Hello everyone. For all of those who suffer from any neuromuscular diseases, you are in my thoughts and prayers.
The reason that I'm on this board is that I'm having some symptoms of ALS and I'm hoping that someone can tell me other possible diseases that could cause these problems. I orginally posted on the ALS board and one gentleman suggested Lyme disease. For anyone who would like to help, below is break down of what my symptoms are.
1. Approximately four weeks ago, I started to notice visible twitches...mainly on my left shoulder and right knee. In the last week or so, the twitches have not been as frequent, but they're still there.
2. Two weeks ago, I noticed my biceps and triceps felt weak in both arms, but much more so in my right arm. It really seemed to flare up during a stressful situation at work and never returned to normal. There is no visible atrophy and the weakness hasn't affected my daily life...yet. It just seems my right arm has really gotten weak after just 14 days.
3. My legs, rib cage, and neck are sore on an off and on basis.
4. I have a tingling sensation on the back of my legs, my shins, my face, and my arms. It isn't constant, but enough to notice.
5. I'm not sure if this is related, but I've been running an on and off low-grade fever for the last month.
I've been to my regular doctor several times and my chiropractor several times as well. My regular doctor had me do physical tests and said he couldn't find anything wrong with me. He said it was probably an irritated nerve or a virus because of the fever. He said to call back in a few weeks if it isn't better so he could make arrangements with the clinic's neurologist.
My chiropractor was much more concerned. He had me do physical tests as well and said he could tell my right arm/shoulder were weak. After a few visits with no improvement, he called a current patient he works with that has ALS. He wanted to hear about his early symptoms. Unfortunately, his started with twitches and weakness in one arm. My chiropractor said if I'm not much better in a week, I need to get an MRI.
I'm a 29 year-old man with no family history of diseases of this type. I have a wonderful wife and an amazing two-year old daughter, so I want to know what I may be up against so I can try to plan my future. When I go to the doctor next time, I'm looking for something to suggest to him as he seems perplexed.
If anyone has any suggestions, I would be very thankful for your help.
You likely have what is called benign fasciculation syndrome, which is a form of peripheral nerve hyperexcitability. Although the cause is not specifically known, many patients exhibit elevate antibodies, suggesting an autoimmune origin. I have had similar symptoms for 4 years. They tend to wax and wane, flaring up under times of stress (either physical or emotional). Muscle twitching in ALS rarely preceeds significant weakness. When your GP performs a basic neurologic exam, there are specific indicators of motor neuron disease (ALS) that would be evident. More extensive testing using EMG/NCV is warrated only if there is a possibility of MND, and are used for differential diagnosis or to confirm MND.
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I've been back to the chiropractor and he said he thought my strength has improved. Also, I've been better about lifting weights three times a week and I've noticed my strenght has increased there as well. I'm not sure, but I'm hoping that even in the earliest phase of ALS, you probably wouldn't be able to increase strength in the affected muscles, once symptoms set in.
Unfortunately, I'm still twitching, my upper arms still feel "off" most of the time, and now both my forearms have a habit of cramping up after typing a relatively short amount of text. I've also noticed that my right hand and forearm seem swollen and clumsy at times. I don't think this is a symptom of ALS or any other NMD that I've read about, but I'm still going back to my regular doctor next week. Hopefully, he'll have some answers or at least give me a referral.
If anyone else out there has any idea what this could be, please let me know and many thanks in advance.
I've been twitching for 4 years now. I was 37 when I began having symptoms. It began with isolated twitches in my left hand, upper arm and chest, and spread throughout my body within a month. I have constant twitches in my feet and calves. Additionally, I have cramping in my feet and calves. My recent EMG/NCV showed slowing of motor nerves in my legs and fibrillations in my feet. I feel weak, but have no demonstrable weakness. I coach baseball and referee soccer games. If my twitching that began 4 years ago were a symptom of ALS, I would likely be dead or confined to a wheelchair or bed.
My doctor diagnosed me with benign/cramp fasciculation syndrome. It is a form of peripheral nerve hyperexcitability. There is strong evidence that it probably has an autoimmune cause, although this hasn't been proven. Many BFS patients have had a recent viral infection. There is also an association with voltage-gated potassium channel antibodies (VGKC). Essentially, the hypothesis is that these antibodies attack the ends of the motor nerves, interfering with the nerve impulses. This produces the muscle twitches. Additionally, I fatigue easily, get sore muscles easily, have tingling, buzzing, stabbing pain sensations in my feet and calves. With me, there is also cranial/facial nerve involvement.
Muscle twitching in ALS patients rarely precedes profound muscular weakness, atrophy, loss of coordination, and hyperactive deep tendon reflexes. The muscle twitching in ALS is due to the death of the motor nerves. By then, the weakness is usually apparent.
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