Advice please....

[JimmyF]

Hi – male aged 47, here my history is below, would be very grateful for some input.
For just over 2 years (since Sept’15) I’ve had fasciculations – started suddenly in my calves one day. They have been constant there over the 2 years and have spread – I get them on my back and sometimes arms, have very occasionally seen on my cheeks (eyelid twitching too). Fairly constant pain in legs over the two years, and over the past 6 months or so a “radiating” type back pain. During these two years my balance has been intermittently off. 2 Neuros (one of whom did an EMG have seen the fascics).

Suddenly last week a couple of new symptoms came on

A “weakness” in both hands but particularly the right – it’s odd, I can still use my wrist grip thing for wrist exercise, but once I’ve used it and put it down I can barely open the hand for a couple of minutes. Fingers appear more sluggish when typing and “slower” and less precise.

A pressure under the chin – voice is more hoarse, and feeling of pressure in nose (feeling of pressure in nose I had had for quite a while intermittently). Swallowing feels weaker. Went to my local doctor, said there was no evident swelling of glands.

Balance has felt worse, and I’ve had calf cramps a couple of times in the past month, along with a painful left shoulder and elbow.

And now, “obviously”, I’m starting to think I can see atrophy in my muscles….

In terms of testing, after 4 months of twitching I had an EMG and NCV study (done on the calves, the Neuro could see them twitch at the time). And 2 MRI’s at the time, and a further MRI at start of this year. All fine. Blood work was extensive and normal.

I don’t lurk on this board, and believe it or not hadn’t given much thought to having ALS/MND despite the constant fascics over a lengthy period (I am at work, a desk job) but am thinking of asking for a Neuro referral and some more testing. I had thought there was a possibility i had progressive ms (though i know fascics aren't a classic symptom there).

Please could I have some thoughts on this, does this sound like a presentation of ALS?

 

[Clearwater AL]

Jimmy, second from the last paragraph...

"In terms of testing, after 4 months of twitching I had an EMG and NCV study (done on the calves, the Neuro could see them twitch at the time). And 2 MRI’s at the time, and a further MRI at start of this year. All fine. Blood work was extensive and normal."

You probably won't like this but... most of your symptoms point away from ALS but do point towards Anxiety. Anxiety can create symptoms that seem real. The more you read about ALS the more anxiety will bring on your thoughts seemingly to relate to them.

Yes, ask your Neuro for another referral but accept what he/she may say.