Worried after EMG / MRI

[jw242]

Hello,

I told myself I would stay away from posting here because I figured I was working myself up for nothing. I have read the sticky and know most of my symptoms (sensory - pain, numbness, tingling / burning) point away from ALS. I am a 29 year old male. I do have bad anxiety and depression that have gone unchecked since having to quit going to the gym due to the pain. I have started counseling and am going to see a Psychiatrist soon. I have three children and a fiancé and am just frightened.

My symptoms started at the end of June after getting a tooth infection and having it pulled. I was laid up on the couch most of the week leading up to it and the day after. I awoke one day to a shocking / burning sensation next to my armpit on my back whenever I’d reach up. This went on for a week and went away but has been numb since. I returned to my normal activities (work, working out, etc.) I was jogging up the stairs and felt the same sensation in my ulnar nerve. A few weeks go by and my entire arm and hand starts hurting. After using my arms they feel bigger and crampy. Similar symptoms start in my left arm but to a lesser degree. My arms feel weaker and heavy, although I can still do everything (outside of the offending motions that cause flare ups) I just get tired easier. Diagnosed with tennis elbow. Started physical therapy and she tells me she thinks it’s not tennis elbow but a nerve issue in my back. Saw ortho and he says I have cervical radiculopathy after cutting me off before I get to my left side symptoms. Says it will be better in six weeks and to continue PT. Around this time I notice my muscles are incredibly twitchy, especially in my arms and legs. This is where my spiral starts with ALS fears.

I noticed my hands are always cold and finger nails are turning a purplish hue. I am also having tingling, burning and stabbing pains in my hands and forearms, especially at night. I know circulation is not an ALS symptom but I go to my PCP and he orders and EMG on my arms. I will attach the actual EMG but here are the impressions:

1. Electrodiagnostic Evidence of a Moderate acute Right C8 and Mild acute Right C6 and Left C6, C7 and C8 Cervical Radiculopathies. This pattern is often seen with cervical myelopathy but he denies any significant balance or bladder habit changes therefore I have no other evidence that would support a myelopathy. He has symptoms in the left flank which strike me as T3 level but I was unable to prove any upper thoracic radiculopathies on the left. Nevertheless, given his CT scan and his symptoms, I am nearly convinced that the left flank symptoms near the armpit are a T3 (or adjacent level) sensory radiculopathy. He could have pressure on his cord at T1 or T2 which could manifest as his left near armpit symptoms as well.
2. Electrodiagnostic Evidence of a Mild Ulnar Neuropathy only at the Right Elbow. There were no other noted ulnar neuropathies bilaterally.
3. No electrodiagnostic evidence of any carpal tunnel bilaterally
4. No electrodiagnostic evidence of any brachial plexopathy bilaterally
5. No evidence of any other nerve injury or disease noted bilaterally today
6. Note that he has at least some hypermobility, which would make him more susceptible to neurologic injury from trauma.

I know radiculopathy can mimic ALS but I try to put that in the back of my mind because my neck and back have been hurting since starting physical therapy.

I continue my physical therapy but nerve pain starts to get worse. My legs start to tingle and have weird sensations. I start to feel shaky going up and downstairs. By now my twitching is all over my body. Every other morning I wake up and my foot arches and toes are twitching until I start moving. It hurts to walk and I get random aches in my calves, ankles, hamstrings. I can feel my throat and ears twitch.

My doctor ordered an MRI for my cervical and thoracic spine. I had been holding onto the MRI to show something to explain everything going on but I had the cervical spine MRI yesterday and it was completely clean.

I am at a loss and just maybe want some reassurance. I have seen EMGs that look like mine and end up being ALS and I’m just scared. I apologize for the long winded post and I wish you all the best.

 

[ShiftKicker]

Hello-

It's pretty clear you've read the "Read Before" post, as you do acknowledge your symptoms do not align with a motor neuron disease. You do not seem to list the hallmark symptoms of ALS, which is clinical weakness/muscle failure.

I think you may be scratching an anxiety itch here- you know you don't show the symptoms of ALS based on all that you have read already, but you want a real live person on this forum to tell you so. Hopefully you will be able to track down what the real cause of your symptoms is, as it certainly sounds distressing for you. I heartily encourage you to stop researching ALS further and continue to work with your doctor, following their guidance on next steps- and also continue going to see someone to provide you anxiety support while you search.

Please take care

 

[jw242]

Yes, I think you are correct. I think the thing keeping me spiraling is the EMG with PSWs / spontaneous activity and the widespread twitching. The nuerologist did shut me down when I even said ALS with “ALS does not cause numbness.” but anxiety doesn’t listen to reason. I appreciate your reply.

 

[jw242]

Just wanted to update, got a Neuro cancellation with his PA and he did a clinical examination and said it was completely normal. Took my EMG to the attending physician and walked back into the room and said “You do not have ALS.” We are going to do another MRI with contrast and test for some things and have a follow up in November.

It is still in the back of my mind a bit but I will do my best to put this behind me and continue to seek help for my health anxiety.

All the best to you all.

 

[jw242]

Just wanted to follow up one last time for people that don’t want to listen to their healthcare professionals (like me.)

Neurology re-ordered my EMG and it came back way better this time. We discovered I am very hypermobile and that makes me way more suspectible to neurological injury. They think I had a minor spinal injury that wouldn’t necessarily come up on an MRI and they see it happen relatively often. I still have some symptoms, but they are also getting better.

Feel free to lock this thread, I just wanted to tie up the loose end for people that obsessively check this forum and may be having a similar issue.

 

[lgelb]

Thank you for stopping back, JW. It does help others. Given a finding of significant hypermobility and your other issues, you might want to ask the neuro if they think you should consult with a connective tissue/medical genetics clinic to rule out conditions such as EDS and Marfan. These are best addressed earlier than later.

Before I close this, I will highlight the mention on your EMG report of Wellbutrin's association with jerking. Many antidepressants, including Wellbutrin (bupropion) and all the SSRIs/SNRIs and more can cause jerking, twitching, disrupted sleep, and potentially worsen depression/anxiety to the point that some people commit suicide.

If an antidepressant is not working for you, or you begin to experience things that you don't like, do discuss options with your prescriber. For most people, "soldiering on" or adding another psychoactive drug to counteract side effects of the first one is NOT the best answer.