Update: Went to the GP

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Apr 1, 2024
Learn about ALS
Initial request: Worried twitching was early ALS

Dear all

I know I should not post a second thread, please can you move my update into my initial thread above?

I wanted to share the update that I went to see my GP or better he had the mercy to see me (he didn't want initially).

He did a very basic neurological exam on me which consisted of:

Coordination: Hopping on one foot, lifting one leg after the other continuously and counting backward from 100 subtracting 7 (100, 93, 86 etc.) with the eyes closed. When finished I wasn't standig where I was before the exam.

=> He said no deficits there, elastic hopping

Reflexes: Poking the crooks of both arms, the knees and heels

=> Reflex on left knee was elicited (one jerk), right knee silent, crooks of the arms ok, heels too, no clonus elicited

Strength: While he only tested my strength in my arms I had to kind of wrestle with him for a short time and he said jokingly I was stronger than him. Not sure he meant it.

Muscle jerks/twitching: Of course when I wanted to show the muscle twitching to him none showed up for like 30 seconds when I layed myself on the exam bed. As soon as I had all my clothes on it resumed.

Bottom line: Everything he saw looked normal thus no referral to a Neurologist for that matter.

I asked my GP why the Neurosurgeon I saw in January 2024 (brain tumor scare) replied to my plea that he wanted to see me to discuss the twitching and the ALS scare in person. I was scared that this is because the Neurosurgeon might think this is serious. My GP answered that this is possibly because no Doctor, no Specialist wants to be to blame to not have picked up a possible disease early when a patient sent a request like I did. He (my GP) was different he explained in that he was an "old traditional GP" who only does a referral if he saw something was clearly off. He said he could refer me to a Neurologist, do a spinal tap and whatnot, but that he doesn't see the necessity.

Do you guys think that this basic exam is enough for me to try to relax or is this not sufficient in my case as the twitching goes on daily and unrelenting? It is mainly confined to both my legs. I must say however that my GP doesn't know ALS very well, less so than I do from reading. He didn't even know that twitching was a hallmark sign of ALS. This doesn't soothe me too much..

Please accept my apologies for having opened up a second thread.

Thank you all.
We don’t reopen old threads and I will be closing this one too.

The exam was plenty. Your doctor studied for many years and has done that exam hundreds of times for diferent reasons. He knows what normal looks like. And guess what twitching is NOT a hallmark sign of ALS. Clinical weakness is the hallmark. Your googling is not better than his years of education supplemented by years of practice and continuing education. You are lucky to have this doctor

I am sorry you didn’t take our advice. Good luck. No more posting please
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