Concerned about symptoms (approx. 4 months)

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22anxiousmale

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First, thank you all in advance for your care and responses. I sincerely appreciate the effort and kindness and will hopefully be out of your hair soon.

I'm a 22 year old male with a history of health anxiety. No FALS. 4 months ago, I finished a course of doxycycline for early-stage (1 week from bite) Lyme Disease - I had no neurological symptoms during or before treatment, with the exception of spontaneous tinnitus in both ears which persists to this day. Once I finished the course I began fixating on other diseases I thought I had, and in this time, my muscles began twitching constantly. No weakness, but definitely globus (assuming it was benign). The twitches got better for a time, and then came back at the beginning of this month. They've been primarily in my legs and feet, with some involvement from my back, shoulders, abdomen, arms, hands, and face. Along with this, I began feeling subjectively fatigued - still able to do everything I need to do, but my legs feel like they get tired far more easily. My lower back feels *off* - not quite pain, not quite weakness - but I've been a bit hunched. When I walk, it feels like my knees are not bending as much as they should, which makes me feel tight in my knees and hips.

Last week I went to a Neuro who performed a clinical exam - no clinical weakness or atrophy, normal reflexes (except absent plantar reflex, bilaterally), and he actually did not observe (nor did I feel) a single fasciculation during the appointment - but no EMG or anything else.

Now, I've read the "Read Before Posting" thread a bunch, and was hesitant to post, but in light of all this, I primarily had questions regarding the nature of my twitches. They primarily happen at rest, but can occasionally be elicited by movement - in which case they occur /after/ movement, not while the muscle is contracted. If a muscle is twitching, the twitch stops when I contract and sometimes comes back once I release. Additionally, when I wake up, if I just lay in bed I generally do not twitch; once I move my legs or roll over, then twitching begins. The only other twitches that I can elicit are my right (non-dominant) thumb, which pulsates/contracts after tightly pinching an object; and my eyelids, which often twitch after being closed tightly. Occasionally when I focus on it, I also feel that my legs vibrate.

I understand this all points away from ALS, and I am in the process of beginning treatment for my anxiety. Currently, my concern is the possibility of LMN involvement preceding UMN involvement in my case. My primary question is whether, according to what I've described, I should seek another opinion or an EMG, or whether the thought of ALS should cross my mind at all.

Apologies for taking up your time, and I am immensely thankful for any advice you can provide. God bless, and hopefully I will soon be out of your hair!
 
One addition: I woke up this morning feeling not quite short of breath, but more like I can't quite fill my lungs on a deep breath. Seems to be about the same when I lie on my back, no worse no better. Thanks all!
 
Twitching is common, nonspecific, and meaningless in the absence of muscle function failure which you have not described. The nature and character of the twitching is irrelevant. Anxiety can make twitching worse. Nothing in your post suggests ALS. The neurologic exam along with your history clears you of ALS. An EMG is not necessary.

I’m glad you are starting treatment for your anxiety. It’s also important to develop other hobbies and interests and to stay away from forums such as this which can fuel anxiety.

Best of luck.
 
Thank you very much for your reply. I have just one more question and I'll be out of here - I noticed some new tongue indentation yesterday that wasn't there about a month ago (having perused the forums enough to know how nasty tongue pics are, I'll spare you), it's bilateral, perhaps /slightly/ more pronounced on the left side. Without noticeable changes in speech/swallowing, is it fair to assume this is most likely just scalloping, not atrophy? I.E., is it fair to assume that the weakness would have been noticeable before any tongue atrophy? I have occasional tongue fasciculations at rest, but I don't think I've ever been able to hold my tongue totally still, even when it's resting on the bottom of my mouth.

Thank you so much & God bless!
 
Stop looking at your tongue in the mirror. Dents are irrelevant.
 
Point taken. Thank you again - I'll see myself out.
 
(Done with this, just wanted to check. Donated to ALSA + the forum, thank you very much and feel free to close the thread.)
 
Thread closed per request
 
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