Leg pain/weakness & globus sensation

[koopatroopa]

29 y/o male, 5ft 10in. Last Nov, woke up with acute neck pain, exacerbated by moving my head. Resolved within a week. Since mid-May: tingling, warm sensations, mild pain in both legs but greater in the left.  Pain is worse by standing and relieved by laying down/sleeping.  In last month, been having widespread fasciculations, which had me concerned for ALS. In last weeks, leg pain eased after taking NSAID's but legs feel week. I still do get bouts of tingling in both hands (little fingers) and some neck discomfort. In the two weeks, feel globus sensation in throat with hoarse voice that's been chalked up to heartburn and NSAID's...of course, this has me concerned for bulbar-onset ALS.  

Imaging studies/tests:after right facial numbness/headaches in June, I went to ER, where a brain MRI was neg. but found Chiari I malformation with no syrinx, and C3/C4 herniation w/ cord compression. Full spine MRI was negative for syrinx. All neuro exams normal.  2 neurosurgeons r/o Chiari Malformation was culprit, since no headaches and symptoms are not aggravated by exercise or the Valsalva. Currently awaiting cervical disc replacement w/ Prestige disc with a ortho. surgeon who recommended 2nd neuro opinion, as he felt that leg pain was unusual with cervical cord compression.  New neuro is equally skeptical and thinks it may be a systemic issue.  EMG/NCV of three limbs normal. Tibial SSEP pending. CK, Sed Rate, ANA panel, Compl. Metabolic Panel, Fasting Glucose, Hemoglobin A1C, B12, Lyme, RA normal.

I am starting to wonder if my health issues may be thyroid-related (no TSH test ran yet).  For the last year, I recall having bouts of body-wide itching. I've always had a high metabolism...plenty of energy and unable to gain weight despite a healthy appetite (I am 135 lb. and 5'10"). For last year, glucose borderline high @ 104. I've just read that hyperthyroid can cause fasciculations/weakness, and globus in throat. But what about leg/joint pain? Is thyroid test warranted?  

[anniejack]

A related discussion, too much medicine was started.

[Mark Lupo, M.D.]

The thyroid levels are all normal, including the TSH - cannot attribute the symptoms to thyroid dysfunction.  I hope you are able to work with the neurologists and neurosurgeons to get to the bottom of this.

[koopatroopa]

Well, I went ahead and got a thyroid panel done.  TSH=0.62, Free T4=1.4, Free T3=3.5.  Even though the values are within their respective reference ranges, isn't the TSH a bit low?

Thanks.

[koopatroopa]

I forgot to add that the NCV found mild ulnar entrapment/neuropathy which most likely explains the pinky fingers tingling.  A repeat flexion/extension cervical MRI last week failed to demonstrate any gross sublaxation, but reconfirmed the C3/C4 herniation with mild ventral cord compression. At this point, I am still a bit concerned about ALS due to the globus sensation in the throat, as it's unlikely that the disc herniation is causing that and the EMG was not performed on bulbar muscles.  In looking for alternative causes to my constellation of symptoms, I stumbled upon the thyroid topic.

Thanks for reading and your opinion.