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Fasciculation, fatigue and other symptoms: ALS?

I am a highschool senior (just turned 18) currently being bombarded with standardized tests. About a month ago I've started getting dizzy (which would subside after eating a snack) and developed a faint ringing sound (sort of like wind rushing through) in my ears. I could also feel numbing in the back of my head (doesn't hurt though), which was accompanied by fatigue. At first I thought it was just stress, but when the symptoms continued for more than a week I decided to go to the doctor's. They gave me a routine checkup, including measuring my blood pressure, looking into my ears, etc. But no blood test because the doctor thought it was unneccessary and concluded that I was dehydrated. Afterwards, I had a good day's rest and the dizziness disappeared. But the other symptoms didn't go away and I started developing a weird tingly feeling on my scalp and occasionally "jumping" sensations in the back of my head. I also noticed frequent fasciculation in my legs and arms. When I walk or excercise, my legs feel weak/stiff and tire out very easily. Could these be signs of ALS? I'd looked up my symptoms online and was (and still am) completely terrified of the answers they provide (such as brain tumor and ALS). My stress levels are at an all-time high right now and I have poor concentration because of worry I might have ALS or some other form of fatal illness. I have occassional trouble swallowing/breathing and I can't tell if they're caused by anxiety or ALS. I have not noticed any weight changes. I'm getting really scared right now so any help would be greatly appreciated!!
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Avatar universal
Hi all,
Just wanted to update my situation, because I think it might be helpful to some of you with similar concerns to mine.  I have had about 4 months of twitching and strange sensations in my arms and legs. Along with this came the most awful terror I have known in my 39 years.  Everything I read directed me either to some awful disease or plain old anxiety.  Since the onset did not occur with any stress I was aware of, I of course went down the mental street named "Awful Disease". I have had blood work done. Normal. I have gone through the excruciating process of waiting for referrals to specialists and then hoping they have an opening, etc---all the while living my days in terror.  I have heard alot of people in this forum talking about how they feel anxiety AFTER the symptoms, not before, so how could they be caused by anxiety?  Well I have had an experience that has me convinced that the brain is processing and attempting to handle things we are not even aware of!!!  Last week the man I was in a relationship with for many years and from whom I have been apart from for the past year due to his alcoholism went to the emergency room convinced he was dying of some awful disease. I have had VERY little contact with him for more than a year. I have been living my life, raising my daugher, moving on from this very good but very sick man.  He was finally convinced by the Dr.s that what he has is alcoholism--something I  of course told him many times. That night my twitching stopped for the first time in 4 months.  I was totally floored. I had no conscious awareness of carrying around anxiety about this man's situation, and I am a pretty self aware person. So...there it is. Coincidence? Perhaps, but I doubt it. The mind is very cunning and I am convinced now that it is working on my body in ways I am not even aware of.  I hope this gives hope and some clues of places to look for answers within your own lives.  By the way...I don't have any confidence that this man will necessarily stop drinking, but now I have the awareness of my own anxiety about it and can address it for myself. Thanks for listening.
Ivymom
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Avatar universal
You might want to read on benign fasciculation syndrome (BFS) regarding all the twitching.  Regarding getting out of breath with walking a short distance, have you been tested for anemia?  Since you are seeing a neurologist soon I would tell him/her about the SOB with walking short distances as well as the water-like feeling in your ears that just started.
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Avatar universal
I forgot to add that since yesterday am, my right ear feels on and off like water is in it.
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Avatar universal
Hello. Im a 29yr old female and terrified I have MS or ALS. I've been having fasciulations on my legs, back, buttocks, and arms, mostly legs and now my muscles feel tired but Im still able to pick up stuff. Also I have shortness of breathe. I feel hot a lot. Been hot then feeling like chills the last few days, but do not feel sick. Twitches been going on for about a month. I do have anxiety and depression. I just started taking effexor, imipramine and three weeks ago, but had the twitches before taking the medication. HAve hot flashes and insomnia(for about a year).

The twitches and the weak feeling in my leg(calves and front thighs) are worrying me. Sometimes I have shortness of breathe when only walking a few steps and Im out of breathe. Im very worried. I have went to the ER and had some testing done(thyroid, diabetes, and one other) and all were fine. I made an appt with the neurologist next week. I feel doomed.

