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Leg twitching at night / pain during day
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Leg twitching at night / pain during day

I am a healthy male age 36.  All of the following began suddenly.  I began having strange leg pains at night approx. 2 months ago.  After 2 nights of cramp type pains and tightness in right leg,  I began to have twitches and vibration type sensations in my right calf for the next week.  I went to a spine specialist on the advice of my family doctor.  He did a complete MRI of head, neck, back, and lumbar area.  The only abnormal finding was a moderately herniated disk at L5-S1 with nerve involvment.  I have a history of lower back spasms with pain about twice a year.  He diagnosed me with sciatica and sent me for physical therapy.  The twitching has now spread to my other calf and I have soreness in my left foot and calf during the day along with the right calf.  My legs become very tight during the day if I do much walking such as Christmas shopping.  The twitching sensations wake me up around 4:00 AM every morning.  Some days it feels like I have bugs in my left leg trying to escape.  If I move my legs alot or get up and walk around things calm down a good bit.  I have very little twitching during the day, maybe 10 times and occasionaly(4 times a week) my legs will jerk at the same time for no reason. I have also recently experienced some pain in my buttocks and my lower back with a 24 hour episode of twitching in my buttocks.  I do not have any true weakness in legs. 1. Could this all be related to the diagnosis of sciatica and a herniated disk?  2. Will EMG verify sciatica?  3.  Can a herniated disk lead to RLS?  4.  Should I be concerned about ALS or MS? Thank You!
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Avatar_n_tn
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
   The symptoms that you describe could all be possibly related to your L5-S1 disc herniation.  When a disc herniates out the vertebral column it can compress nerve roots as they exit the spinal column.  The region of the body that you feel the pain is the area of the body that the compress nerve serves (called a dermatome) The dermatome that corresponds to a disc problem at L5-S1 is in the Calve region.  In addition to pain from the compressed nerve (dermatome) you can also get pain in the local area of the compression (low back pain) and along the length of the nerve (from the buttocks, down the leg to the ankle).  The diagnosis of sciatica is anything that may be disturbing the nerve, on of which causes is a hernitated disc with nerve root compression (also called a radiculopathy).  I would suggest an EMG to evaluate what is going on.  It is unclear to me why you would have associated twitching with a radiculopathy, or maybe the twitching is incidental? (the EMG will help sort this out).  Restless legs syndrome (RLS) is not caused by herniated discs.  This is thought to be relates to dopamine (a neurotransmitter) in some way (not completely understood).  The symptoms that you describe may be related to RLS (the bugs in the legs part that gets better with walking around).  You should have iron tests done since iron deficiency can mimic RLS.  The treatments of RLS include Requip, neurontin, and narcotics (used rarely).  Given the symptoms that you have described thus far, I would not be concerned about ALS or MS, but I would recommend that you get the EMG to further characterize what is going on.
I hope this has been helpful.
10 Comments
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Avatar_n_tn
Did this neurologist specialize in ALS? If not, I suggest, to be on the safe side, that you get that ruled out.
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Avatar_n_tn
Hi Southern,

I to have twitching all over my body and jerking motions.  I was a marathon runner when all this started two years ago.  Long story short for me I was diagnosed with lyme disease.  I spent a lot of time outside hicking and running off road.  The fact that you have had an MRI is very good especially with clear results.  At any rate if you would like to email me then feel free to do so.  I spent two years thinking I had MS and wished I had known about lyme disease sooner.
Good luck and let me know if you have any questions.

***@****

Lesley
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Avatar_n_tn
I have a lot of your symptoms too and know first that sciatica can cause leg and buttocks pain and some twitching.  I had a horrible case when I was pregnant 5 years a go.  I still get the sciatica but never thought it was related to all of the symptoms I'm experiencing now.  I too have been worried about ALS..have strange body twitches which are more like pulses in arbitrary areas of my body.  I have muscle/body weakness as well, but I still run and workout so it's not severe.  Still, it's completely abnormal for my body. I am scheduled to see a neurologist at the advice of my doctor.  He doesn't want me to worry about ALS, tumors etc...but wants it to get checked out all the same.  He said it could be related to a pinched nerve which is hard to believe. I didn't think to ask him about Lymes disease b/c we live in Arizona and there are not many ticks here.  I do get sharp prickly pains in my hand especially when I first touch something cold and sharp pains in my legs too.  

