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Avatar universal

Neurological symptoms progressing with no answers

In January I began to experience tingling in top of head and in left arm.  That went away but then came burning feet, feelings of having ice packs on my thighs, body-wide muscle twitches, and pain in left arm and shoulder.  Burning feet and ice feelings went away, but the upper arm pain/shoulder pain then spread to right arm as well.  My neuro did a EMG on left arm deltoid, tricep and bicep which was normal, a c-spine MRI which was normal, and CBC, lyme titer blood work which was normal.  My symptoms are progressing, as I get these intermittent feelings of extreme muscle weakness in my arms and/or legs, which come with severe nausea and the need to have a bowel movement.  This happens several times a day, and I am also having great difficulty sleeping due to twitching, feelings of weakness, and internal vibration feelings in my arms.  I have also noticed that after I lift something fairly heavy, my arms will shake afterwards, if I go to do something like lift a can of pop to drink, etc.  I am still twitching all over, and I feel sicker with each passing week.  My neuro is referring me to a major medical teaching university as he doesn't know what to do for me.  Can ALS be ruled out with a clean EMG on just one limb?  I had a brain MRI one year ago due to headaches which was normal.  Could a syrinx or spinal tumor cause these problems?  I'm afraid I'm going to end up in the ER soon.  My thryoid levels are normal and I am not an anxious person.  I'm a 32 year old female and just want to feel normal again. This progression of symptoms is affecting my daily life.  Thank you.
36 Responses
Avatar universal
Muscle twitching in the absence of objective muscle weakness and wasting is unlikely to be ALS. Muscle twitching can also occur (more commonly) in other situations such as an overactive thyroid gland, a pinched nerve, as a result of cold or exercise, certwain medications, as a benign syndrome with or without cramps, or more rarely due to some spinal conditions such as a syrinx or viral infections. Definite ALS requires a diagnosis by either clinical signs or EMG in at least 3 limbs. An EMG is unlikely to be abnormal in an aymptomatic limb. EMG should always be interpreted with a nerve conduction study (where they give electric shocks and measure the muscle response). Widepread twithes from onset are more likely to be of the benign type.

Internal felling that you describe associated with disturbed sleep can be due to a condition called restless legs syndrome. It can be diagnosed by the clinical history, and is associated sometimes with iron deficiency anemia.

I cannot give you a formal opinion over the internet, but you hopefully will get some answers from your referral

Good luck
Avatar universal
I'm sorry you're feeling this way and I hope you'll feel better soon. I don't know if ALS could progress that quickly..ALS is a slowly progressive disorder. It does sound like you have a lot of muscle weakness. Do you have any other neurological symptoms, like double vision?
Avatar universal
No, no double vision. My lyme titer came back negative as well.
Avatar universal
its odd that people mention weird vibration feelings, i have that feeling in my back a few years ago, it was weird, was like a faint warm vibration every few seconds, i never told a dr since i thought it was weird, it eventually went away but for the last 12 to 15 years I have been having tingling in my head ahnds arms and my legs, i get sudden urges to have a bowel movement and break out in a sweat if it happens in public, i guess i fear that i wont find a bathroom.i also get electrical zaps in my spine and have really weird sensations in my brain, I think I have Ms, I have has every blood test known to man, all were good. I am seeing a new neuro tomorrow since my old one doesnt listen anymore!
Avatar universal
Are you on any dieuritics, blood pressure medicine or huge doses of caffeine?  If your electrolytes are not in balance you will have that weird sensation, twitching and/or cramping and generalized weakness.  All of these high energy drinks people are consuming I feel could bring on troubling symtoms too.
Avatar universal
No diuretics, no medications, and no caffeine intake.  Thanks!
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