21 year old male worried and anxious

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Apr 28, 2024
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Just to clarify i have read up on the 'Read before posting' thread but Iam still having issues and have become worried about my gradual progressive symptoms. Iam well aware given my age that a diagnosis of ALS/MND is extremely rare, but I have become extremely anxious and its badly effecting my quality of life. I also admire the courage of those affected by MND or who have loved ones effected and appreciate the generosity it takes to reply to those worried about symptoms who are not diagnosed.

Iam a 21 year old who works on my feet full time for long hours. In early February i noticed some light twitching in my right calf muscle which has spread to my left calf about a week or so later. These twitches were wide spread and now seem to be more concentrated to my outer gastrocnemius on my right calf ,although my left calf still does constantly twitch, as do random parts of my body but less consistently. I also have been experiencing some weakness where my right leg feels strange to walk on and can not keep up with the pace of my left (Iam right leg dominant)- although i understand this is very different to clinical weakness.

I saw a neurologist within a week of these twitches and received a clean emg and my strength seemed normal to her as i was able to comfortably do calf raises. the Neurologist did however point out some calf atrophy in the muscle where i initially noticed the constant and persistent twitch which was worrying. It is worth noting i have had a clean MRI of the spine and head to rule out any other issues. I have recently noticed my right leg becoming fatigued and i do not quite have the same agility as i did before, paired with the 24/7 twitching. It is worth noting iam still able to walk a few hours a day and do calf raises but noticing lots of fatigue, cramp and strain. I was hoping to get an opinion if it was worth getting a follow up EMG as it has been some months and this weakness seems more pronounced. Or if this sounded like possible juvenile ALS at all?

I also read that atrophy only really occurs after that muscle completely dies and there is no strength in there anymore, however i still have movement although slightly limited. but my symptoms are confusing and hard to work out. I also get the odd tingling sensations and cramping in random parts of my body like under my chin, hand and jaw ext along with body jerks, which may point away from MND? any advice or opinions would be really appreciated on if this sounds like MND, or how i should approach this if it seems like something else, perhaps even extreme health anxiety. Thank you
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We ask that people read here first: Read Before Posting. You will read that twitching absent clinical weakness and accompanied by sensory issues point elsewhere. We would not contradict the findings of a trained neurologist, so if your neurologist stated no ALS, then you must believe them.

If you still have concerns, please return to your doctor. They would be the one who could detect any changes, as they already have a baseline from your last exam.

Take care
You could have a subclinical calf injury or irritation. A lot of PTs are kind of off calf raises anyway, so I would consider working out with squats (including body weight ones where you lift your heels) and deadlifts that work your whole body, rather than targeting your calves directly.

A personal training session might help you pinpoint whether your mechanics are off bc of your calf or vice versa.

I would also track your sleep with a wearable, as diffuse twitching and odd feelings/fatigue in your leg can relate to the quality and quantity of sleep. You can also ask your PCP about being screened for a sleep disorder. Overtraining, anxiety, and a stressful workload can all contribute.

I agree that this does not sound like ALS at all.
thanks for taking the time out of your day to respond, I greatly appreciate it
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