ms??

[rich]

In June of 1996 I started to get muscle fasiculations-with no other symptoms.  In May of 1997 I had the twitching and also a strange feeling in the back of my calves.  Not numbness or tingling, just a strange feeling.  My doctor referred me to my neurologist.  I had ct scan of the brain, and eeg, and emg. All were negative.  The neurologist told me that I had benign fasiculations and not to worry.  The feeling in the calves went away.  I had a follow-up with the him in August 1998-again all was fine.

This past summer, the feeling in my calves returned.  I also have tingling in both of my feet.  The tingling is only on the bottom of my feet and right in the arches.  At various times, I also get tingling in my hands.  The tingling in my hands would seem to be coming from my neck-as I can ususally turn my head and this feeling will go away.  Whenever I scratch my skin, get tingling or goose-bumps all the way down my body.  I have a Spondo of the L5 and my doctor said this might be coming from the back.  

I have had the fasiculations for over 3 years and I had resigned myself to live with them-until theses other things started to happen.  None of the symptoms are constant and they seem to come and go at various times.  I have no muscle weakness or fatigue.

My questions are as follows:

1.) Could this be the early signs of MS?
2.) Could this tingling from the scratching be coming from the back?
  Thank-you in advance for your time!

[CCF Neuro[P] MD, RPS]

Dear Rich:

You do not have ALS.  Whether a Chiari malformation is the cause of your problem is unknown.  A severe malformation could cause symptoms, but I would not think that you would have a severe malformation that would just show up now.

Sincerely,

CCF Neuro MD

[rich]

When I first started going through this they thought the fasiculations might have been ALS.  Would the length of time (3 years) and the negative EMG make this unlikely?   My sister has recently been diagnosed with Arnold Chiara Malformation.  Could this be the root of my problem?  I am scheduled for a neck MRI in January to check on this possibility.

Thanks again for your help.

[RR]

Just got back from the neuro.  He said the office person who told me he wanted to discuss steroid injections and surgery consult was not correct.  According to him the disc condition is not extreem and is most likely not the cause of leg fasciculation and definity not the cause of any upper body twitching or cramping.  DX with bfs.  He said give it time, but he was very understanding of the problem.  Hope this helps. God bless you.

[RR]

My symptoms seem very similar.  I started twitching, cramping and buzzing in June of this year.  I mostly have twitching and cramping in my calves that are always annoying.  My EMG, ultrasound of lower extremeties, bloodwork and cervical MRI came back perfect.  I had a lumbar MRI done and it showed a minimal left disc protrusion of the L5-S1 disc with loss of disc space.  The test further showed that there is contact with the thecal sac and nerve root.  I guess by the sound of what the DR. just said this may or may not have something to do with my lower leg problems.  Like you I have had upper body twitching but it is mild compared to the calves and feet. I am meeting with my neuro today to discuss options with the back problem.  His office indicated that Steroid injections and surgical consult may be on the agenda.   I will post what he says.  Also I do have tingling,and occasional pins and needled pain in my calves and feet. Good luck and may God's peace be with you.

[CCF Neuro[P] MD, RPS]

Dear Rich:

Sorry about your fasciculations and parasthesias.  One can never say never in medicine, but your symptoms do not have the MS flavor.  Although the CT scan was normal, one way of checking out the MS issue is either a MRI of the brain or LP with CSF analysis. Have you had a MRI of your brain? The L5 disc could create the leg symptoms but would certainly not produce the upper extremity symptoms.  How do your know that you have a spondo at L5?  Did the MRI indicate thecal sac compromise or cord compression?  

Without examining you it is difficult to tell you what is really going on.  My guess is that you do not have MS.  Whether the L5 disc is causing the symptoms is hard to tell.  If the MRI is pretty much okay (just disc protrusion) then it would be less likely that your disc is causing your lower extremity problem.  But if there is alot of herniation, then yes it could be causing the problem.  But, it is not causing the upper extremity symptoms.  Given the upper extremity symptoms, it would make one think about whether the lower limb symptoms is really not your back.  Get a good view of the disc herniation and revisit with your neurologist.

Sorry this wasn't more informative.

Sincerely,

CCF Neuro MD