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shane42

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Hello everyone, I really appreciate any feedback i get from this post.

My Situation, Symptoms, Preliminary diagnosis by Neurologist

AGE: 31
Sex: Male

About a month ago i felt my right ankle giving out very easily after sitting at the computer for extended periods of time, which resulted in falls. I fell about 3 times which causing in pain in both of my feet and ankles (due to them buckling). About 2 weeks ago, i could barely walk on either foot due to extreme pain in the ankles. The pain resolved but i was left with numbness in the tops of both feet and the inability to life my toes off the ground from the ankles (foot drop in both feet). The numbness and weakness in my right (dominant) ankle is worst then my left. The numbness in my left ankle has subsided quite a bit since the onset of the problems. When i first went to my general doctor (at the time of the pain) he said i had a pulled hamstring in my left leg and right achilles tendon strain. However, 2 days later i experienced the foot drop in both feet. I called the doctor again and he did some routine office tests (scratching the bottom of my foot to see if my big toe exteneded away from the rest of my feet- which he said was negative for motor nerve damage). He gave me an mri on my lower back which revealed a bulging disk, but he said that the neurologists who looks at the mri said this should not be causing my symptoms. I then was refered to a neurologist, she did a bunch of office tests on me, using some electric gadget to see if could feel vibrations in my toes (i seemed to past that test), looked at my tongue, had my take each foot and run it up the opposite leg. She tested my hand strength by seeing if i could keep my fingers spread apart or closed together as she tried to open them or push them together. I showed no weakness in the upperbody. However, she said i was a bit hyperreflective in my lower body, but she attributed that to the anxiety and stress i have had over this. I asked her if this could be ALS and she said it wasnt possible because i would NOT have the numbness or pain, and that the disease does not progress in the way my symptoms are appearing. Her diagnosis is that i have perennial nerve compaction (i.e Perennial palsy) from sitting at the computer with my legs crossed for extended periods of time. She said i need to have a nerve conduction test to confirm her diagnosis but the earliest appointment i could get for the test is April 17 :( . My symptoms were localized to just my feet until last night. I was using the pc mouse for about an hour and i notice a pain in my right wrists (the same side were my foot first started bothering me- but its also the hand i use for the mouse. I woke up this morning and the pain is still there and my wrist feels weak when i twist it. My fingers still feel strong (i.e i can can keep them closed or spread apart as i try to pull them apart or close them). I dont recall hurting my wrist at all, and it seems strange that just 1 hour at the computer could have caused this (again maybe it has built up over time like crossing legs at the computer). Furthermore, I am somewhat skeptical of how crossing my legs could have caused this foot drop. My symptoms seemed to be more progressive not instantaneous, as i felt my ankles being weak for a few weeks prior. Could it be that the falls were enough to push my nerves over the top, and Is it possible that my wrist problem is linked to my feet? I am so worried about this, that any pain i get i start think that the problems are related. I haven't noticed really any muscle cramping, and i am not sure what a twitch should feel like. Sometimes my legs may shake a bit while sitting in a wierd possiton. I have also noticed that my feet, legs and hands fall asleep alot easier now. If i cross my legs at all it falls asleep a few minutes later. I can toe walk, bend toes and move my ankles left and right but cannot move toes up or walk on heals. I also cannot tell if my left leg is getting weaker due to the fact that my left ankle is not giving me good support. It seems to be easier walking up or down stairs then on straight ground. I went in bathroom to look at my tongue and it seems to move a bit when i stick it out by the doctor also looked an my tongue and didnt seem to be concerned. Is there any other symptoms i should be looking for? What does a twitch feel or look like? I also must say that i do get a great deal of anxiety over stuff like this. About a year ago i experienced headaches, and was sure i had a brain tumor- my mind actually manifasted other symptoms such as lightheadness exct. It turned out that there was no turmor and the symptoms eventually went away even the headaches. The problem this time is, once doctor told me it could not be ALS i stopped worrying about it untill today. The wrist issue has me a nervous reck again. Do my symptoms sound like ALS? Any feedback here will be appreciated
 

wright

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Hello Shane

It sounds as if you are someone who would be VERY aware of their body. If that is a fair statement, then I would have to think that your symptoms came on much too quickly and presented initially in too many limbs at the same time; both legs and an arm in a matter of a few weeks, just isn't the way ALS works. The other thing you have going for you is your age. Certainly people get ALS in their 20's and 30's, but it is very rare. I didn't see any mention of muscle atrophy: do you have any?
I think you can relax and trust your doc. Get the NCS/EMG and I'm sure it will show some type of peripheral neuropathy . . . or may show absolutely nothing if it's a mild case of nerve compression.
In the meantime, I think you can relax . . . and get up and walk from time to time when you're sitting at that computer.

