neurologist testing

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neurologist testing

Postby concerned on October 25th, 2002, 1:02 pm

I went to the neurologist at the end of September after I had been twitching in various places for over a month. It all started in my left pinky, it twitched for two days straight and then stoped. The twitching spread to various places throughout my body, I only seemed to really notice them when I was resting. I have had frequent headaches that comes and goes very quickly. I expressed all of my concearns to the neuro, he did a series of test on my strengths but told me an EMG would not be necessary because it was benign fasciculation. My biggest concearn is everything I have read about ALS sais that it usually starts in the hands. I am only 24 and I have a son, that I am scared of leaving behind, should I trust the Neuro, because he is the expert or demand an EMG to put my mind at rest. I read that Aarron was self diagnosed but he has time on his side, I have only been twitching for two months now, I am not noticing a difference in my strength, other than achy hands, at night time my quads twitch alot but I do jog about 2.5 miles a day, it is getting harder to jog, but I think that is weather related, the colder it is the harder it is to move. I would greatly appreciate any insight to this matter. :oops:
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Symptoms not indicative

Postby Davey on October 25th, 2002, 3:19 pm

First, your neurologist probably performed a basic neurologic exam with some strength tests. He/she probably tested your reflexes, etc. He/she has based the diagnosis on years of study, experience and training (none of which you or I have). Therefore, I would trust the doctor and go celebrate the good news and your new lease on life. :D

ALS typically begins in the peripheral motor system, so the origin is typically in a hand or foot and then progresses. Progression is typically assymmetric. The primary presenting symptom for ALS is profound weakness. As the motor neurons die, the stimulation to the muscles decreases and the muscles become weak and atrophy. The fasciculations are the final "death throes" of the neuron as it randomly fires off, causing the irregular contractions. Fasciculations are typically a late symptom of ALS and most patients presenting to doctors complain about weakness. ALS also causes an increase in deep tendon reflexes, so when the doctor taps below your knee your leg kicks like a soccer player. You will also have Babinski's reflex, which is the reflex that babies have when you stroke the bottom of their feet. Babinski's reflex goes away by the time babies hit 2-3 years old and is considered abnormal. Your neurologist knows what to look for!!

The average age of ALS onset is 55 years. It would be almost unbelievably rare for someone 24 years old (like you) to develop ALS, unless it is the familial type (the genetic version), in which case there likely would be relatives before you that had ALS.

If your neurologist has given you a clean bill of health, accept it and get on living your life. Don't destroy yourself with worry. If you can't get past it, go to your neurologist and demand an EMG/NCV test and tell him that the anxiety is driving you insane. He/she will likely relent, give you the test, and you can have peace of mind.

My twitching started in June, 2001 in my left hand and spread throughout my body within a couple of months. At first it was isolated mainly to my left arm, but it is everywhere now. I have two kids, ages 4 and 8 and was convinced that they would have to watch me die a slow and hideous death. I was a regular customer at my GP and obsessed about ALS until I finally got an EMG. Now I am free of anxiety. I still twitch, cramp, ache, tingle, etc., and the location and severity comes and goes, but that is life. I make the best of it, and you should too. :)
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I hear ya

Postby Jeff on October 25th, 2002, 3:24 pm

I read your story and sympathize. I was twitching for 2 months when I saw a neuro, he was very good in my opinion and an EMG specialist. I too only twitch when resting, particularly while sitting... for some reason laying down makes them stop (thank goodness so I can sleep!) Any way, the neuro asked me a bunch of questions and performed the strength tests. At the end he pronounced "benign fasiculations".

In my slightly paranoid state I suggested an EMG to be sure... now picture this from his perspective. I, a freaked-out-by-the-internet patient telling him, a neurologist-EMG specialist-probably had 15 yrs. of schooling, what to do! Well, he looked at me and said "No, No, NO!"

So I decided to trust the experts (2 GP's had already told me it was benign as well) and let it go. I'm now at 6.5 months and I have the odd scare but on the whole I've left it behind me and gone on with my life since then. I refuse to let it control me any more. Hope this helps!
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Postby concerned on October 27th, 2002, 2:59 pm

just wanted to thank Davey and Jeff for replying you are probably right, I just let my imagination get the best of me. My husband thinks I am hypochondriac and that I imagine most of my twitching. The sad part about it is when my twitching is at its worse he is never around to fill them. and the ones he has seen were only minor.
Thanks again to those who replied.
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Spouses!!!

Postby Davey on October 28th, 2002, 2:29 pm

Ah yes, the "my spouse thinks I'm imagining things" or "my spouse thinks I'm a hypochondriac"!!! Arrggh! :x

I had the same response from my wife. I dealt with this by printing up articles about BFS and conveniently leaving them around the house. Then, when I was having a particularly twitchy night, I grabbed her hand and placed it on my left arm while it was pulsing and twitching. She felt the twitches and was almost instantly "enlightened." When she finally realized that it wasn't in my mind, she began to empathize.

However, things really didn't improve until I got over the ALS scare and changed my mood and attitude. Instead of moping and being depressed, I decided to be proactive about BFS. When that happened, she became more supportive. :lol:
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Postby Twitchette on October 29th, 2002, 8:41 pm

Concerned-
I just wanted to say that I feel like we are in the same place! I too am 24 with a little boy (5 months one week and a day.) I totally understand the fear of leaving behind your child! All I think of is how much I want to see him grow and learn new things. I want to be there at his wedding, and I want to be there when he graduates from harvard medical school (he he he, I have big dreams... stick with me here :D ) I am petrified that something, anything could keep me from that. He is my life. Anyway back to the subject at hand. I have been twitching all over, but lately and right now it is centered in my left pinky finger and pinky toe. Though all of my fingers and toes on the left jerk periodically. I don't think there is any weakness, but God knows I am constantly checking. My husband roles his eyes, and complains about the medical bills that keep coming in because of my "hypochondria". I know he has no clue how I feel, but he does try to be supportive, I guess. I printed of a neuro exam off of a neurologist's web site and make him do the exam every night. So far reflexes are all right, and strength seems normal to him. You should try it. It makes me feel a little better anyway! ANyway, I just wanted to say that I totally understand where you are coming from. It is just plain scary :shock: !
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