What do you guys think?
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Avatar universal
It is good to read so many entries from folks experiencing what I am.  I am 39, and have always taken my good health for granted. For the last 3 months I have been experiencing fasciculations all over my body, and I feel as if I have put myself under a microscope and am constantly looking for signs of impending doom.  I have never thought of myself as a particularly anxious person, so this is upsetting. ALS is about the scariest thing I can imagine, so I try not to even go there, but it seems the more I try not to go there, the quicker I find myself there. I live in a county that has only one neurologist so the wait to see him is more than 7 months.  That feels impossibly long.  So...I have taken to carrying prayer beads with me (which is SO not like me, but seems to help). Any suggestions for other ways of finding peace in the midst of uncertainty would be greatly appreciated. Many thanks.
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Avatar universal
Thank you Nervous Guy!  You are very wise!!  I have really appreciated your words today.  I am a 36 year old female who has been experiencing muscle twitching in my right bicep for over a month.  It is intermitent but really disconcerting especially since the twitching is just in one muscle and not all over.  I too have been worried about ALS but I tend to worry about health concerns unnecessarily.  Many years ago I was convinced I had MS b/c I felt tingling in my feet and hands.  I think I made something benign worse b/c I wouldn't let go of it.  It really took me not focusing on it and getting on with my life for the symptoms to stop.  Last year I experienced a bout of extreme fatigue and again was concerned I had a major neurological disorder.  Again, it took a change of focus, getting confirmation from doctors, giving it over to God and focusing on being healthy for it to stop.  Now that my arm is twitching, I am going down the same path.  Reading to much on the internet (very bad!), imagining all the worst scenarios and I think the anxiety is taking over again.  I am going to see my neuro so I can get answers and try to get on with life but I think stress and anxiety is a powerful thing.  I have experienced how it can manifest itself in very physical ailments.  God bless you for your words.
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Avatar universal
Everything that I have been told by docs is that the twitching is profound, not random and transient.  Non-stop, 24/7.  Also, that it comes after wasting and weakness have OBJECTIVELY (clearly and obviously)occured.  Is that carved in stone?  Probably not. It is a very rare and strange illness and I'm certain it has differences in different people.

Unfortunately, there is no definitive test to detect early on-set ALS.  It is dx by a number of different presentations and process of elimination of other, more common illnesses.  SO to a large exent, you are looking for specific answers where there are none.  But if this helps, there is a saying they teach first year med students:  "If you hear the sound of galloping, look for a horse, not a zebra."  That means, look for the most obvious and common causes of the problem, not some exotic or rare cause.

Once again, everything you are describing fits perfectly into classic anxiety.
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Avatar universal
I can totally relate Desperate! I'm 23 years old..and am feeling the same symptoms. Like the twitching moves all over my legs..and  knees, and even one of my ab muscles was twitching. But correct me if I'm wrong nervous guy, but Your legs would have to be REALLY weak to the point where you can't climb the stairs, AND accompanied with the twitches. ALso isn't it really rare for guys our age (23 and 18..to have ALS..especially since we don't have any real weakness..)
I have been thinkign about ALS on and off since Mid august, and

it all started due to a really stressful time. Then, I started carrying this heavy lap top shoulder bag, and my legs started hurting, and my bum did, and my lower back, and my arms.  So then I started to freak out...AGAIN.  I didn't think about the fact that maybe my lap top bag is causing all this odd pain in my arms and legs...I thought about ALS>.because thats what I was freaking out about before.  I keep checking to see if my tongue is atrophying..I keep checking to see if I have babinskis..I keep checking to see if I walk properlly..I keep monitoring my swallowing...and when you do this..it feels like your swalling is laboured...its not a good way to be.  It really throws you off from what your supposed to be doing..which is living life. I haven't even tripped over my own feet while walking and i haven't choked on anything, I can run, yet I stil am going through the anxiety..You just have to tell yourself..Hey..I'm young..healthy..ALS is a VERY RARE disease as nervous guy stated..I can walk..I can talk...I need to get on with my life..and concentrate on other things..I have to keep telling myself that..a 23 year old healthy guy like me..probably doens't have ALS>.but a combonation of lack of sleep, improper eating habits, and stress...easier said than done mind you eheh. oh yeah..INTERNET..BAD BAD BAD for symptoms..I get caught in that trap SOO MUCH....But yeah..we got our whole lives ahead of us..and even while I type these words.my foot is twitching..my calf is twitching..BLAH hehe...

