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Neurology (Expert Forum)
Fear of ALS
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Fear of ALS
by nd10, Dec 13, 2006 12:00AM
I am a 26 yr old female. About 13 mos ago I began experiencing fascilitations all over my body. I went to a nero who said it was BFS. I also have an itchy crawly feeling on skin at times. I had a normal MRI and all blood work up normal. I then had a horrible case of sciiatica and an EMG showed instabililty of the sciatic nerve. I was sent to PT and it really helped. The pain has subsided.
My current fear is ALS due to a small dent in my quad muscle about two inches long that runs horizontally (left leg). It is more evident when my muscle is flexed. It looks lioke two buldges with a dent running through it - very slight and would be hard for someone to see. I was able to find others on the internet w/ same dent and noone knows what it is. My fear is atrophy. I haave very muscular legs from cheerleading and gymnastics and I work out a lot. I twitch a lot in the morning when I stretch after sleeping - it sets off firewoors in my tummy. I have never had a bit of weakness and nero exams were normal as well as follow up EMG 6 mos ago. Does the dent sound like muscle wating that is eenin ALS. Both quads are still the same size. I am terrified b/c my left foot arch has been slightly twitchin fot the last 9 days - every five misn or so in one sopt. Seems to subside at times.
Pleae let me know if you think ALS should be a concern or if you feel the dent in my quad and foee twitch are unrealted. I really do nto want to make another very expensive trip to the nero unless you feel it is necessaey.
My current fear is ALS due to a small dent in my quad muscle about two inches long that runs horizontally (left leg). It is more evident when my muscle is flexed. It looks lioke two buldges with a dent running through it - very slight and would be hard for someone to see. I was able to find others on the internet w/ same dent and noone knows what it is. My fear is atrophy. I haave very muscular legs from cheerleading and gymnastics and I work out a lot. I twitch a lot in the morning when I stretch after sleeping - it sets off firewoors in my tummy. I have never had a bit of weakness and nero exams were normal as well as follow up EMG 6 mos ago. Does the dent sound like muscle wating that is eenin ALS. Both quads are still the same size. I am terrified b/c my left foot arch has been slightly twitchin fot the last 9 days - every five misn or so in one sopt. Seems to subside at times.
Pleae let me know if you think ALS should be a concern or if you feel the dent in my quad and foee twitch are unrealted. I really do nto want to make another very expensive trip to the nero unless you feel it is necessaey.
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jan 07, 2007 12:00AM
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.
From the symptoms and story that you describe, I do not think you need to be worried about ALS (amyotrophic lateral sclerosis-also called Motor neuron disease). Fasiculations are small twitches in muscles that do not lead to movements across joints. Fasiculations can be found in normal people, after exercise, with metabolic disturbances, after some viral infections and in some neuromuscular conditions (including ALS). Thus, fasicualtions are non-specific and are only "concerning" if additional features of neuromuscular disease are present (weakness or atrophy being the most important). The "dent" in your quad that is best seen with flexion, sounds like muscle definition and does not sound like atrophy. If you are concerned about atrophy, you can measure your thighs at their maximum diameter and compare the two sides (should be close) and measure them over time. With 2 normal EMGs, no weakness or atrophy I would agree that it sounds like benign fasiculation syndrome. I would recommend that you have your electrolytes checked (complete metabolic panel plus magnesium and phosphorus) to make sure your electrolytes are stable. Avoid any diuretic or "weight loss" pills that can cause metabolic imbalances.
I hope this has been helpful.
From the symptoms and story that you describe, I do not think you need to be worried about ALS (amyotrophic lateral sclerosis-also called Motor neuron disease). Fasiculations are small twitches in muscles that do not lead to movements across joints. Fasiculations can be found in normal people, after exercise, with metabolic disturbances, after some viral infections and in some neuromuscular conditions (including ALS). Thus, fasicualtions are non-specific and are only "concerning" if additional features of neuromuscular disease are present (weakness or atrophy being the most important). The "dent" in your quad that is best seen with flexion, sounds like muscle definition and does not sound like atrophy. If you are concerned about atrophy, you can measure your thighs at their maximum diameter and compare the two sides (should be close) and measure them over time. With 2 normal EMGs, no weakness or atrophy I would agree that it sounds like benign fasiculation syndrome. I would recommend that you have your electrolytes checked (complete metabolic panel plus magnesium and phosphorus) to make sure your electrolytes are stable. Avoid any diuretic or "weight loss" pills that can cause metabolic imbalances.
I hope this has been helpful.
I suggest that you see your family doctor and go from there. Stressing on the other hand will get you no where though I understand that you are worried.
Good Luck!
JCmcc.
Thanks,
JCmcc.
I am sorry to hear of your continued fear but I am also excited for you to learn that ALS appears to be out of the question for you, and that, it also appears that your neurologist saw nothing else wrong with you.
The dent is odd, I agree, but if he believes it is benign he is more than likely correct. He would take a great danger in just telling you that.
If the fear continues to be a problem for you, you may want to consider seeing a neuropsychologist. It is interesting to learn how fear and the mind can have devastating effects on our Central Nervous System. Many physicians believe that the worst thing for medicine was that of the theory of Descartes which separated the mind from the body-truly-they work hand in hand.
Good Luck!
JCmcc.