Weakness, spasms, twitching, fatigue, tremor . . .

[Kelley1]

I'm a 40 year-old female with various problems starting about a 1-1/2 ago.  During this entire time I have had right-side muscle weakness, neck/shoulder tightness with pain and some spasms, and tremor in the right arm/hand.  I have had 2  major "flare-up" periods with my current one starting about 2 weeks ago.  My current flare-up has included the following:  EXTREME fatigue (like you are doing your last set of reps with weights) this is in both arms and legs constaint, twitching of right calf, twitching of left thigh (severe enough to look like a reflex if my leg is dangling, twitching of midldle face (nose flares and moves upward like a bunny), and vision blurring right-eye, and pain/deep uncomfort in the spine when first laying down/relaxing. All these symptoms get worse after exercising.

After the first flare I got an MRI, but it was quite a while (6 months) after the flare-up due to the insurance not wanting to cover it.  I also had an EEG, and evoked potiental tests; all of which came back normal.  Currently they are re-running tests and have ordered additional tests as follows:  EEG, Doppler Ultrasound bilateral carotid and transcranial, evoked potentials (all types), MRI brain with and without gadolinium, and an MRA of the head and neck.

Can anyone tell me what this might be or what the tests are ruling-in or ruling out.

[Kelley1]

Shugsryan -- I do have a fair amount of stress in my life and do a lot for my parents and mother-in-law too and stay very busy at work, but tend to like being busy.  I have experienced stress related issues in the past, but have found ways to balance stress better as I have gotten older so I don't think it is that this time.  I have essential tremor in the right hand for about a year or so now, but I think I have too many other symptoms for too long of a period of time to chalk it up to stress.  I know my body and I feel real off when I'm having these flares.  Parkinson's is fairly rare and with just a thumb twitch I wouldn't be too worried.  There are some movement disorders that are idiopathic in origin (i.e., not associated with a specific medical cause), many case of these have other family members that have a history of tremor.  I'm adopted, so I don't have any family history.  You should check to see if any other members of your family have had tremor.  If you have a neurologist who specializes in movement disorder you should probably make an appointment to put yourself at ease, but I wouldn't be too concerned.  Here is a link that explains more about movement disorders.  http://www.neurobc.com/conditions/essential_tremor.htm
Make sure to take care of yourself first because if you let yourself get run down you won't be able to help anyone.  Personally I find a mix of aerobic exercise and yoga or pilates to be the best stress relievers for me and I've learned to say NO when I start to get too much on my plate.  Good Luck, Kelley  

[Kelley1]

Dr. Kalra -- Thank you for your response.  I probably do need to get my blood checked again.  I forgot to ask my Internal Med. doctor to have it checked when the worst of the symptoms were going on.  My former PCP said he didn't think it was thyroid, but I have test positive for hashimoto thyroiditis in the past.  I took medicine when I was 16-17 years old, but not since. The weakness and tightness remain, but the twitching seems to have calmed down a bit, I am only getting it occasionally now.  The twitching started up a bit when I did the 3-minute deep breathing/hyperventilation in the EEG test.  Thanks for the comment of the blood testing.  If the symptoms aren't persistent now, would you recommend waiting until the next flare for blood testing or checking it now with less symptoms?

[DrKalraMD]

Hi, they are trying to find out lesions in brain which can cause the symptoms e.g. multiple sclerosis, white matter disease, ALS, etc. What about blood calcium levels and thyroid status?

[shugsryan]

Kelley,  I am a 39 year old female and I am experiencing tremors in my right thumb.  Kind of got me worried especially since I have seen that this could be signs of parkinsons disease.  I do lots and lots for my family and parents, I stay very busy doing for others.  I was wondering if maybe this could be a sign of stress and was wondering if maybe yours could possibly be stress or anxiety.  After all I believe in this world as a woman we stay stressed out.