Fasciculations - EMG

[nic_non_work]

I am 32 years old, I live an active and stressful live. I've had fasciculations (permanent in my calves - bag of worms, on and off in the rest of the body - more like "popping muscles") for about 2 months now, they were preceded with a longer period of paraesthesis in my feet and hands and one month of me feeling dizzy. Before this I'd taken high doses of cortisone and nootropil (tinnitus, which stressed me out a lot).MRI is clean. 3 weeks ago I first noticed that when my left hand was lying on the keyboard of my laptop the index finger and/or thumb felt like they were seizing up. Sometimes they would then "jump", i.e. move the joint once or twice and then feel fine again, before starting to freeze up again. This would take around 30 seconds. Sometimes they'd also shake (side to side) for a minute and then stop. This only happens when the hand is supported, it does not happen at night. Sometimes all there is is the feeling of tension (particularly under the nail of the thumb) and sometimes there are these jumps and shakes. I've also woken up with my hands asleep. I've had an EMG (lower right leg where the fasciculations are most prominent) which says there are no fibrillations but may be very weak and uncertain signs of chronic neurological damage as well as slightly higher F waves. The neurologist's diagnosis was that he did not know but that he was not too worried. I go running 3x a week and feel fine, I run the same times as I did before all this happened.
My questions : 1) Any chance this being ALS?
2) Other tests that I should do?
Thanks a lot.

[Jevi]

I have been suffering from subjetive tinnitus in both ears since December 2002. In October 2003 I heard a loud pitch in my left ear and after 30 second the pitch decreased but the basal tinnitus in this ear remained a bit louder. A mounth  after I began to hear that the noise in this ear ondulated, like the rushing wind, and I heard a click at night. Two or three months after, the clicks became more frequent. I was having alprazolam for two months and when I finished the treatment the clicks came back but much more frecquent indeed. Since that moment I hear the clicks with a frecquence about 3-4 per hour in the left ear and scarcely in the right. I also have fasciculations in several muscles of my body (legs, arms, shoulders, face). I feel very bad with this cliks and I am wishing they to leave me. I think that I have any neuromuscular disease but I do not know which one. Do you think it is going to finish? Do the clicks have any relation with the rest of spams? Do you think I shoul have muscle relaxants? If affirmative, Which is the most appropriate?

[CCF-Neuro-M.D.-CS]

Based on the information you have provided, I cannot exclude or diagnose ALS. Your age, lack of weakness, and lack of progression would make it unlikely. The findings on the EMG are confusing, and did not involve your arm. Perhaps a second opinion at an academic center would be reasonable. This would provide more evidence to exclude ALS, and put your fears to rest. I assume you thyroid function and  electrolytes have been tested. Also, a muscle enzyme level (CK and aldolase) would be reasonable. Good luck.