I have read that with ALS the weakness comes one limb at a time and then spreads, so that eases my worry a bit. Hopefully yours too.

I just registered today and am amazed by the the people who share these symptoms. It's horrible, but good to know I'm not crazy.  We can't all have ALS so perhaps we should be asking more questions of our doctors.  Not sure.  Hey, if this is all caused my sciatica, I'll be happy.   I hope you get some answers.
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Avatar_n_tn
Thanks for the comments.  My neuroligist ordered many blood test last week including Lyme and I was notified by phone that all of my bloodwork came back normal but I could discuss the results with the Dr. when he does my EMG this Wednesday 1/10/7.  I have read that the basic test for lyme disease is very inaccurate.  Did you have a certain type of test for your lyme and if so what type of test did you have.  I spend many days in the outdoors in South Carolina helping my father-in-law work on fencing and other things.  His land has many deer and much undergrowth so lyme is definately a possibility.
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Avatar_n_tn
The neurologist that is doing my EMG this Wednesday does not specialize in ALS, but he does work closely with the ALS clinic in Charlotte, NC and refers patients to them as needed.  Should I be concerned that he is not an ALS specialist?
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Avatar_n_tn
I will keep you posted on my situation.  Like you, I hope and pray that all of this is related to the sciatic nerve and coming from my back problem.  I hope you have a positive outcome and some relief soon.  I never thought that I would consider back surgery as good thing until this happened and I consider the other possibilities.
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Avatar_n_tn
I have been diagnosed with a peneal cyst.  I get headaches on and off and feel like the pressure in my head is going to make it explode, pretty frequently.  Along with this, my vision gets doubled at times...usually when I have a headache. My legs twitch at night really bad!  Every night!  So, my doctor decided to put me on Requip for RLS.  Not sure if this is where the problem originates...sometimes the pills seem to help and other days it doesn't help at all.  My elbows are extremely painful, in the joints and now my hands have the same issue...It feels like my arms are unable to move sometimes, and they are stuck in one position..I force them to move and this is painful. So, if I hold onto something, like a shopping bag, it feels almost like it "locks" my arms, and now my hands are doing the same.  It makes them difficult to move too. Some times I am fine while other times it's horrible. (not depression) My doctor has actually done some cranial sacral work which does releave the pressure and headaches for a short time, although not the other issues.  I get muscle weakness frequently and joint pain.  (I have had MS ruled out.) My lower back, actually has a bump at the base of my spine on the right side that has been an issue on and off for the last 11yrs, since I was pregnant with my daughter. My doctor keeps saying I think you are going to end up out at Mayo one of these days...I can't figure out what is going on with you.  He knows it is something though.  Along with everything else, I have interstitial cystitis, I don't know if this just happens to stand alone. If anyone has any thoughts or suggestions I would greatly appreciate them!!! Thanks in advance for any guidance you may offer!!! Have a great day!
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Avatar_n_tn
Update for everyone. EMG results were "completely normal"  My neurologist said "I heave treated many young patients with very nasty diseases and I do not think you have any of these".  This was very comforting.  He also said that he can not put his hand on what is causing my symptoms and that he does not feel like the symptoms are coming from my back, but he is unsure.  He said he sees many patients that never get a diagnosis, but their symptoms usually resolve themselves over time.  I really like this Doctor and he is very experienced and respected, but it is hard not knowing what is going on with your body.  He prescibed Requip for RLS, but this has not changed my symptoms, after two weeks.  I actually stopped taking the requip a few days ago and have seen some improvement in my night time symptoms.  Thanks.
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Avatar_n_tn
Please tell me what ALS is. I just had an MRI done today.. But by what my CAT scan said i have 2 buldging disk that are interupting a nerve.. if someone could help please do so
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Avatar_f_tn
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