Advice appreciated

Hello,

I am a 30 year old male with some concerning symptoms. Around two months ago, I visited a neuro who requested I get a brain MRI in regards to symptoms I was having. He later communicated the results to me as being normal and that my symptoms may be due to anxiety. However, when reading the report from the radiologist, there was a comment that I had multiple (2-3 mm) non-specific lesions on the front part of my brain that could be due to protein deposits or subtle demyelination. The symptoms were consistent and constant muscle fasciculations.

Fast forward to today. I have 24/7, multiple fasciculations in my lower legs (both left and right). They are fine in nature, meaning I can barely see them on the surface. They occur randomly and often. In addition, it has been spreading to my upper legs as well, right above the knee. I went from some light twitching/tingling two months ago, to constant spreading fasciculations traveling higher up my legs. I visited my GP today and am being referred to a neuro in Beijing (I am in Shanghai) who specializes in these types of issues. She stated that I will need to get multiple tests done (EMG, etc.) to help make a diagnosis. She did, however, throw out that at this stage, early ALS diagnosis is possible. So I just have a couple questions:

1) Anyone familiar with similar symptoms and what are your thoughts?
2) Any insight on what to expect from the EMG test?

This is all very hard to process and I want to stay positive no matter what. Thanks for all that you do to help others and God Bless.

I also wanted to add that these fasciculations appear to look more like worms crawling under my skin, and not the classic visible twitch or spasm you would see from dehydration, etc.

Couple things:

First, I'm not a doctor. Seems to me that if your first neurologist said the EMG was normal, then it probably is. So the "multiple (2-3 mm) non-specific lesions" might be normal, like the Dr said. Our bodies are filled with all kinds of weird stuff that really won't affect our lives.

Second, the GP may not really understand ALS. My experience with dozens of doctors and dozens of nurses while my wife had ALS convinced me that not very many medics understand ALS at all. It's rare.

Third, having creepy crawlies in BOTH legs isn't really very ALS-like. ALS kills motor neurons in a serial fashion, one-by-one going generally either UP the body, or DOWN the body. Generally, it'll start in one hand, work up the arm, then attack another limb. Both legs at the same time makes me think something else is going on.

For the EMG, they'll insert needles into your flesh. I'm told it's uncomfortable. Some say it hurts a lot. But everybody seems glad they did it.

So if I were you, I would definitely go to the appointment and chase this weirdness toward a cure, but I wouldn't worry about ALS. Your symptoms seem common, ALS is rare: When you hear hoof beats, think of horses, not zebras.

Enjoy China. I loved it for 20 of the 21 days I was there. If you see China Air, p!$$ on it for me.

Hey Mike,

Thanks for the feedback. I will be following up with the EMG after the Chinese New Year. I will re-visit the site and post my findings (hopefully positive) and bring some peace of mind to others who may visit with any concerns.

I've been enjoying China as well. I have been here for six months, with six more to go! I will pass your kind comments along to the China Air team.

Just one follow up question, ALS will never progress in two limbs at once? Or is it possible, but extremely rare?

I've never heard of it. And from what I know of the brain, it doesn't make sense to attack both legs at once. But, like I said, I'm not a doctor. Another person here may say otherwise. But...however, that doesn't really matter, because:

You probably read the sticky post titled "Read Before Posting..." It covers this subject. Basically, it says that twitches and fasciculations are common to many conditions, and so they are diagnostic of nothing.

The important thing, the time to wonder about an MND, is when a voluntary muscle fails to respond to command, ever, at all, and there is no reason for it, no feeling of weakness, no exhaustion, no nothing, it just doesn't go. The muscle lays limp and useless, paralyzed.

Typically this gives a person drop foot or trips them. My wife's first symptom was simply falling over because one of the muscles in her right foot stopped working. A month later, she needed a cane. A few months after that, the whole leg was non-responsive and her other leg, plus a few fingers, were profoundly weak. But her case was exceptionally rapid progression, like world-record fast.

If there is something wrong causing these worms in your legs, it is much more likely to be anxiety from a change in your life circumstances, or something simple, not fatal. Maybe an alien invasion. But not ALS.