculopathy, or maybe the twitching is incidental? (the EMG will help sort this out). Restless legs syndrome (RLS) is not caused by herniated discs. This is thought to be relates to dopamine (a neurotransmitter) in some way (not completely understood). The symptoms that you describe may be related to RLS (the bugs in the legs part that gets better with walking around). You should have iron tests done since iron deficiency can mimic RLS. The treatments of RLS include Requip, neurontin, and narcotics (used rarely). Given the symptoms that you have described thus far, I would not be concerned about ALS or MS, but I would recommend that you get the EMG to further characterize what is going on.
I hope this has been helpful.
I to have twitching all over my body and jerking motions. I was a marathon runner when all this started two years ago. Long story short for me I was diagnosed with lyme disease. I spent a lot of time outside hicking and running off road. The fact that you have had an MRI is very good especially with clear results. At any rate if you would like to email me then feel free to do so. I spent two years thinking I had MS and wished I had known about lyme disease sooner.
Good luck and let me know if you have any questions.
***@****
Lesley
I have read that with ALS the weakness comes one limb at a time and then spreads, so that eases my worry a bit. Hopefully yours too.
I just registered today and am amazed by the the people who share these symptoms. It's horrible, but good to know I'm not crazy. We can't all have ALS so perhaps we should be asking more questions of our doctors. Not sure. Hey, if this is all caused my sciatica, I'll be happy. I hope you get some answers.