Twitching, muscle fatigue and atrophy - advice?

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Twitching, muscle fatigue and atrophy - advice?

Postby Nytviolet on August 27th, 2014, 11:25 am

I've dealt with twitching for ages. When I began feeling a "heaviness" in my left leg and left arm, I had an MRI and X-rays which showed: lumbosacral spondylosis,
Cervical spondylosis, cervical radiculopathy, cervical spinal stenosis and slight sciosis and spondylosis of thoracic spine. Also C4-5 moderate left neural foramen stenosis
C6-7 central disc extrusion, 3mm AP and extending caudad 4mm with mild central canal stenosis.

I've been referred for physical therapy 3x per week for one month than will return to my ortho. Both my ortho and the PT acknowledged that there is a visible difference (left calf is a full inch thinner). It also happens to be the calf that feels heavy; my PT said he noticed it was slightly weaker.

No one seems concerned except me. Perhaps I'm looking at it wrong, but as I see it: 49 year old female with hx of fascics, slight atrophy of left calf, and mild weakness. I am trying SO HARD to remain positive, but I am worried.

I saw a neurologist in early August who seemed utterly unconcerned (i did not mention atrophy at that point), he did not find a Babinski and said reflexes were decreased (this was confirmed by my PA). I have not had an EMG and am due to see neuro again 9/11...not looking forward to it.

I am not enjoying this ride and wanna get off. My apologies for the lengthy post, but I can't solicit advice without providing facts. I'm taking Ativan for the anxiety which helps some, but this has been going on for almost 5 months (the weakness, now confirmed by PT and ortho). I no longer have the luxury of telling myself it's "all in my head". The good news is that I still walk normally and can walk on toes/heels. My PT has prescribed exercises for me to do twice daily.

Anyone going through a similar situation?
2 Timothy 1:7 For God hath not given us the spirit of fear; but of power, and of love, and of a sound mind.
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby leaflea on August 27th, 2014, 4:12 pm

Hi Nytviolet,

God is good! I read your post earlier today and it made me anxious as I was awaiting my own MRI results. I am 47. I have been aware of my twitching and other problems since October, they may well have been happening for longer. The MRI was of the entire spine, a "screening" otherwise it would have cost a fortune and taken a whole day. I have scoliosis, 41-46 degree curve in the thoracic area. Not sure what it is in the lumbar area. This is quite significant. Surgery is considered at 50 degrees. I was supposed to follow every five years but hadn't been back for 12, so I decided to investigate, partially due to one of your recent posts. The spine specialist sort of poo pooed me and said scoliosis should not cause any pain at all. He expected my MRI to be totally negative except for some arthritis (which was indeed found) I beg to differ. I do not have loads and loads of pain, but it is there. Always. I can function fine and am not even usually aware of it - sometimes it burns through the upper back and I twitch in that area also - and I have sometimes felt my issues stem or radiate from that area and I've seen others on this board say the same. I know it isn't cardiac.

Anyway, I was going to post a reply earlier today but didn't have time and didn't have much to say until I got my results. I have heavy feeling forearms. I developed lymphedema in my calves last year (very rare and super strange and I tied it in my mind witn MND when the twitching started only a couple months later). Well, I have now looked at my results online of the entire back screening MRI but still haven't talked to the doctor about them, so I can hardly wait to hear what he will have to say. If I hadn't seen your post today, I'd be hopping on one foot with anxiety. I have little layman interpretation, but here is what it says (if anyone has medical knowledge please chime in). I will not post the bad things it rules out and mentions it did not find or the "normal" findings:

Interpretation:

Cervical Spine Disc protrusions contact the bentral cord at C5-6 and C6-7 associat4d with moderate to advanced degenerative disc space narrowing. Also disc protrusion and osteophyte to the right at T2-3 without central stenosis or cord impingement.
Last edited by leaflea on August 27th, 2014, 4:24 pm, edited 1 time in total.
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby leaflea on August 27th, 2014, 4:22 pm

Interpretation continued:
Thoracic Spine: Right convex curve...no inflammatory change (this surprised me). Multilevel upper thoracic right-sided facet arthropathy from T3-4 to T6-7 with accompanying significant foraminal stenosis to the extent visualized at T4-5 and T5-6. Also active hypertrophic and inflammatory left T9-10 facet arthropathy correlate for active pain generator. I know the arthropathy means arthritis.

Lumbar Spine: Multilevel disc degeneration and facet arthropathym including grade I L3-4 degenerative spondylosis bases.

Conclusion:
1. Everything that is normal including no masses or lesions (YAY)
2. Active hypertrophic and inflammatory left T9-10 facet arthropathy with marrow edema. Correlate for potential facet mediated pain. Multilevel right-sided facet arthropathy is noted from T3-4 to T6-7 including right foraminal stenosis at T3-4 to T5-6
3. Cervical spondylosis and moderate disc degeneration at C5-6 and C6-7 with cord contact by disc protrusion and osteophyte. Also multilevel disc and facet joint degeneration in the lumbar spine, especially at L3-4 with grade I degenerative spondylolisthesis.

I you search "scoliosis" on this board, a woman who used to be very active had a doctor tell her "I'd be surprised if you didn't twitch with what you have going on in your back." I was disheartened when my doctor did not concur. He did do a neuro exam and I heard his dictation "no atrophy, no weakness" and I hang on to it like a raft since since I also see atrophy in one calf. No true weakness I guess, but sometimes it really feels that way, especially in my left hand.
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby Nytviolet on August 27th, 2014, 5:10 pm

I don't have a medical background, but know that significant foramen narrowing will cause all sorts of issues (weakness, pain, and depending on severity, even atrophy). I swear...sometimes I feel we weren't meant to walk upright, because so many people have radiculopathy, osteophytes, scoliosis, etc.. Just as a pinched hose gives uneven water pressure, pinched nerves can cause twitching and varied weakness...I can testify to it.

