Body wide twitching and atrophy in right foot

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Wokesimian

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Learn about ALS
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Hello, first off I want to thank all of you for the knowledge you give on the forum! You are all saints.

Now, some more about myself... I am a 26 year old male, about 5’9”, and around 320 lbs. I was a former athlete who played football and wrestled, and now coach both sports, as well as teach at my Alma Mater!

Anyways, I first started twitching about four months ago, and it started in my finger, but has spread since then to pretty much my entire body. I’ve gotten them in my butt, eyelids, calves, feet, hands, biceps, triceps, lower and upper back, stomach, chest, etc... The neurologist I went to wrote these off as anxiety related, as did the MD I saw before, and pretty much everyone else I have seen since. I notice they calm WAY down when I start relaxing and even seem to go away completely at times, but when I think about them or that I might have something like ALS they start goin crazy. Also noticed my limbs fall asleep a lot when I sleep, and I can’t sleep to save my life

Now, I’m not so worried about the twitching as I am the atrophy in my right foot. I noticed it about three months ago after looking at my feet while trying to go to sleep. First off, it’s flat, at least flatter than the other one, and I had never noticed before, and the neurologist I saw took note of it. Next, the muscles on the left side of my right foot are much smaller and less toned than the ones on my left foot, the neurologist did not seem to notice, or it was not of significance to her. Also, on the right side of my foot there is significant atrophy in my extensor digitorum brevis, and she said she noticed slight weakness when did the clinical test, but it was so slight there was basically no difference. Also noticed a lot of popping in that ankle recently. She asked if I had any back pain, and I said yes, and she said that could explain the atrophy in the extensor digitorum brevis that I have. I should also note that I haven’t really noted a change in muscle size or strength since I first noted the atrophy, and that I got turf toe before I noticed any atrophy that caused severe swelling of my toe, and I was on crutches and favored the other foot and heel for about a month.

At the neurologist, she tested all my reflexes and they were good, walked on toes and heels no problem, Babinski test was good, strength in all my other limbs were good, and she said although I am overweight she can tell I’m extremely muscular, and that I don’t have much fat on me. Before this I had bloodwork done that was normal, and an MRI of my head that was clear.

My neurologist said that young men my age come in all the time thinking they have ALS but it is always stress and anxiety related. I asked if she had ever diagnosed people with ALS before and she said yes, and that my symptoms don’t look like that. She said that no EMG was needed, not even to rule it out. I sorta called her today asking for reassurance and she scheduled an EMG for two weeks from today.

It should also be noted that I squated 500 lbs for one rep three months ago, and two weeks ago did the same (If that means anything...) without losing any strength or working out. Hypothetically speaking, if I had it I would’ve lost significant strength to the point that I wouldn’t have been able to do that right?

Here is another question, does atrophy come after the muscle has weakened and is unusable? She noted atrophy, but no significant loss of strength, she said it was so slight that she hardly noticed. So would that loss of strength be enough to make it atrophy that much?
 
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