Take care..and I hope we both can put this crippling anxiety behind us..and Thanks Nervous guy..your posts help me:)
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Avatar universal
I can totally relate Desperate! I'm 23 years old..and am feeling the same symptoms. Like the twitching moves all over my legs..and  knees, and even one of my ab muscles was twitching. But correct me if I'm wrong nervous guy, but Your legs would have to be REALLY weak to the point where you can't climb the stairs, AND accompanied with the twitches. ALso isn't it really rare for guys our age (23 and 18..to have ALS..especially since we don't have any real weakness..)
I have been thinkign about ALS on and off since Mid august, and

it all started due to a really stressful time. Then, I started carrying this heavy lap top shoulder bag, and my legs started hurting, and my bum did, and my lower back, and my arms.  So then I started to freak out...AGAIN.  I didn't think about the fact that maybe my lap top bag is causing all this odd pain in my arms and legs...I thought about ALS>.because thats what I was freaking out about before.  I keep checking to see if my tongue is atrophying..I keep checking to see if I have babinskis..I keep checking to see if I walk properlly..I keep monitoring my swallowing...and when you do this..it feels like your swalling is laboured...its not a good way to be.  It really throws you off from what your supposed to be doing..which is living life. I haven't even tripped over my own feet while walking and i haven't choked on anything, I can run, yet I stil am going through the anxiety..You just have to tell yourself..Hey..I'm young..healthy..ALS is a VERY RARE disease as nervous guy stated..I can walk..I can talk...I need to get on with my life..and concentrate on other things..I have to keep telling myself that..a 23 year old healthy guy like me..probably doens't have ALS>.but a combonation of lack of sleep, improper eating habits, and stress...easier said than done mind you eheh. oh yeah..INTERNET..BAD BAD BAD for symptoms..I get caught in that trap SOO MUCH....But yeah..we got our whole lives ahead of us..and even while I type these words.my foot is twitching..my calf is twitching..BLAH hehe...

Take care..and I hope we both can put this crippling anxiety behind us..and Thanks Nervous guy..your posts help me:)
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Avatar universal
nervous guy: first off, you're awesome =) even though i still feel like **** right now, reading the comments you've posted really helps calm me down -hugs- my stomach's been acting kinda funny and it hurts faintly whenever i breathe. admittedly i freaked out when it happened 2 nights ago because i thought the ALS symptoms started kicking up another notch and that i'd started to have difficulty breathing too! honestly, i didn't get a good night's sleep last night because i kept thinking how my organs were starting to go bad too... even though in the back of my head i know i've had similar symptoms years ago (mild case of GERD) and it's totally unrelated to the other things i've been experiencing now. but anyway, since reading your comments, i'm going to try to stay on the positive side. but just a side question, what exactly constitutes as "weakness" in ALS? i can still walk and run but i tire out easily, feel like i don't have any strength, and sometimes there's almost a loss of balance when i turn. and how rapidly does ALS progress? could it be in its early stages, you can still walk fine but then only to start stumbling and/or falling a couple of weeks later? if so, then should i go to the doctor's afterall for another checkup?
sorry about the questions, but you obviously know a lot more than i do when it comes to ALS and just thought i'd get some more sound advice from you. hope you don't mind!
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Avatar universal
so by the time you start getting the twitches, your muscles should have already started wasting? see that was one area that confused me that most! i've been on sites which cite twitching as an initial symptom and the atrophy occurs later on... which gave me the impression that you would feel fatigued and weak at first when the twitches start and then eventually your muscles would waste, causing the patients to fall/stumble.
and another thing, would a neurologist be able to detect ALS in its early stages (ie. twitching) with manual neuro exams and/or MRI? and how rapidly does ALS progress? (for example, from the time the twitches start, when should someone with ALS expect to see diminishing motor functions?)
sorry for asking so many questions! and thank you very much for the many informative responses you have already given me =)
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Avatar universal
My understanding from several internists and neuros is that weakness is objective and not perceived.  In other words, there must be clear physical evidence that is determined by a simple physical exam in a neuro's office. Fascics are the result of the wasting, not the other way around.  BEING TIRED IS NOT A SYMPTOM OF ALS.  It is a rapidly progressive illness that does not get better and then get worse.  However, if you read my posting on the Dr site, you wil see that your concern is a very understandable one and all the confirmation you can get helps to feel better.  Re-read my earlier post on this thread for your other question. The most important thing you can do for yourself now is to break the fear cycle and let your nerves calm down.  Also, it would be a great help if you had one person like a good, non-judgemental psychologist who you could unload to.  You will be surprised to learn how common your condition is. You could also explore medication to help with obsessive thinking.  Hypochondriasis and fixating on an illness like this is often an indication of obsessive compulsive disorder (OCD). You could get great relief from an SSRI like Zoloft.  Finally, fixating on a terrible illness is often a way of avoidance of things we don't want to see or do.  It is a very powerful state of denial.  PLEASE just try to give yourself a break for a while and watch what happens.  Peace.
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Avatar universal
oh it feels great that to know that i'm not alone! and i am just praying right now that everything is just as you say- caused by anxiety and such and nothing else!
just out of curiosity though, do you still have the twitches all over? i get them on my face and body too, though it is the worst in my legs (happens to my feet too). and do you also feel weak in your legs and arms? i know i do, but it's not as profound as not being able to climb the stairs. though i still am somewhat nervous about it all since ALS progresses at a different pace in different individuals.
at any rate, i think all the advice you gave were really great. and i've been checking to see whether i have atrophy in my arms and legs too! and it's funny how everything starts to look wrong when you're  anxious. anyway, i'm going to start to stay on the positive side (even though it's really hard) and focus my attention on something else right now. thanks!!
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Avatar universal
PS:  Your legs feel like "jello" from anxiety.  You are exhausting yourself.  Get as much sleep as you can and re-read the very first posting to you by mineandours.  That is excellent advice.  When you talk about your symptoms to people, friends and family, you are binging like a person with an eating disorder does with food.  And get off the net for a week and stop binging on symptoms and info.  You are not alone.  DOn't beat yourself up.  Peace.
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Avatar universal
You should do whatever it takes to give you a comfortable level of confidence but in the state you are in, you probably will only feel relief for a few days before the fear comes back to grip you again.  At that point, you wont have any alternatives left but to go through the whole thing again.  Get a hold of some Xanax or Atavan and start taking it.  If you don't calm down, you can't break the anxiety, adrenalin, fear cycle and your symptoms will continue to amplify, creating more anxiety and on and on. I can almost assure you that if you can just calm down, your symptoms will dwindel and disappear.

