Concerned about new symptoms.

Jd1030

New member
Joined
Feb 26, 2024
Messages
3
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Learn about ALS
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00/0000
Country
US
State
CA
City
Santa Paula
Previous thread here: Concerned About ALS

My name is Jose and I am 32 year old male. I started with trouble swallowing in September 2023 and was referred to a GI Dr for an endoscopy and there was nothing concerning. I was then reffered to an ENT Dr who ordered a barium swallow test. The test showed I had a mildly delayed pharyngeal response and mild slowing and stasis of the proximal esophagus. I was reffered to a neurologist as both the GI and ENT did not find any explanation to my symptoms.

I don’t have any aspiration. My lips, tongue and chewing msclels are good. It’s just that the food or drink doesn’t flow automatically to my throat I have to process and think about it. Then I make the decision to pus the food or drink to the color my throat. I recently about 23 days ago began with muscle twitching in my feet particularly in the vein of my ankle bone. Also in the calves, quads, hamstrings, shoulders, biceps, and triceps.

In my hands my left hand ring finger and my right hand middle finger are twitching, the twitching is not constant but it is bothersome and is intermittent throughout the day and more prevalent at night. I have told my PCP and he performed an asssesement and did not see any twitching and deferred any further evaluation to a neurologist.

I had an initial consult with a neurologist 10 days ago in which he gathered medical history and performed a physical examination. He did not see any issues with my physical examination a 5/5 in all muscle groups and reflexes are 2/4 head and mouth muscles and walking is exceptional. The neurologist advised that objectively he does not see any abnormalities in the physical examination. There was no clear fascinations in the 45 minutes he took evaluating me and in the appointment. He sent me for an MRI of then brain and brainstem. I have a follow up in 4 months.

For about a month now I’ve noticed that I have been dropping things and tripping/ losing my footing. Most recently in the last week I have noticed weakness in my arms at my elbows and weakness in my quadriceps/hamstring, knees and calf’s which also feel like soreness and burning. I am concerned that I may have ALS. Please let me know if you see any symptoms or if it sounds like I should be worried.

Follow-up as my last thread is closed for further replies.

I had an NCV/EMG in June in which the neurologist said was normal. He did note that I have a mild/postural action tremor or physiological tremor.
He did note any muscle atrophy, weakness objective sensory loss or fasciculations.

The emg showed normal insertional activity, spontaneous activity, motor unit apmlitude, motor unit duration, recruitment and interference pattern.
No polyphasic potentials.

I still continue with problems swallowing. I feel it’s actually getting worse and randomly though out the day I choke on my own saliva.

For the last 10 days I have been feeling noticing twitching in my abductor polics brevis at the base of the thumb on my palm twitching of my right hand. It twitches for a few seconds then it stops for 3-4 minutes and then twitches again. My thumb also twitches and my index finger hurts when I bend it. I talso twitch all over on my left hand both arms, legs and feet. I feel my hands are weak and have a hard time opening bags such as chips.

Thank you

-Jose
 
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It sounds like you've had a good workup and ALS has been ruled out. If you have anything wrong, it seems more systemic, possibly post-viral even if you don't think you had Covid, so I would keep in touch with your primary care clinician.

Remember, there is great variability among humans. A delayed pharyngeal response does not mean that there is anything treatable, other than modifying your diet to what is comfortable for you. It can help to drink sips of juice (not citrus or tomato) before, during, and after eating, and avoiding plain water if it's irritating.

And of course if you need counseling to get past these fears of ALS, certainly seek it out for your own wellbeing.
 
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