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Revader

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Hello. I want to start off by saying it's wonderful what you guys do here, and my heart goes out to every one of you. I've read through the stickies and a number of threads. I'm an 18 year old Caucasian male. I realize my age makes having ALS incredibly unlikely, and that's a fact I remind myself of often.

For the past two years, at least I believe, I've had bodywide muscle twitching. I don't remember if there was a specific spot where it started. I have degenerative disc/bulging disc issues in my neck, so I believed it was due to that.

I even had an epidural injection done in my neck, a year ago. From what I recall, my twitching seemed to subside for perhaps a week, then returned soon after.

In March of this year, I had an upper EMG done at the mainland Bacharach Institute, and it was normal. This abated any sort of ALS fear I had at the time, and I continued on with my life.

Four months ago, I noticed a strangeness in my right foot, particularly when I put on a shoe. While walking my dog, it was especially noticeable, so I tried to just ignore it and chalk it up to hypochondria and anxiety. Two months later, there was an entire day where my right buttock experienced very fine micro-twitching. A day later, it felt heavy and possessed an almost numb sensation.

From there on, that persisted, occasionally traversing down my right leg, and I constantly noticed it. There on, I was incredibly afraid and anxious over ALS, and I had to take anti-anxiety medication to get through the days.

A month ago I went to a neurologist. She's a general neurologist, not a neuromuscular specialist, and is secondly a pain management doctor. She conducted a quick upper and lower EMG, which detected C6 radiculopathy and L5 radiculopothy, but nothing else.

An MRI of the cervical and lumbar showed C6-C7 inferior bilateral foraminal narrowing in the neck, along with other degenerative issues and disc space narrowing, as well as L5-S1 bilateral foraminal narrowing, with herniated disc material abutting the L5-S1 nerve roots.

She said that would explain my symptoms, and I was relieved for that day. However, recently I've had serious balance issues when walking, resulting in a weak wobbly gait, where I've almost fallen a few times.

My right foot is getting worse, and when I put my body weight on it it feels as if I'm about to tip over. I've noted that my right leg in general has less muscle mass than the left, but whether that's atrophy or not, I can't tell.

I brought my gait problems up to her and she dismissed them after a cursory glance of me walking across the room. Meanwhile, she's administering trigger point cortisone injections while I'm not even having pain.

My anxiety is through the roof and I'm incredibly concerned. It's consumed my life. My gait is only getting worse and I'm afraid. I don't believe a minor pinched nerve would cause this.

I don't know what to do. By the way, I can elicit fasiculations by rubbing muscle, which I read can be done in an ALS patient.

I'm seeing a therapist Wednesday for my anxiety, but my physical symptoms are persisting.
 

Nikki J

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balance issues and wobbly gait are common symptoms associated with compression at c6 c7. I would pursue that issue and see what comes of it. I do do not see any reason for your ALS concern given your description
 

Revader

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Thank you for your response. I appreciate it. But I don't understand what you mean. I don't have spinal cord compression at c6-c7, just something that pinches the c6-c7 nerve roots and those go into my arms and hands.
 

Nikki J

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I don’t know how bad your cervical narrowing is. Did your mri specifically say no compression?

Read about cervical myelopathy and you will absolutely see wobbly gait and balance issues. I don’t know that you have it but you should ask
 

lgelb

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Pinching and compression go hand in hand. When the pinching goes on for long enough or in just the wrong spot-- as if an object "sits" on the nerve to a certain extent, you get cord compression.

Ask for doc about PT. When the nerve is being pressured, it can be like a light bulb flickering on and off -- the circuit breaker is flaky -- causing symptoms such as pain, loss of balance, numbness, tingling.

I'm not sure what you read about eliciting fascics, but that is not some kind of sure ALS sign. It's just a sign of nerve→muscle irritability, which we know in your case relates to damaged nerves in the spine.

Best,
Laurie
 

Revader

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It doesn't mention or specify any spinal cord compression, no.

Thank you for the response, Laurie. I've had PT a few times over the last couple years, but I'll see about getting another script for it.
 
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