Twitching, tight face and neck muscles

[Erik867]

Hi, I am a 23 year old male, otherwise in good physical condition. My only other health issue is that I have suffer from occassional vertigo due to orthostatic hypotension. I write because I am very scared regarding my health. Over the past 3 to 4 months, I began suffering from hand tremors. The neurologist performed thyroid testing and copper testing for Wilson's disease, said it was nothing serious (Parkinson's, etc). He said it was essential tremor. However, within the past 2 months or so, I have been experiencing twitching in different parts of my body... forearms, triceps, biceps, hamstrings, quads, upper back. These twitches come and go, typically do not remain once I move the muscle. They are also very noticeable twitches, not tiny snakelike movements like I heard are typical of ALS. I have not experienced weakness, however, as I try to exercise (cardio and light weight training) on almost a daily basis and do it without a problem.

However, what has me most worried is that for about a week now I have been experiencing tightness in my neck, and now I feel like the left side of my face/mouth is very tight. I look in the mirror and my face looks symmetrical, no drooping. I also do not have asymmetrical movement of my face. But nevertheless i feel very tight on the left eyebrow, cheek, and jaw. My upper lip also twitches sometimes. Now I also feel tightness on my second toe on the right foot, and often my right big toe twitches as well. I also feel tightness on the inside part of my right knee.

I have had a brain and IAC MRI done (for above mentioned dizzines), and it was normal. I have been under a lot of stress lately, as i have had some family / work problems. This may be stress/panic/anxiety. Also, my grandmother suffers from Fibromyalgia, which may also cause some of these symptoms. I am not taking any medications at the moment. I am terrified that this could be ALS, possibly bulbar onset. Can anyone give me some advice or thoughts? Thanks so much.

[Lmg11]

Have to agree with the above comment. I suffered extensive muscle twitches from head to toe which I instantly focused on and thought that I had the worst possible diagnosis ever, ALS. I was so convinced I had numerous appointments with the GP, MRI and a CT scans and all negative. The diagnosis was Benign Fasiculation Syndrome, which I experience daily but I know it's totally benign. There is a huge element of anxiety and stress that partakes in these symptoms because once you've got ALS in your mind, it instantly causes anxiety and of course anxiety symptoms. There are a multitude if other things this could be. But please take my advice, do not focus and worry until you've heard from the horses mouth, besides, what you've mentioned regarding negative MRI results is always reassuring.

[MSull1987]

The symptoms you describe are not typical of ALS.
All of points you mention are very typical of an episode of anxiety, GAD or panic disorder with some root cause stemming from hypochondriasis.

The mind is so powerful that it will trigger many bizarre physical manifestations you described, even to the point that it will mimic the very disease process you fear.

ALS has more to do with muscle wasting.  The first symptoms are loss of strength and coordination problems.  Sure, twitching and tingling sensations happen....BUT they happen after, many times long after, the patient has experienced progressive issues with muscle strength, balance, coordination, etc.  
The fact that you have muscle twitching in many vary different portions of the body are not indicative of ALS.  ALS twitching and tingling happen in isolated sections in the area of affected.  The symptoms you describe are so widespread and simultaneous that they do not in anyway suggest the typical pathway of any of the sclerosis diseases.

Trust me....I've been on this same merry-go-round for multiple times during a 15 year period and its all indicative of a hypochondria gone awry.  You will get sucked down a hole that is tough to get out of.  Once your mind fixates on the stuff, it perpetuates a very vicious cycle that only exacerbates any benign symptom you may have and raises the intensity of it up 10 notches.  Suddenly, a stomach ache is interpreted as colon cancer.  A muscle twitch is a fatal disease, etc.

I have had numerous such symptoms as yourself and they always manifest after days of fixation on some rare life-threatening disease.  
No doubt, the symptoms are real....but they are benign.

[elisheva14]

Did you ever get an answer.  I have some similar problems.  My father had ALS and the diagnosis I got was Myofascial Pain Sydrome.  

[Erik867]

Now I have a fairly constant twitch between my thumb and forefinger and on my forearm. Any suggestions?