Growing concern

Hi all,

Firstly I would like to say a massive thank you to all those who contribute to this forum you all display courage and empathy which is incredible given what you have or are facing.

I am a 39 year male with a fairly recent history of anxiety following a number of unexpected deaths in my family and friends. Last year in May I started to notice a number of twitches which were fairly constant but did tend to move around my body (I have read the stickies). after an initial panic, thanks to google, I managed to calm down realizing that twitching was/is pretty normal. The twitches are now fairly constant in my arches of my feet and as such came to the conclusion that I must have BFS (benign fasciculation syndrome) Also my local doctor preformed a clinical on my and said that I was great and i was on my way.

fast forward to this past month when I went to another doctor on an unrelated matter but while in his room I asked about why the gap between my second and third toes seemed to be growing, while he was examining my foot he noticed the twitching and i said to him that they had been there for months he grew a bit alarmed and started asking me if I had been experiencing trouble swallowing or tripping etc to which the answers where no said that given the duration i Thought that ALS is off the table to which he agreed but though about the possibility of MS. He then goes on to check my reflexes and they are extremely brisk which really concerns him (and me) , I say that potentially they are brisk from anxiety. So He gives me a referral to a neurologist and send me for a brain MRI.

The MRI was conducted last week Monday and results back on Wednesday all comes back absolutely fine, I debate the going to the neurologist now but reckon what harm so off I go on Monday. The neurologist who is a general neurologist, gets me to do all the usual strength tests and so forth all of which are fine then onto the reflexs and well all really brisk also mentions I had 4 beats of clonus in my right ankle, but she could not get this to repeat and two beats on my left My babinski and hoffmans signs were both normal.

After the examination she was very vague, said that i should have a thyroid test and full blood panel, that I definitely didn't have MS but that i should do an emg and nvc she then went onto say that there was no rush to do the emg. When I asked her specifically about ALS she mentioned that it was a possibility but unlikely as I have no weakness or atrophy . So hence my reason for posting on here looking to see if someone can clean of the confusion about UMN signs ( brisk reflexs call hyperreflexia by neurologist ) and LMN sign -fasciculation. I have had the blood tests done this morning but I am holding off on the EMG until I get my life insurance sorted out. So thought I would get your thoughts on the situation, should I be worried or am I being a drama queen.

Thanks in advance

Andy

I don't think you have anything to worry about on the MND front. Hyperreflexia is way more general/common than the UMN dysfunction typical of ALS, and as for a gap between your toes, that can be anything. I really cannot recall anyone here for whom ALS was essentially an "incidental finding." If she wants to do an EMG, that might point out/rule out a nerve problem in your foot, good to know, but that's about all I can see happening.

Best,
Laurie

Thanks for your response Laurie must admit it is the beats of clonus which has me in a bit of a spin. Think the toe thing is a plantar plate damage so not concerned about that.

Transient, unsustained beats are not considered a problem in the absence of more serious features. You can find that statement in any neuro text.

you are my hero its like the weight of the world is being lifted thank you very much.