Hi, I'm a previously healthy 19 year old of Indian descent, recently I have been going through a period of health anxiety with wide and varied symptoms. I have had CT and MRI scans done of my head, both came back clear. My bloodwork and blood pressure are normal and I am sedentary and slightly obese but have normal blood pressure. An EMG performed of my left and right hands and arms came back clear except for mild polyphasia in the left first dorsal interosseous.
However, the right side of my tongue feels "thick" and I'm having trouble pronouncing "th" sounds but no trouble with velar and lingual sounds. I am not having slurred speech or swallowing difficulty (yet?) I'm also having what appear to be tongue fasciculations. My tongue was not EMG'd so I'm beginning to get worried. I've had fasciculations all my life, but recently they seem to be more frequent in varied places in my body, and I've only noticed the tongue fasciculations now.
Could this be the start of bulbar ALS? No one in my family has ever had ALS. I understand that ALS is rare in teenagers and bulbar is even rarer but I don't know how to explain these symptoms. Should I ask my neurologist to EMG my tongue? If so, when? If this actually is the start of bulbar ALS, when should I expect swallowing difficulty and noticeably slurred speech to appear?
In all probability the symptoms are due to vitamin B 12 or vitamin D deficiency. Another possibility is low testosterone. 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 (fasciculations) 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. Do discuss this with your doctor and get yourself examined. Take care!
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