Could this be the beginning?

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shole1

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Hello,
male, 46, from Croatia(Europe).
My visible symptoms started in December 10, 2020, when I ended up at ER because of panic attack and that day I noticed twitching in my left calf. At the beginning of 2021 I started to limp(left leg). I had cramp in my left calf for a couple of days, after that strong pain in my heel and paresthesias in my calf. I was very worried regardless the fact that als doesn’t manifest like that, because of the fact that pain can occur in some cases at the beggining. Soon after that during sleep i noticed that my fingers and palm on my left hand are numb when I flex my elbow, thumb tendon started to snap, and my thenar hurts every time I use it(not while resting). So I made an appointment for emng on 19th January(left one in att) which all came clear. Since my symptoms got worse, twitching, myoclonus and a like was spreading further(I have constant strain of my right upper eyelid and in one point on my face) I made another emng on 19th March(right side in att) on different location which again came clear but this time with conclusion chronic mild neurogenic changes in L5-S1 area and dg radiculopathy. Since last month I have trouble with swallowing and occasionaly cough, feeling something is stuck in my throat and I need to clear it. I made swab, it was clear and my MD says it is probably gerd. She prescribed pantoprazol for two weeks. My therapy also includes clonazepam and venlafaxine. I also made mri of cervical spine which shows bulging discs c3-c6, and blood work which is ok. Now i walk pretty normally with occasional paresthesias in left leg. I have similar issues with my right leg, but for now to a lesser extend. My bicepses and forearms sometimes have burning sensations like they are about to cramp. Yesterday when i was washing my face, when I look in the mirror my SCM jerked once so hard that IT really scared me.
How is it possible that chronic neurological changes progress in only 2 months? Should I be worried that “something is happening”?
What is the dynamics of these changes?
So, for now, I have dg radiculopathy L5-S1, obviously carpal/cubital tunnel syndrome(I hope so) and gerd, practically all happened in short range of period, and that is the most suspicious to me.
Can this all together eventually, in some time, turn into als?
Thanks in advance for your (constructive)replies, I really appreciate it.
Best regards!
 

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affected

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I'm sorry you are having so many issues. This is not pointing at all towards ALS, but you need to just keep working with your doctor as you need one person who can keep examining you over a period of time. That way you can get a good indication of any changes that are truly happening.
The diagnoses you have should be addressed and you may find that in only a month or two you have much relief of most symptoms.
 

lgelb

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None of these diagnoses has anything to do with ALS, and all are common. The test you posted was the NCS, but the more pertinent test to ALS is the EMG, if you want to post it.

To address your discomfort, I would ask for a physio referral from your primary physician. I would guess that you have overexerted yourself physically at some point, and it's catching up with you. It doesn't have to mean that all this began just a couple of months ago.

The SNRI and benzodiazepine that you are taking can actually cause some physical symptoms and the clonazepam in particular is usually not a drug that you want to be on long-term. So you can also discuss the strategy for tapering or continuing the drugs with your doctor.

Best,
Laurie
 

shole1

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Thank you so much for your responses, I really appreciate it.
Something isn't clear to me: my left hand tingles during flexion in the elbow, especially when sleeping..
if I lean my elbow on the car window when driving, my palm tingles due to pressure in the elbow..
the left thenar fails.. hurts when flexed, my tendon near palm snapping and I notice a slight atrophy ..
fist grip is a little weaker and my fingers kinda hurt when squeezed ..
these would be the symptoms of a carpal / cubital tunnel?!?
And my neuro says it’s not carpal/ cubital syndrome, because it would be seen on emng.
What could then be the cause of the problems with my fist?
Also, my left calf is visibly smaller (peroneus area)-my wife confirmed it, but I still walk normally, with tension in the dorsiflexal part and tibialis anterior and I can walk on both toes and heels .. is that normal?
 

affected

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I'm sorry none of the members here are doctors so truly, no one here should answer what they think symptoms you report are.
I would however say, and I'm quite serious, don't lean your arm on the car window while driving, sit correctly and straight, with both hands on the wheel.
We know ALS really well and can help discuss that one disease.
You need to go back and ask all these questions of your doctor who can examine you and discuss it fully.
ALS is a disease that starts in the brain and affects motor nerves, you don't feel anything like tingling as they are sensory nerves.
All the best.
 

shole1

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I’m driving with my both hands on the wheel, I lean my left hand only when I stop on traffic lights or alike :)
Ok, let’s stick to thenar. One of the more knowledgeable pals told me that first muscles on arm that stops working and atrophies are thenar muscles.
In my case thenar hurts when flexed, and tendon around thumb snapping.
I don’t have any weakness in arm so far.
So I’m just asking if anyone maybe had a similar situation?
Pain that occurs when thenar flex points away from als or?
Does the pain appear when muscle is damaged or in process of atrophy?
If medianus and ulnaris are motor/sensory nerves, and during sleep I feel numbness in hand(nocturnal paresthesias), and I don’t have weakness or trouble with finger movement so far, does it means that only sensory neurons are affected, that also points away from als or?
Sorry if my terms are not on point.
Best regards.
 

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I've had ALS for a number of years. My thenar muscles are completely gone - just have depressions where they used to be. I never, ever had any pain or numbness. First symptom in hands was inability to hold my fingers together/touching - just couldn't do it. With ALS, dying motor neurons do not hurt or cause numbness.
 

affected

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Here is a link to read through carefully that will help you.
It really helps our paralysed members not have to answer the same thing over and over.
No pain when flexing muscles, no numbness so this is really good news as everything you describe is always pointing more and more away from ALS.
Please work with doctors as our PALS don't experience what is happening with you, they are the only ones examining you. This is great news and I truly wish you the best as a diagnosis and treatment are worked out.
 
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