Beginning of ALS

[vinnie341]

I've been experiencing some strange sensations lately that have me concerned.  Sensations are sporadic, not constant and mostly in my lower left leg, but occasionally in my other leg and both forearms.  I get a tingle that lasts for a couple of seconds maybe every now and then throughout the day.  Again, it has been mostly in the lower portion of one leg, but once in a while elsewhere.  I've even felt it in my cheek muscle in my face once or twice.  I haven't noticed any weakness or any daily activities hindered aside from worrying about it constantly and my calf muscles being tender to the touch from time to time.  Also, I've noticed an occasional warm, but not burning, sensation going from the top of the outside of my thigh going down the leg from time to time.  Could this be the beginning of ALS or is this some sort of neuropathy? Or could it be something else? Any information would be greatly appreciated.

[Abhijeet Deshmukh, MD]

Hello.

These symptoms are not suggestive of ALS. In ALS, you get muscle weakness and twitches.

Most probably, you have peripheral neuropathy. Generally diabetes, anemia, vitamin deficiency are the common causes. We need to rule them out. Have you consulted a neurologist?

Regards

[vinnie341]

Thank you for the response.  I have an appointment with the neurologist later this week.  I do have twitches in my muscles from time to time, but nothing that I had ever given a second thought to.  They aren't specific to one particular area of my body.  I've been for general bloodwork from my primary physician and the only thing mentionable there was very slightly elevated liver enzymes.  As far as weakness, like i said, i haven't noticed any decreased ability in movement or anything, but since I've been worrying about it, I notice that my legs seem  to cramp more after physical activity or being on my feet all day.  I'm hoping this is just a paranoid reaction and not a sign of weakness.

[vinnie341]

I posted a new question today and was advised I should keep the followup with this thread so here it is again.  Sorry for the repetition, new to this process.

Lately I have been experiencing localized twitches, which I'm assuming are fasciculations in my body.  They are mostly in my legs, specifically one, but sometimes the other and sometimes throughout the rest of my body.  The leg that seems to get the majority of them is also sore from time to time and I even feel a warm sensation going down it at times.  I haven't noticed any weakness or problems with stumbling or anything yet.  Should I be concerned with ALS as a possibility? Would the fasciculations show up before weakness or atrophy?  And would they be spread throughout the body while seeming to be more consistent in the one particualr limb?

[Abhijeet Deshmukh, MD]

Hello.

While the presence of muscle fasciculation is necessary for a consideration of ALS, it is not sufficient for diagnosis. By the time a person has fasciculation, some weakness does become apparent on clinical examination, may not be observed otherwise. Fasciculation can be more in one part than the others.

Once again, ALS is a motor neuron disease. Sensory symptoms are rare to occur. You may ask your doctors to assess you for ALS and rule it out. Please keep in mind the "benign fasciculation syndrome". While I don't say you do not have ALS, I feel your symptoms are not suggestive lf ALS.

Regards

[vinnie341]

Once again, thank you for your time and the information.  I have the neuro apptmt. later today so I'll keep my fingers crossed and see what he has to say.