Need advice with these symptoms

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ryanb

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Hello and thank you for taking the time to read this as it is a bit long, so for that, I apologize. I appreciate your time and knowledge.

I've had some very odd symptoms over the past 2.5-3 months. It all started with a sudden onset of constant belching, not matter if I had eaten or drank anything. Within one week I began to have strong heart palpitations (extra beat every 20-30 beats) so about 2-3 extra beats a minute thought it never turned into afib or anything sinister. Had a heart monitor for two weeks ( still waiting on findings, unfortunately). This all caused me to stop working out during this time. I had usually worked out 5 days a week for the past 3 years or so.

Thankfully both the bleching and palpitations slowly resided. However, in early Feb getting out of bed one morning I noticed my right leg was unusually weak from the knee down the right side of my leg to my foot. I hadn't started working out again so it took me by surprise. I explained it like my right lower leg was in a pool and I was trying to walk through the resistance of water and it just didn't feel right. Within a few days I also woke to my left arm feeling very weak and struggled to use the pinky and 4th finger. I had an X-ray and it shows mild osteophyte formation, facet hypertrophy with mild intervertebral disc space narrowing at the level of C5/C6 with mild bilateral bony neuroforamen narrowing at the level C5/C6. The left arm and finger weakness has since diminished some. T

he next week Feb 21st I woke to fasciculations on my right leg from the knee down to my foot. The very same area that felt weak.The next day I began to have fasciculations in both legs (knee down) and feet. It has since spread to both quads, around my elbow and on my right hand between the thumb and 4th finger. During this time, I did get a lucky appointment with a local nero who flat out told me this is all coming from my brain. He ordered a brain MRI that showed one tiny focal hyperintensity noted in the white matter of the left frontal lobe anteriorly. He deemed this to be normal for a 37 year old.

He ordered an EMG which he did himself (both arms and right leg). Interestingly the EMG did not pick up any fasciculations during my test even though I have them 24/7. He did witness them in my calves but just told me it looks benign. He did say my knee reflex was brisk but that was it.

He wasn't particularly friendly or reassuring so I guess the whole thing has not put my mind at ease. He did mention MS as a possibility since my mom has MS. With the MRI only showing one tiny focal lesion he just felt it was okay for now.

Also, all blood work has been within norm with the exception of ceruloplasmin being 15mg/dl (normal for this lab is 20mg/dl-60mg/dl). The Dr has not addressed this low level as of yet. I am waiting on a response.

I am really struggling with all of this since I did the unfortunate appointment with Dr.Google for my I'll call it "felt weakness in my right leg" with fasciculations. My right leg still feels weak and it's localized and has not spread to other areas.

I don't understand how the EMG did not pick up the constant fasciculations throughout my legs feet and arms/hand.

Attached is the EMG of upper. Trying to get a copy of lower.

Thank you again.
 

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ryanb

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I forgot to add his findings of the EMG of my legs. Trying to get a copy of the report itself to upload.

ASSESSMENT: There is no electrodiagnostic evidence of any
peripheral neuropathy or lumbar radiculopathy.

CLINICAL CORRELATION: The twitching in the legs and weakness in the
legs may be due to the sensory lumbar radiculopathy, which cannot
be detected by this study.
 

lgelb

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ALS has been ruled out. The low ceruloplasmin level calls for correlation with copper level tests, that your internist can order.

As you note, Ryan, other possible causes of your issues include the brain lesion as an MS precursor, spine damage, and simply benign fasciculations. The belching/extra beats may or may not be connected. You could have a nutritional imbalance that the blood work is not showing, and/or quivering muscles because you changed your workout/exercise patterns.

Some or all of these could contribute, so it's good to follow up with your internist and neurologist, but my bet is that at least some of this can improve with attention to your lifestyle longer-term. I would also ask about PT.

EMGs are designed to pick up specific kinds of abnormal electrical activity, not everything that you feel.

Best,
Laurie
 

ryanb

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Laurie,

Thank you for your reply and valuable insight, I greatly appreciate it.

I suppose the lingering concern stuck in the back of my mind is how/why the EMG did not pick up any fasciculations even though I have them constantly. The Dr. also did not have me flex any of the muscles once the needle was in place especially in the leg which is concerning me with the weakness, which I find a bit odd. So of course, I think, did he even do the test correctly or thoroughly enough.

Ultimately, his unwillingness to provide a depth of info or reassurance didn't help my peace of mind, especially when the first thing he looked at me and said is "this is all from your brain" before he examined or tested me.
 

affected

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Ryan, with the greatest respect, I need to say that you need to let go of these irrational thoughts - the doctors know how to do their job, and they don't always have the words to give you want you want to hear.
If you are not reassured by the doctors or the replies you have had here, please go back to your doctor and seek help for your fears.
Twitching means nothing, most don't show up on an EMG. Truly, millions of people twitch without there being anything wrong and with completely normal EMG examinations.
I doubt we can give you peace of mind either, so please do keep pursuing this with your doctor, but it is not ALS and that is what we are here to deal with. All the very best.
 

ryanb

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To your point, Lauri's informative response did give me additional peace of mind along with many other threads on the subject, which I value highly.

My post above was the few sticking points that sat in the back of my mind, as such I wanted to merely express what brought on my thoughts, why I had questions, and ultimately what brought me to this forum to seek such advice. Seeking additional insight is what I was hopeful of especially as to the lack of divulgence by the Dr. and the newly experienced symptoms I am experiencing and of course what it could pertain to.

Thank you all for taking the time to address my post.
 
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