ALS fear

[Dee566]

Dear Doctor,  
For the last two months, my arm and leg on the right side of my body has almost constantly been having inner vibrations (not seen but felt).  It started with two episodes that woke me up and felt like the bed was shaking.  The last four days, I have had cramping in my leg on the same side along with sporadic pain from the ball of my right foot.  I have had an MRI which was normal and an EMG but on the left side last year before I was experiencing these symptoms (it was normal).  My anxiety level is quite high for fear of ALS even though two neurologists have said it is nothing serious and that this is not how ALS presents.  They suspect anxiety but I am not convinced.  Any information would be helpful since the anxiety is greatly affecting mine and my families life.

[Chipman1]

Good afternoon,

I am a 32 year old male, sporty (fishing and lawn bowls) My dad suffered with motor neuron for 7 years. He was hospitalised in Feb. 2011 with severe lung infection last year. i was called a 4:30am and rushed to the hospital...very traumatic for me - cold sweat and emotional wreck.

He was in hospital for 3 weeks and finally made it home. He passed in his sleep in Dec 2011 3 days after i got married.

Since that day the strangest things have happened to me. I have always been healthy and sporty with no accidents or major injury. I had a full medical done and all is 100% except my cholesterol of 5.5

Every time my phone rang with his number or the home number i thought it was the same news and i totally freaked out every time...nervous wreck to say the least. Since then i have been getting muscle twitches in my calves and arms, am now on Ciplalex 10mg per day for anxiaty..still twitching - no muscle weakness.

In March 2011 one evening i woke up a 2am with the most agonising pain i have ever experienced (left shoulder - centre deltoid) it passed after 3 - 5 minutes, could not lift my arm the next day, went to a physio for 4 weeks no improvement, went to an osteopath twice and made an amazing difference yet never got back to 100% then went to the world angling champs in Italy no problem, got back to catch shark and did a few pushups, shoulder buggered (sore in front, then at the back, then top of the chest - every day a different spot). Had the shoulder scoped no damage and after an examination was diagnosed with thoracic outlet syndrome got a Botox injection in the scalene muscles, 10 days later i could cast for the first time in 3 months (to painful previously). Working on the TOS with the biokinetic guy...burns after exercise. not sure is the diagnosis is correct (Parsonage Turner syndrome?).

Ring finger and pinky feel numb/dumb. No grip strength loss have deltoid apothy, possible after not using my arm in fear of dislocation after being worngly diagnosed with a bankart lesion 4 months ago. The arm falls asleep often and can not be moved. I through it off the bed with my right arm and feel the blood flowing into it before it can be moved again. It is very frustrating when it burns and the thoughts keep running through my head. It least i can fish again.

NEXT...In July 2011 i was sitting in the bus on the way home and had the most painful burning sensation in my calf, lasted 60s until i clicked my hip, sense then pain in the but then below the knee(top of calf) went to every one, manipulations all said pinched nerve / bulging disc... it improved 3 months later (overnight ) after 3 sessions with a new physio, it hurts every time i get up from a seated position. sharp stabbing pain. This has improved i the last month after getting so hip rotation exersizes done. Not perfect but led still feals a little strange.

I have been anxious about having Motor neuron disease and cant get it out of my head, are any of these related to the disease. If not i can get over it and move on with my life.

I would appreciate any feedback emensly.

Regards
Andrew

[Dr. Kokil Mathur]

Hi!
Since you woke up with these symptoms, possibility of a sleep disorder like restless leg syndrome should be looked into. Tremors or vibrations are often associated with drugs, alcohol, smoking, lack of sleep, poor sleep patterns, stress and fatigue. They can be seen in peripheral neuropathies of diabetes, in hyperthyroidism, parasomnia, multiple sclerosis, TIAs or transient ischemic attacks or mini strokes, hypoglycemia, disorders of calcium metabolism, hyperparathyroidism etc. Certain epilepsies too could be the cause. Consult an internal medicine specialist or your PCP. Discuss these possibilities with your doctor.  A comprehensive investigation is required keeping all the points in mind. You will need blood sugar monitoring, MRI of brain (done) and cervical spine, T3, T4, TSH, sleep studies, serum electrolytes, brain EEG, etc to reach a diagnosis.  
Since I cannot examine you and know other related conditions you may be having, nor is a detailed history possible on net, I have listed the various possibilities that should be looked into. Please consult your doctor to run tests and examination to clinch a diagnosis.
Take care!