Having dealt with my symptoms for nearly 5 months, and realize I simply MUST stop thinking about MND; you and I would both show highly atypical presentations, and there would surely be visible deficits at this point. Yes, God is good and I pray for those who are worried sick on this board, and especially for the unfortunate souls who truly have MND. We are getting closer to a cure. Anyone who has twitches accompanied by weakness or paresthesias should have films of the spine ordered. Be well and reach out if u need to chat.
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby leaflea on August 27th, 2014, 5:17 pm

You also Nytviolet, we have things in common here. Hope my post helped you in some way. A few months ago I tried to reache the other woman (also in her late 40's) but couldn't find her. I will update if I get any useful information from this MRI - I would not say it is totally "clean" but I will take it. All I want is some answers. I am thankful there were no tumors or lesions as my doctor implied a tumor would be the most likely cause of back pain in the area identified on MRI.
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby Nytviolet on August 27th, 2014, 6:42 pm

Yes, it was nice to chat with someone who has symptoms other than just twitching. When I see someone post that they have occasional twitching, but can still run 5 miles daily without pain or weakness, I'm jealous lol. Yes of course I'll keep you posted and hope you'll do the same. Hugs
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby leaflea on August 27th, 2014, 8:42 pm

Now I am wondering if the things found on EMG would be reflected on the MRI or vice versa? It seems the ventral cord is related to motor nerves/anterior horn from what I can make out (one of my issues). Just looking for a CLUE
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby Nytviolet on August 27th, 2014, 9:48 pm

I know anterior horn cells are involved. I've had strange motor problems since 1996. I was an avid runner at the time, and had sudden onset of fatigue, shaky limbs, exercise intolerance, inability to fully empty my bladder (aka neurogenic bladder), widespread fascics and about 75% loss of sexual reflex (bummer, I was shocked too). My clinical exam was normal and they found no lesions on the MRI (they were looking for ms). Much later noticed widespread pain, spasticity in the mornings, occasional trouble swallowing, and about 2002 was told "fibromyalgia" which is a garbage dx that they give when they can't figure you out. So here I am in 2014 with additional symptoms on my left side, and (I apologize to any physicians out there) but I've lost faith in the medical profession. Symptoms must be glaringly obvious to reach a proper dx. I don't really fit the MND mold, nor do I fit the ms mold (and I really dont fit FM mold either). So the last 17-18 years I've dealt with fatigue, pain and frightening symptoms without answers. I've spent a small fortune on doctors, psychiatrists, prescriptions, vitamins/herbs, acupuncture, massage, Reiki and co-pays / deductibles. The only place I put my faith these days is in Jesus. I pray that you'll get the answers and treatment you need, and I pray the same for all the folks on this board. WHY HASNT a researcher thought to investigate our group? There's obviously something causing nerve excitability, and we have 5k people under one roof who are happy to answer questions. Just some thoughts :). Sorry for ranting, but it's been a long ride to nowhere. Hugs
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby leaflea on August 27th, 2014, 10:45 pm

I really can relate, though haven't been at this for as long as you. I just read a journal article posted on the FB page about autoimmune channelopathies, and it makes it sound like all of us must have a paraneoplastic syndrome which is clearly not the case. So mysterious.
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby Nytviolet on August 28th, 2014, 12:26 am

I'd love to read that; when u have the time, could you send the link? Thanks!
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby leaflea on August 28th, 2014, 9:35 am

Nytviolet, it really wouldn't be helpful for you with as long as you've had your symptoms it definitely wouldn't apply to you. It says that our symptoms are most often caused by antibodies against a cancerous tumor. It says the symptoms can precede the discovery of a tumor by up to 4 years. Other reliable sources say the paraneoplastic syndromes move very quickly - in days to weeks you would have severe deficits. Most of us have been here at least many months and as far as I know none of us have come up with any of the normal cancer culprits such as lung, breast, ovary or lymph. The ONLY one who has had a cancer is a doctor, jebmd, and it was a thyroid cancer. She is a doctor and does not believe herself it was a paraneoplastic syndrome she was experiencing. My point is that there are thousands of us here and on the FB page and NONE of us has gone on to discover a cancer responsible for our symptoms - certainly not higher than cancer incidence rate in the general population. It would only increase your anxiety unnecessarily as it cannot apply to you after all these years. I have been aware of my symptoms now for 10 months and it is unlikely to apply to me but it sent my anxiety through the roof last night. The good thing is I was totally checked out for cancer just before this started...it was likely the stress that caused the bfs. I am more likely to have cancer caused by all the radiation necessary to rule out cancer. Gosh, it is disturbing just to write about it still. It isn't cancer in our cases and we don't need that seed of doubt planted at this point.
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Re: Twitching, muscle fatigue and atrophy - advice?

Postby Nytviolet on August 28th, 2014, 1:33 pm

Many of us on this board have health anxiety, so it's not unusual to imagine the worst case scenarios. With all the testing and bloodwork I've had (and you as well), SOMETHING would be out of whack if cancer was tge culprit. Had my second round of PT today and it made me feel hopeful since I could do all exercises without tripping or having any mishaps. So my left side is slightly weaker than my right...I'm sure many people are the same, but they don't assign the same significance to it that I do. I guess I'm saying that it's very easy to imagine you have a serious illness with minimal symptoms. Must change my thought processes...it's a journey. Hope you're having a carefree day. Hugs!
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Re: Twitching, muscle fatigue and atrophy - advice?

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