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Could this be ALS?

I have had strange symptoms for the last 6 months or so and I've been to my GP many times and he has referred me to a Neurologist -- with no formal diagnosis of anything.

I have had muscle twitching on and off in my left tricep area.  It is intermittent and will sometimes show up in different locations.  My Neurologist calls them "benign", but they scare me.  They are pulse-like and they are not visible.  Also -- my left foot has this weird "buzzing/vibrating" sensation.  I think it might be rapid fasciculations????

My main symptom, however, is a Carpel Tunnel like feeling in my right arm.  I have had an EMG which was normal -- so -- it is obviously NOT Carpel Tunnel.  My arm is painful (forearm, upper arm) and my hand tingles and goes numb.  Most bothersome/worrisome, however, is the pain that I feel in most of my hand.  This pain seems to move all over the place in my hand.  I feel pain in my thumb area (the muscle between the thumb and index finger) and then I feel pain in my pinky area and my palm.  The hand does not seem weak, but, the pain does interfere in some "range of motion" activities.

I also have "migratory" muscle pain throughout my body.  My right hand will hurt then my left hand will hurt (usually on the outside pinky area).  My calves ache and then my ankles will hurt.

Does ALS cause migratory pain like this?  Can the pain in my right arm be from ALS?

The EMG I had was ONLY done in my right arm and hand -- and it came back normal.  Can a normal reading in ONE limb only rule out ALS?

My Dr. and Neuro say it is NOT ALS but I am still worried
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Avatar universal
This is my first time posting, so I am not sure if I am following the forum etiquette, by asking a question myself - of the others (have not been able to get through to actually ask a question of the doctors).

I have been experiencing a range of symptoms over the past 8-10 months, including:
-numbness, tingling and weakness in hands immediately following birth of my son (subsequently diagnosed with carpal tunnel)
-in December/January, tingling, burning sensations in legs, feet lasting for several days and with odd brief sensations of numbness in different locations
- intermittent periods (lasting several days at a time once a month or so) of unexplained profound fatigue accompanied by muscle fatigue/soreness in my legs and sometimes also in my arms
-most recently, my legs and sometimes my arms have begun to buzz or vibrate - which I gather is known as fasciculation.  (They are not visible to the eye and cannot be felt by my husband when he places his hand on the spots).  This buzzing or vibration is like a racing, adrenaline like sensation and seems to be constant when I am at rest (most noticeable in the evening and morning, but I am noticing it at other times).


I have had a nerve conduction test which diagnosed carpal tunnel in both hands - moderate to severe in the right. I am hoping that carpal tunnel explains the fact that I am clumsy with my hands and am often dropping objects.  

I have had the standard blood work and a head CT scan and saw a neurologist several months ago who did an in-office exam.  At that time I had not been experiencing fasciculations so I was not worried about ALS (I was tending to think about MS instead)

However, now with the onset of the twitching I am terrified about ALS and have been unable to speak with either my GP or neurologist (both away on vacation) to talk about scheduling an EMG.

1. From what you have learned, is this widespread buzzing or vibration a common phenomenon (associated with non ALS conditions)?

2. Everything I have read seems to suggest that twitching in the absence of weakness does not point towards ALS.  IS this weakness as defined by some objective standard (EMG or doctor's office), or would it also be weakness that we could actually feel ourselves?

3. DOes ALS related fatigue and muscle soreness come and go (couple of days a month) - can you return to normal energy levels for the rest of the time and still be suffering from ALS?

Thanks for any advice.........as the mother of a one year old and a three year old I have been panicking....
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Avatar universal
Thank you for the response.

I did, in fact, have an EMG and a NCV.  They both came back completely normal.

Assuming, then, that the EMG/NCV were normal and I don't have CTS or ALS -- then -- what could be causing my hand/wrist/finger pain?  My forearm also aches.

Interestingly enough, both hands hurt. Mostly on the outside pinky area.  But .. I also have an aching pain within each thumb.

This is very scarey and worrisome. However, your reassurance that pain is not a symptom of ALS is comforting.

Thanks again.
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Avatar universal
Pain is not a prominent early or late symptom of ALS, and does not suggest ALS

Fasciculations in the absence of objective muscle weakness or wasting is not likely to be ALS. More commonly fasciculations are benign and provoked by exercise, cold, certain medication, pinched nerves and some viral disorders. A buzzing sensation is unlikely to be fasciculations.

Carpal tunnel is not diagnosed by EMG but by nerve conduction studies. If normal and it is a good and thorough study, the problem may be muskuloskeletal or muscular. I cannot be more specific in your case unfortunately with the information you provide.

The El Escorial criteria for the diagnosis of ALS require evidence of ALS in more than one limb (three for definite ALS). This evidence is based on clinical or EMG grounds, so even if one limb was done on EMG (the most symptomatic one?), lack of other clinical evidence would not suggest ALS. An EMG in other limbs would not be indicated unless you developed symptoms in them such as muscle wasting or muscle weakness.

Good luck
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