Progressive muscle twitching, clonus, tongue biting and foot tremor/shaking

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epipani

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Hi all,

I am a 25 years old asian female with several concerning symptoms that has been developing starting from early 2018. Here is the timeline of my symptoms:

1. Around march 2018, I began developing muscle twitching after a leg injury. At first, it was only affected my leg calf which was the site of the injury, then it spread to the right calf and as the time went by, the muscle twitching keep spreading (progressive) and now has affected almost all part of my body such as my thighs, feet, butt, arms, neck, abdomen, face (eyelid, lips area, jaw, cheeks), head (around temples's area and above ears area), and the most concerning one, my tongue. The twitching are fairly constant and tends to be moving from one area to another. In the case of my tongue, I can feel the twitch and tingle, it is not always constant, but if the twitch did appear, it will twitch for about a day or two.

2. After one year living with widespread muscle twitching, around February 2019, I began developing what i believe as clonus. I could literally feel the affected area (mostly my leg and toes) jerking/moving by itself (i.e rising up and down by reflex) even without being touched.

3. Not long after the second symptom, i began experiencing tongue and cheek biting, which mostly happen during eating, talking or the process of waking up. Sometime i believe the biting happen due to jaw jerk which cause my mouth to close or move by itself. In addition to this symptom, i also have problem with swallowing which my doctor believe was due to acid reflux. I frequently choke on my saliva and having trouble controlling my food during biting and swallowing process. (only with solid food, I have no problem with thin liquid such as water).

4. recently, i began to notice that my left foot and toes will shaking uncontrollably/tremor everytime after i curl my toes. I did have compared my left to my right foot and notice that my right did not shake as much. . Tbh, for me this is the most concerning symptoms because based on the reading that I've done, i learnt that you will experiencing tremor or shaking once the nerve or muscle in that affected area begin to die and as it is only affected one limb,as a result i begin to think that this is may be due to als. though, up until now, i dont have problem with standing and walking on my toes or heels.


The truth for the past two years before experiencing left foot tremor, i always believe and be able to convince myself that what i have is only bfs and acid reflux. but after i developing foot tremor on one limb, i began to think that this might not be benign afterall . i do know that based on statistics, it is very unlikely for me to have als, given that I am a young asian female. but there is still a small possibility.

Currently,im still considering whether i need to go to neurologist or not as it cost me a lot of money.
in my country, access to free public healthcare is very hard for young people so i have no option to go privately and paid all the medical bill by myself.

before making a final decision, I would like to ask whether some of you have experiencing the same symptoms as me (especially the one limb tremor) before being diagnosed with ALS. next i would like to ask whether in your opinion, i need to see neurologist and asking for EMG or not ?

I am very sorry for the imperfect english as I am not a native speaker, hopefully you all get the idea of what im trying to explain.

I am very thankful for your answer and help.

have a good day.
 
It’s worth your time and money to see a neurologist. At the very least, they can ease your mind and answer questions for you. The neurologist can tell you if you really are experiencing clonus and if you are having true tremors or something else. They can also determine if your strength is normal.

Your symptoms are not suggestive of ALS unless you have true weakness on exam along with hyperactive reflexes, and even then there would be many other possible explanations. Anyway, a good neurological exam should answer a lot of questions for you. The neurologist will decide whether or not you need an EMG.
 
Definitely see a neurologist rather than asking strangers on the internet. Doesn't sound the least bit like ALS which is great news :)
 
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