As for the likelihood of ALS, you are behaving like someone who buys a lottery ticket and then rushes out and buys a Rolls Royce and a mansion because he is 100% positive he's going to win.  The possibility of winning exists certainly but it is so remote, would you ever conceive of doing something as stupid as that?  You are suffering needlessly on the remote, remote supposition that you have a rare fatal disease, even more rare because of your age.  I'm not a doc but I am a very well read hypochondriac :).  I have many, many, top doctor friends at top hospitals in NYC and they have all confirmed what I'm telling you.  RELAX!

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thanks for the comments, everyone! i just went to the doctor's for a bloodwork and it turned out to be normal (thyroid, blood cells count, etc). but i still feel weak in my legs and arms and the twitching has not stopped. i have no problem walking/running but when i do, i feel like my legs are jello (kinda like the opposite of a stiff feeling). is this because i am tired or that i really have ALS? the doctors at the clinic did a thorough neurological exam on me (manual though) to check my reflexes and such. with no abnormalities. but i'm still really worried. should i get a MRI, NCV, and/or EMG?
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Avatar universal
Listen to the voice of the "Worried Well."  I'm going to tell you things that I admittedly have a hard time accepting myself but I try (read my posting on the Dr site).  First, although it has happened, it is EXTREMELY rare for a person your age to have ALS.  Now, add that simple fact to this:  If you filled 11 Yankee Stadiums, it is statistically probable that the only one there with Lou Gehrig's Disease would be Lou himself (that's one in 600,000 people).  That's how rare the disease is.  Put that together and the fact that you are exhibiting classic anxiety symptoms and maybe you can start to get a grip.  Mindandours and Demi have both given you good advice.  If you read about these symptoms in the state you are in, you will certainly start to have them.  Part of the reason that so many people are irrationaly obsessed with this is that the symptoms are so common.  Get off the NET!!!  Pray, meditate, exercise, or whatever you do to relax your mind and soul. Get off junk food and caffiene and CHILL.  I pray that I can follow my own advice that I offer you but I know how hard it is and what you are going through.  Good luck, pal. You can do it.
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Avatar universal
Use SEARCH box above & click. Then key in ALS & it will give
you posts to read from others that may help you. MANY POSTS!
It will also give you the posts & the Doctors response since
this is patient-patient forum & other is answered by MD.
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Avatar universal
I'm not a doctor but as someone who has been through the run-around with doctors and other medical staff I would recommend you get a second, third, fourth opinion. It's your body, your life and this is obviously causing you more stress at an already stressful time.
If it gets really bad and you can't get in to see someone referred by your doctor then you might consider your local emergency room.  If you can wait for your primary care doctor then I'd try to get in soon for some routine bloodwork. Make sure they include thyroid, since if they forget they'll likely send you back (they did that to me).
I hope you all of the best.  Never forget that you have a right to thorough medical care.  
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Avatar universal
Sounds like you admittedly have a lot of stress in your life and the constant pumping of adrenaline into your system is just fueling it. It's like throwing gasoline onto a fire.  I recently had a friend pass from ALS and, believe me, you would not "wonder" or "worry" that you had it.  You would know it.  You need to get a grip and try to relax.  You're too young to be obsessing about these sorts of things.  I bet if you would make a deal with yourself to stay offline for one week, lay off any caffeine and junk food, clean up your diet and take some time to yourself and organize your priorities, things would be a lot better for you.  I betcha.  Good luck and I hope things work out for you. :)
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