Symptoms continue

[Jmom]

I have posted in past and left. So I promise just a review and question.

January: trouble with "fuzzy legs" and feeling of left leg wanting to give out.
Emg/NCS: study normal, EMG upper right arm suggestive of carpal tunnel +fib on median nerve, lower left leg EMG normal

Twitching in left calf.

Since then...the twitching is in both calves and constant. I get twitching in ribs, stomach, back, bicep. Most twitching is in left leg and seems constant.

I have sciatica down the left leg from spinal stenosis.

I have a deep impression/dent in left calf and this leg muscle is 3/4" less than right for past 9 months.

Recently while visiting a spine dr. He found both right/left leg to have hyper flexia at knee and clonus in right ankle.

I am just concerned instead of better; more symptoms are progressing. My reflexes at all prior neuro visits were normal.

Do you believe my status warrants a further look with neuro? I am really scared and worried. I am not sure if I should start the neuro eval all over bc symptoms are worse and a few added?

Advice?

 

[Atsugi]

Jmom, I understand your concern but I think you shouldn't leap to worrying about ALS right now. That you had an EMG free of ALS a year ago is a good thing, as is the fact that you don't have any paralyzed muscle laying limp and useless.

I suggest you see your family doctor and see what she says. While this could be all neuro-related, you don't want to exclude other factors.

 

[Jmom]

Thank you. I was trying to ignore the twitching as I have read the stickies and been advised not to harp on this symptom. I got nervous when my reflexes came back over reactive.

I felt like it became a combo. I wasn't sure if the EMG was significant enough at this point to still be certain this isn't ALS since I now have added symptoms.

Trying not to jump the boat. Just feel weird about the combo and not sure what to think.

 

[Jmom]

Can you clarify something for me.

The stickie says:
"The major initial symptoms of ALS are clinical weakness, atrophy and hyperreflexia. Some people may have slurred speech. If you don’t have any of these, why are you here?"

Is it the presentation of all three initial symptoms together that is a concern? Or is the hypeflexia alone with twitches as I have an equal concern. I don't want to bark up the wrong tree misunderstanding.

Lastly, is the EMG still valid to rule out ALS (the one I had in January) or does it need to be repeated Bc of new symptom?

Thanks so much. I am done. Just want to make a decision about next step.

 

[Nikki J]

Hyperreflexia can be a normal variant and twitching as you noted is non specific. Clonus is non specific but I would as Mike suggested visit my pcp to review everything and take that person's recommendation about what your next step should be