twitching and numbness due to als?

[scaredwifeandmom]

Hello,
I am a 34 year old female, mother of two that is scared to death.  About 4 months ago I began experiencing numbness and tingling in fingers on right hand that lasted about 2 minutes.  The next week I experienced the same feeling in the left hand.  A week or two later I had a tingling/tickling sensation that occured for a week or so on the left side of my chest.  A week afterwards I had the same tingling and numbness in both feet.  A fews weeks after that I began noticing twitching in all areas of my body!  I went to google and als and ms came up.  This has been going on for 4 months now.  I have had no headaches or vision problems.  I have noticed a definite bout with fatigue here and there but has not been with me for a couple of months.  I went to GP and he did blood work.  Everything was normal.  My relexes are normal and muscle strength seemed normal.  I now have weird vibration sensations that come on my legs all the time.  He said he did not think this was consistant with ALS.  I have had a little muscle weekness but it is not consistant either.  I can do the basic things move my feet up and down, move my toes, look up down and side to side, touch my nose with eyes closed, walk on my toes, stand for a bit on one foot, I pick up toys all day and do not drop them, etc - Anyway, I am scared to death.  I should mention that my grandfather passed away of als.  He was 74.  I am scheduled to see a Neuro in 2 weeks to further evaluate.  Your help would be greatly appreciated.  Thanks!  oh and 2 questions- :) - is numbness and tingling an early sign of als or is it a late sign due to muscles being still.  also, I am confused about the muscle spasms, people with als seem to have noticed them as their first sign although reports say they come later on after noticible muscle weekness...  -would als twitching appear in just one muscle or all over- I will have a twitch in my shoulder, then in my knee, my foot, my finger - -sorry - guess this was 3 questions!  

[scaredwifeandmom]

I do not have progressive weakness, muscle wasting though.. It is something that I generally notice when I am fatigued.  Again, would twitching be localized in a specific limb or area or would they be all over my body?  Also how common is twitching for the first symptom and do vibrations, tingling, and numbness occur in als?  Thanks so much,.

[Dr. A. Srivastava]

Hi, Thank you for your question. Amyotrophic Lateral Sclerosis (ALS) is a motor neuron disease. Your symptoms of progressive weakness, muscle wasting, and muscle fasciculations, spasticity could be related with this motor neuron disease but without being to examine you it will be quite difficult to say anything precisely. In this disease, motor neurons are affected mainly that may affect all voluntary motions. Investigations such as blood tests, EMG/MRI, genetic reasons are extremely important in order to know its progression. Usually, there is no permanent cure but effective rehabilitation program would surely help in providing relief in your symptoms. Hope this helps.