Old 03-07-2019, 04:19 AM #1 (permalink)
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Default Questions about symptoms

Hi everyone. I am posting here for the second time, my first thread being that I was due for an EMG. The neurologist I went to here in South Africa deemed it unnecessary, although he did zero tests for any muscle weakness and is by no means an expert on ALS. He was extremely dismissive and did not examine me thoroughly at all.

I have read the sticky about muscle twitches not being indicative of anything without weakness. I am still concerned. The twitches in my calves are there 24/7 and have been for three months. In the past two weeks they have spread to my thighs, and now they are more pronounced in my back and stomach area too. My anxiety is consuming me.

30-year-old male. Blood tests all normal.

I would highly appreciate opinions on what I should do next?

Last edited by lgelb : 03-07-2019 at 04:23 AM Reason: added hyperlink
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Old 03-07-2019, 04:36 AM #2 (permalink)
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Default Re: Questions about symptoms

Our story will remain that twitching is not concerning. Anxiety only magnifies it, and I am sure you were also upset and frustrated after the neuro visit.

Truly, if you use the search box, you will find hundreds of people in your boat, whose most persistent issue is twitching, who come to ultimately understand through their lack of further symptoms that they do not have ALS!

What about the other issues like breathing that you had mentioned? If they have subsided or wax/wane, that is a good sign.

If you have further, progressive symptoms beyond twitching, i.e. the inability to do something specific, you could ask the MND Association there for a referral, but based on what you have said, I can't see what you would be walking into another neurologist to say or ask at this point, assuming you have had some kind of strength testing from your PCP (who can still do that if not). You could also discuss general health and strategies to address the anxiety with your PCP or find one that you like more.

Swimming, stretching, walking, tai chi, whatever helps your muscles elongate naturally that you like to do regularly, may also be helpful to pick up as a habit.
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Old 03-07-2019, 05:11 AM #3 (permalink)
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Default Re: Questions about symptoms

Thank you so very much for your continued assistance in replying. Fortunately the other symptoms I mentioned have largely disappeared and I believe were mainly just related to the panic I was feeling about the twitching.

My PCP did refer me for an EMG, which is why I was pretty certain I would get one from the neurologist. Not getting one, and not feeling happy with the appointment, has just left the uncertainty there.

I realise that anxiety is a big issue, and one that I am trying to confront through CBT. I have made lifestyle changes, exercising and eating healthily, but it has not made a difference so far.

I know that the possibilities of having ALS are minimal. I guess I am just going to have to wait it out for a few months, keep track of things and see whether anything gets worse? Perhaps I will try to arrange an EMG for peace of mind, as the lack of any sort of diagnosis is at the moment my main issue.
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Old 03-19-2019, 05:39 AM #4 (permalink)
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Default Report Back, New Symptoms

Good afternoon everyone.

I went to a neurologist about the symptoms I was concerned about in my previous thread. An EMG of my thigh muscle appeared fine, but she said there were "slight changes" in the EMG of my calf. Her exact words were however, that she "Does not think it's ALS". Unfortunately I did not ask for further elaboration on what she meant by "slight changes", nor did I get a printout of the EMG. Reflexes were brisk but not asymmetrical. Muscle strength seems okay.

In the past few days, my fingers, especially on the right hand, have been feeling stiff and slightly cold. This is particularly evident when picking up small objects. My twitches have subsided somewhat, but are now more widespread although less frequent.

I am still grappling with the thought that ALS could be the cause. Would someone provide some pointers? Do you think I should seek a follow up appointment or just wait a while to see whether things get better?
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Old 03-19-2019, 10:28 AM #5 (permalink)
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Default Re: Report Back, New Symptoms

I would go back to the doctor. There’s so many things it could be from a localized nerve problem to a musculoskeletal issue. It really takes a doctor re-examining you to sort it out — not something we can easily do here from a brief description.

The EMG sounds reassuring. Try to request a copy of it for your records. There’s usually a summary at the bottom. If you need our help interpreting it, then post a copy of the summary.
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Old 03-19-2019, 12:08 PM #6 (permalink)
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Default Re: Questions about symptoms

Mod note- merged with already open thread. Moriarty, if you could please keep posting here, that would be appreciated.
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