Wife and I - Similar Symptoms within Weeks: Viral Origin?

[biofed]

I'm a 56 year old M.D. 2 months ago, my wife, also 56, noticed a fasciculation in her thumb which has progressed to bilateral calf, foot, buttock, and to a lesser degree, abdominal twitches with some calf cramping. No weakness. Neurologist was not impressed, no EMG done. About 6 weeks after her symptoms started, I began to have fasciculations, mostly right calf and foot, but also bilateral (left leg, foot), and some in abdomen and now arms. I also have cramping, mostly in feet and calves. My feet also hurt upon walking, I believe similar to plantar fasciitis. Neither of us have any objective weakness; we've done every conceivable strength, balance, heel, toe walking, foot drop test, etc. I haven't had an EMG either, but was told by a trusted neurologist friend that it can change from negative to positive.

Any thoughts on the above, and the possibility of a viral explanation for our symptoms occurring within weeks of each other? I've read about a possible viral cause of BFCS. Thanks.

[notme]

As a physician, why not ask for an EMG to put your mind at ease?

I'm sure that as a doctor you've heard of sympathetic symptoms...such as when a man has morning sickness when the wife is expecting. Is that possible?

Is it possible your wife has a vitamin deficiency that you share? B-12 or potassium?

When we reach our age, things just start to go. Normally, the steps would be blood tests, MRI and EMG.

While we may think benign fasci/cramp syndrome, it would be irresponsible of us to say that is the problem when neither of you has had any tests as of yet.

Is there a chance of a toxin in your home? Have you both started any new supplements? We're either of you I'll with a viral type complaint recently?

Lots to take into consideration...but it sounds to me like an EMG would be ordered if there was any doubt. As a MD, I'm sure you could order one for your spouse? Although I do realize its frowned on to write orders for friends or family.

It could well be nothing, but I will say that foot pain doesn't sound like a presenting symptom...nor do fasci without weakness.

Good luck to you both.

[notme]

Off to moderation.

Request E M G was the basic comment ... If only for peace of mind. Pain wouldn't normally be a pre sent IMG sym ptom
In ALS.

[ghost_writer]

Blood work up? Have you screened for heavy metal?

[CGARS]

Viral?
Absolutely.
Explain how my wife and I fairly young(me 40, wife 36) can have all this within a year.

me - 2 cerebellar strokes, and confirmed ALS diagnosis.
Her - 3 bouts of shingles, and Bells Palsy(now has CAT appointment, as ENT thinks it was a stroke)

Oh, and the kicker... Vet who does not know our med history, thinks my dog may have a MND!

Sorry, not hijacking, just agreeing it could be viral.

Good luck, Doc.

Casey

[patricia1]

have you both traveled out of the country ?.Were you checked for lymes.?Do you have well water ?.Were you checked for heavy metals?Do you eat a lot of sushi .?
have you changed diets or new supplement
How about moid in your home

Emg should be done
What kind of doctor are you ?

[patricia1]

[quote=CGARS;239266]Viral?
Absolutely.
Explain how my wife and I fairly young(me 40, wife 36) can have all this within a year.

me - 2 cerebellar strokes, and confirmed ALS diagnosis.
Her - 3 bouts of shingles, and Bells Palsy(now has CAT appointment, as ENT thinks it was a stroke)

Oh, and the kicker... Vet who does not know our med history, thinks my dog may have a MND!

Sorry, not hijacking, just agreeing it could be viral.

Good luck, Doc.

Casey[/qu


Quite a story .Too bad House isn't a real doctor .You both had your share of sickness .
Hopefully its a coincidence .
My dog did have mnd as well
and seven of my neighbors have autoimmune disease .

Patricia

[CGARS]

Originally Posted by patricia1

You both have als.omg so sorry

No, just I have ALS.

Lets not get too crazy!

[TedH5]

Not for nothing but why as a D r are you posting on a forum asking non medical experts? I hope both you and your wife are OK? Obviously as a D r I do not need to tell you that the odds of you and your wife both showing A L S symptoms at the same time are extremely remote. I am not a D r and obviously you are but I would have a spinal tap done for you and your wife and see what they find in your fluid. If it is viral and impacting your motor neuron system they should find something in the CSF.

[biofed]

Thanks very much for all your insightful replies. To adress your questions: First, TedH5, I'm asking you folks about these issues because, as a doctor, I know that doctors know far from everything, and that well educated patients often are excellent sources of reliable information on their conditions. (A neurologist I saw a few weeks ago knew less about ALS than many of you do). I do plan to stop our exterminator service to rule out organophosphates. My wife and I do eat a lot of sushi. I'm a psychiatrist. My wife does remember not feeling well prior to her symptoms beginning. So, due to: the lack of weakness in either my wife or myself, the rapid spread of fasciculations and cramps to multiple body locations over a few weeks (not months or years), and our closely-timed emergence of symptoms, I'll assume and hope that this is either viral or toxic related, and not ALS. We'll base our future work up on whether the symptoms progress, remain the same, or go away. Sound logical? And thanks, again. I wish everyone the best and appreciate your responses.

[patricia1]

Originally Posted by TedH5

Not for nothing but why as a D r are you posting on a forum asking non medical experts? I hope both you and your wife are OK? Obviously as a D r I do not need to tell you that the odds of you and your wife both showing A L S symptoms at the same time are extremely remote. I am not a D r and obviously you are but I would have a spinal tap done for you and your wife and see what they find in your fluid. If it is viral and impacting your motor neuron system they should find something in the CSF.

We don't know what kind of doctor he is?I agree CSF should be done

[TedH5]

Originally Posted by patricia1

We don't know what kind of doctor he is?I agree CSF should be done

We know he is a medical Doctor...Has any DR you have had an appt with ever asked you for your opinion on what is wrong with you or themselves?

Besides they are a fraternity they have plenty of resouces besides a forum of patients.

I am just saying, it seems odd to me but there is probably a reasonable explanation.

[patricia1]

Hmmmmmm! very interesting

[biofed]

Thanks for all of your responses.

I wrote a long response this morning that somehow was not posted. Anyway, I'm a psychiatrist. I'm utilizing this forum because patients are often excellent sources of information on their own conditions, and this board seems to be a great example of that. In fact, many of you are more knowledgable on ALS than a neurologist who recently examined me. Good doctors learn from listening to patients.

I will look into environmental causes for our symptoms, as some of you suggested. I am not going to rush into extensive workups of myself and my wife, but will take a "wait and see" approach for the next several weeks, assuming a viral etiology. I honestly think I feel better already just over the past 24 hours due to your site's information, by calming down, and by being rational about our symptoms and their presentation and time line.

Although I'm encouraged by our complete lack of weakness, I have seen contradictory info on weakness preceding or following fasciculations, even within this site. I know that weakness with loss of function is usually first and what leads a patient to treatment, (preceding twitches and cramps), but I'm curious if anyone knows the time frame for weakness coming after fasciculations and cramps have begun. I'd also like to know the general time frame from spread of ALS from one limb to another. (Again, we've both had fascics in multiple locations over a period of less than ~ 8 weeks.)

Thanks again for all your help and concern, and I wish all of you the best, as well.

[Alyoop]

It is extremely odd, to be consulting a forum. It's not how doctors work, believe me !