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Thomas3857

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Thanks so much for providing this forum. I've learned so much and really appreciate your time and effort in responding. I understand that is difficult. About a year ago I posted my concerns after experiencing facs in my calves (both) and an uncontrolled tremor / clonus in my right foot. My neuro appointment in May, 2019 found hyperreflexia but the rest of the exam was normal. EMG / NCS was normal but for a couple of mild abnormalities on the NCS (right wrist/right ankle). Blood and imaging tests normal. Diagnosis was health anxiety causing an over-reactive CNS. Did CBT therapy and started Prozac which has helped very little.

It's now been a year since that first neuro appointment and my twitching tremor/clonus is still present. I returned to a new neuro (the head of the ALS clinic here) and he again found facs, hyperreflexia and a couple of sensory issues on my right foot. Clonus / tremor still present as well. All other strength tests were normal, no atrophy. I explained to him that I've also had a feeling of heaviness in both legs when going up steps, running, etc. that is new. He scheduled another EMG which I will have in August.

Question - Is it possible that ALS can progress this slowly where over the course of a year the only thing I"ve noticed changing is a heaviness in both legs and some mild sensory issues (numbing/tingling in hands and feet). Seems unlikely but my health anxiety wonders......

Thanks so much for reading this and responding. Tom
 

ShiftKicker

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Previous thread here, for past discussion:
 

lgelb

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Prozac can exacerbate an overactive CNS since it's one of the more energizing SSRIs. It can also interfere with restful sleep, which in turn affects your day. I would ask about trying another, or tapering off entirely, if you are not clinically depressed or anxious.

It would be very unusual for ALS to present as slowly as you describe. The EMG is next month and will hopefully continue reassuring.

A feeling of heaviness in both legs when going up stairs sounds more systemic, if anything, since it's bilateral and doesn't actually keep you from doing stairs. It could be time to look at your diet, fitness and overall activity. And of course, the mind can play a role as well.

The odds are still greatly in your favor, so try not to stress over the next month.

Best,
Laurie
 

Thomas3857

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Thank you Laurie. I continue to appreciate your time and compassion.Tom
 
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