What would you do?

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RHBmom1627

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I’ll preface this by saying I am a 32 y/o female physical therapist with history of general and health anxiety.

In late 2021 I started having periods of ‘weakness’ in my L thigh and calf. I could still do stairs etc but my leg would shake. This happened maybe 1x/week or every other week and would resolve in 1-2 hours. I didn’t think anything of it at first. Around Memorial Day this year I had a period of time that affected my arm as well with the same type symptoms. I started having random body-wide twitches. I went to my PCP who thought anxiety, prescribed meds and sent me for an MRI of the brain as she could not rule out MS. When my MRI came back clean and my symptoms were still occurring after being on the anxiety meds, she referred me to neuro. I do find my L hand feels clumsy—I am dropping light objects but I was able to carry a 5 gallon water jug across my office to the dispenser without any difficulty. It does fatigue easily when working with my patients.

I went for my neuro exam. He found no clinical weakness, but I do have brisk reflexes in both knees as well as clonus in both ankles. I had a very tiny area of tongue flicker at rest. He suggested perhaps these are changes in tone and not strength. He sent me for EEG to rule out seizure activity as well as MRI of cervical spine which were both pristine. I follow up in 2 weeks. At the last visit he did not think EMG was necessary as my symptoms all appear UMN in nature (or, I suppose, benign).

Now that we have ruled out MS, seizures, stroke, cord compression etc should I be pushing more for EMG, if only for my own reassurance? Does this sound anything like ALS?
 

KimT

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It doesn't sound like ALS but an EMG might uncover something other than ALS. The "periods" of weakness sounds like something other than ALS but nobody on here is a doctor so going to a neurologist and asking her/him what he thinks is a good strategy.

Best of luck. Getting anxiety under control just may help in ways you didn't expect. If your anxiety treatment is not working, ask for something else.
 
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