Myclonus, abnormal fatigue in legs , Podromal phase

[VivPa20]

Hello everyone ,
Thanks in Advance for reading this post .
My husband who is 54 years old started at the end of May (almost 4 months ago) with myclonus in left shoulder , and left fingers , rest less leg and with the myclonus ( during the day as well as nocturnal ) itch was present too for some reason . A couple of weeks later intermittent fasciculations in both calves (after waking and during sleep ) ,and left deltoid .
My husband actually started with abnormal fatigue in legs for 2 years now ( , below knees only ) after playing soccer and now is even after long walks . We , saw a Neurologyst , normal clinical and normal Emg . Dr said he is fine “now “ and didn’t elaborate . We need to scheduled a follow up appt .
I have read your post and understand that weakness is crucial to make a diagnosis .he doesn’t have it .
My question can he be in a prodromal phase of ALS . ? Can mild motor impairment ( reduce excercise tolerance, constant calves stiffness ) show early on EMG ? . Some of His symptoms were so abrupt back in May and they remain that I am extremely scared . Neurologyst who did EmG has an expertise in ALS patients .
Thanks from the bottom of my heart for reading my post and answer my questions.
Vivi

 

[Nikki J]

The ALS specialists won’t call prodromal with reduced exercise intolerance and stiff calves ( but apparently no spasticity as a normal clinical exam. ). I know someone who is a documented carrier with some abnormalities on exam that was told not prodromal as their emg was normal. And Dr Benatar’s examples in a presentation for mmi all had abnormal emgs if I recall correctly

Exercise intolerance is pretty non specific

 

[lgelb]

There are good drugs for RLS. If he has it (a sleep study to find out for sure and rule out other sleep problems might be appropriate), that would be a starting point once B vitamin and iron deficiencies are ruled out. If he's not a big greens eater, a low-dose magnesium citrate supplement might help.

RLS and similar movement disorders can show up during the day as well, but the main thing is, they disrupt sleep and make movement/energy use harder overall.

 

[VivPa20]

Thank you so much to both of you .!!
I understand abnormal fatigue in legs is not specific but when I put everytthing together myclonus ,intermittent fascocualtions , constant calves stiffness , some weird movements during sleep , his age and all this was so abrupt that even remember the day and the time when myclonus started I can’t help but ask myself all this questions and think about Als.( from what I read ) .
Neurologist told me EMG normal is very reassuring but let’s see him in a few months just to make sure and another neurologist said if he develops weakness then it is time to scheduled appointment . All this leaves me confused and we still don’t know why he is having all this symptoms ( blood work fine , brain MRI fine ) we decided to go for a sleep study , neurologist didn’t even mention it . We want to go for it . It is very confusing . I thank you for your patience .

 

[VivPa20]

Hello everyone ,
I wanted to ask if anyone had myclonus especially nocturnal as an initial symptom of ALS .This is one of the most prominent symptom my husband has at this time . As I mentioned before the initial symptom was so abrupt it was like if his nervous system was on fire . I am just wondering if myclonus is seen in ALS especially at onset because literature is not very clear about this .
Thanks so much in advance for any feedback . I am very concerned .
Vivi

 

[VivPa20]

Good morning and very sorry to bother … does anyone have an answer for my question about myclonus ? . Thanks in advance for your feedback .

 

[Nikki J]

I don’t believe it is an ALS symptom. I don’t know what is wrong with him but it doesn’t sound like ALS.

 

[lgelb]

I'm glad you're working on a sleep study, which could be very revealing.

 

[VivPa20]

Thank you very much Nikki and Igelb !! . It has been a very stressful time . Let see what happens . Praying.