ALS Fear

I am a 52 year old woman who has had widespread muscle twitching and internal tremors for over 15 months now.  I have run the gamut of neurologists, MRI, EMG back in April and all clean and no bad reports.  For over two years, I have had pain in my left palm off and on and a few days ago, I noticed the it is noticelably smaller than my right hand with a dent in the palm.  Naturally, I panicked and went to my neuro who looked at it and said not to worry that there is no pain with ALS.  Said it could be arthritis or something else.  I am a nervous wreck and wondering what your opinion is.  I will add that when this pain in my left palm started, a different neuro did an emg on it and said no carpel syndrome.

[Dr. Kokil Mathur]

Hi!
If neurologists are unable to find any neurological problems, then dehydration and electrolyte imbalance, muscle fatigue, anxiety and panic attacks, pinched nerve due to wrong posture could be the cause of twitches/tremor/spasm in your case. Try and use the correct posture while sitting and walking and consult a physical therapist regarding some stretch exercises which you can perform to help relieve tension.
If this does not help, then I would suggest you get the blood levels of the following checked if they have not already been checked: potassium, calcium, sodium, magnesium, vitamin B complex, or vitamins B1, B3, or B6 and Vitamin D. Generally deficiencies of any of the above can cause muscle twitching and spasms in localized or generalized areas of the body. Get your kidney function, parathyroid gland function and adrenal function tests done because these affect the electrolyte balance in the body. Stress, alcohol, caffeine and fatigue all cause similar symptoms. Hence if you take alcohol or coffee then cut this down. Sleep at regular hours and see if it helps. Certain sleep disorders and peripheral nerve disorders due to diabetes, Lyme's, lupus or hypothyroidism can also be the cause. Please discuss this with your family doctor and try and rule out these causes one by one. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.