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chapmen

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Learn about ALS
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MN
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Minneapolis
Early 30s,male, slim athletic build, with long history of metabolic issues and chronic insomnia stemming from from stress and anxiety.

3 Months ago I was trying to go to bed and I had widespread rapid vibrations/twiches all over my face and head. They then seemingly spread to all over my body, they feel like small vibrations, most noticeable when I am sitting down. I also have issues with numbness, parts of my body falling asleep, etc, that has existed for more than 3 years. The twiches are not new, but I always attributed them to fatigue, insomnia, but they have been more frequent since I had a concussion 3 1/2 years ago. What is new is that they are going almost non-stop, 24/7 all over my body.

I had emg done 3 months ago after the facial fireworks episode, it didn't show much but mild slowing of motor conduction across elbow. "there is evidence of focal motor demyelination, but no axon loss"

A few weeks before that I went in for clinical exam from Neuro and I was extremely anxious and sleep deprived, extremely, and fasting, so I felt light in the knees and out of it.... he did exam and noted brisk reflex with both my knees (my brother has same brisk knee reflex and he is younger and without any serious illness)
but the doctor also noted mild cross abductor and biceps with vertical spread. No babinski, although on my right foot, my pinky toe fans out. I can't find anything in the literature on this.

Follow up he said good news, emg was good. I told him, but what about the reflexes, those are pathalogical reflexes for ALS, and he said, yes but there is no pathology.

So is this ALS waiting to happen like everything I'm interpreting seems to indicate or am I off here?
 
You probably already know that there is no test for ALS, not even an EMG. Lots of things must be considered, and everything else must be ruled out. The EMG is just one tool. Important, but not everything.

The Big Deal in ALS is weakness. Specifically, a muscle that does not contract, for no apparent reason, with no pain or exhaustion or feeling of weakness, no burning or weird feeling. It just doesn't work.

Reading your description, including the part where the neurologist reads the EMG and says you're free to go, leads me to say you're good to go. It also sounds like he saw no evidence of weakness.

Focal motor demyelination is not necessarily ALS; it could be just an elbow problem. But I'm no doctor. Since you are unsatisfied with your knowledge of the EMG, you may want to get a message to him, asking him to explain in more detail.

Hyperreflexxes can be several things, including normal. Twitches can be anything, or nothing at all. So he's right, your physical symptoms don't say ALS.

If you're still concerned you might have an undiagnosed terminal disease, you might want to ask for referral to a second opinion. Personally, I would ensure my second opinion came from a neurologist who specializes in MNDs.
 
Yeah, no real weakness, but I am younger than most who are diagnosed, and have muscle on me....not sure if that is relevant or not.

What concerns me is falling vit. d and my calcium rising right at the time the twitches went overboard. From what I've read loss of calcium homeostasis plays a big role in the death of the motor neurons.

Thank you for your post.
 
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