Take care
 

shane42

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i dont notice any muscle atrophy in my ankles, however my right hand has a bigger (indentation) grove then my left at the part of my wrist directly below my middle and index finger.
 

shane42

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Also i have never noticed that indentation before. Its very prominant to me now though.
 

shane42

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Update

I still have not had the NCT because Kaiser is not to efficient with this test. I will have it next monday at 2:30. I did however go to another doctor to get fitted for othopedics to aid my foot drop problem. He tried a walking aid at first, to see if that would benefit me. He told me if i had nerved damage or compression the foot should not twitch upward when he stimiluated the nerve. When he first tried the electrical stimulation my foot started moving upward indicating that the nerve was intact. However after doing it a few times he noticed that the rest of the musles in my feet were twitching more then the muscles fed by the perenial nerve. He said its dificult to isolate that nerve, and that device would not work for me because it was not moving upward as much as side to side. His initial conclusion was that it couldnt be compaction but after doing it a few more times he didnt think it was stimilating the nerve as it should so he ordered the bracers. He said walk-aids only work well for people with MS, Stroke because the nervers arent damage they just aren't receiving the signal. I am still bit concerned even though he said it didnt work because i say some upward movement when he turned it up really high. WHile his initial reaction is that it couldn't nerve damage (i.e compaction) he did say it could be a case of compaction towards the end the appointment. I wasnt concerned about als again untill today. He did not mention als but he did mention Tooth-Mare syndrome or whatever. I had blood work and 24 urine collection tests which all came back normal. I just wish the damn doctors can figure out what the hell i have. When u live not knowing what the hell is wrong with you it really stinks.
 

Suzanne Jacobs

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Hello Shane,
My 17 year old daughter has a very similar story to you.
She developed numbness on the top of her right foot which spread over time to right side of right loser leg. Then over a period of one month the condition progressed to foot drop in her right leg and the tripps and falls began. MRI showed 3 x bulging discs in lower back with right nerve compression - no back pain or other symptoms.
We saw a neurologist (who I work which and trust entirely) and braced myself for bad news. He said she had right pereneal nerve compression from crossing her her legs. I believe this, and think the KISS principle applies.
Interestingly the neurolofist said only skinny people develop this, because their is no fat/muscle buffer over the nerve to protect it from compression. My daughter is very skinny and this in fact does occur. I am bigger in build and when i cross my knees there is padding to protect the nerve.
We will be watching this over the next couple of weeks to see if it improves.
 

laurel

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Hi Shane,
Your wrist symptoms also could be related to over using them at the computer. However, I will throw out another disease to rule which is CIDP. It is an autoimmune peripheral neuropathy disease. My husband has it. He started with weakened pincher grip of the right hand, it evolved to major muscle wasting/atrophy of the right hand with him being unable to even lift and hold a coffee cup. Initial diagnosis was carpal tunnel and he had surgery--more wasting and loss of function ensued. He had mri's which were negative. In the beginning, he had EMG and nerve conduction which was negative. After seeking a second opinion, he was tested again with EMG and nerve conduction which showed demylination and axonal damage. He was referred to a neuromuscular disorder clinic. More EMGs and this time of all four limbs. Had lumbar puncture which showed slight elevation of protein--but prior to this he had a query of ALS. While waiting for the results from the neuromuscular disorder clinic, he developed foot drop of the right foot. He has received IVIG monthly and is dramatically improving. So read about CIDP and be informed about it when you talk to your doctor. My husband did have the fasciculations/twitching in his forearm and still does on occasion. It looks like a little muscle ripple in a small area.
Laurel
 
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